What are the symptoms and treatment for insect sting allergies. How to diagnose and manage insect sting allergies. Tips to avoid insect stings.

Diagnosing Insect Sting Allergies

If you are concerned that you may have an allergy to insect venom, your best option is to see an allergist. Your allergist should take a detailed medical history, including questions about previous stings (how many there have been and where you were stung), your reaction to those stings (what you experienced, how long the reaction lasted and what you did to get relief) and any additional symptoms.

Your allergist may perform one or more tests to diagnose allergy to insect venom, such as a skin-prick test, an intradermal skin test or a blood test. In the skin-prick test, a small amount of a liquid containing insect venom is placed on the back or forearm, which is then pricked with a small, sterile probe to allow the liquid to seep into the skin. If a raised, reddish spot forms within 15 to 20 minutes, that can indicate an allergy. In the blood test, a blood sample is sent to a laboratory to test for the presence of immunoglobulin E (IgE) antibodies to insect venom.

If the skin prick test is negative or inconclusive your allergist will likely recommend an intradermal skin test, in which a small amount of venom extract is injected just under the skin. The site is examined after about 15 minutes for signs of an allergic reaction. This test is considered more accurate than the skin-prick or blood tests in determining the presence of IgE antibodies. If both skin prick and intradermal skin tests are negative then your allergist may recommend a blood test.

The strength of a reaction to a skin or blood test does not indicate how severe your allergic reaction will be the next time you are stung.

Managing Insect Sting Allergies

Insect sting allergy is treated in a two-step approach:

1. The first step is the emergency treatment of the symptoms of a serious reaction when they occur.
2. The second step is preventive treatment of the underlying allergy with venom immunotherapy.

Life-threatening allergic reactions can progress very rapidly and require immediate medical attention. Emergency treatment usually includes administration of certain drugs, such as epinephrine, antihistamines, and in some cases, corticosteroids, intravenous fluids, oxygen and other treatments. Once stabilized, these patients sometimes require close observation in the hospital overnight.

Injectable epinephrine for self-administration is often prescribed as emergency rescue medication for treating an allergic reaction. People who have had previous allergic reactions and rely on epinephrine must remember to carry it with them at all times. Also, because one dose may not be enough to reverse the reaction, recent guidelines recommend keeping two doses of injectable epinephrine available and to activate emergency medical services if used. Even if symptoms improve after a single dose of epinephrine, immediate medical attention following an insect sting is recommended.

Venom Immunotherapy for Insect Sting Allergies

The long-term treatment of insect sting allergy is called venom immunotherapy, a highly effective program administered by an allergist, which can prevent future allergic reactions to insect stings.

Venom immunotherapy involves administering gradually increasing doses of venom to decrease a patient’s sensitivity to the venom. This can reduce the risk of a future allergic reaction to that of the general population. In a matter of weeks to months, people who previously lived under the constant threat of severe reactions to insect stings can return to leading normal lives.

If you think you might be allergic to insect stings, talk to your allergist. Based on your past history and certain tests, the allergist will determine if you are a candidate for skin testing and immunotherapy.

Avoiding Insect Stings

Knowing how to avoid stings from fire ants, bees, wasps, hornets and other stinging insects is important for people with insect sting allergies. Some tips include:

• Avoid wearing bright colors, floral prints, and loose-fitting garments when outdoors
• Avoid using scented personal care products, which can attract insects
• Be cautious around flowering plants, garbage cans, and other areas where stinging insects may be present
• Remain calm and avoid swatting at insects if they land on you
• Seek shade and cover up as much skin as possible when outdoors
• Avoid wearing sandals or going barefoot, especially in grassy areas
• Check for nests or hives in and around your home and have them removed by a professional

Symptoms of Insect Sting Allergies

The symptoms of an insect sting allergy can range from mild, localized reactions to life-threatening anaphylaxis. Mild reactions may include:

• Redness, swelling, and itching at the sting site
• Hives or rash
• Nausea or vomiting

More severe reactions, known as anaphylaxis, can include:

• Difficulty breathing
• Swelling of the face, throat, or tongue
• Rapid heartbeat
• Dizziness or fainting
• Nausea, vomiting, or diarrhea

Anaphylaxis is a medical emergency and requires immediate treatment with epinephrine and a trip to the emergency room.

Insect Sting Allergy vs. Bug Bites

While insect sting allergies and bug bites can both cause skin redness, swelling, and itching, there are some key differences:

• Insect sting allergies are caused by the venom injected by stinging insects, while bug bites are caused by the saliva of biting insects
• Insect sting allergies can cause more severe, systemic reactions like anaphylaxis, while bug bites are usually localized to the bite site
• Insect sting allergies require medical treatment and possibly immunotherapy, while bug bites can usually be treated with over-the-counter remedies

If you experience an allergic reaction after an insect sting, it’s important to see an allergist to determine if you have a true insect sting allergy and get appropriate treatment.

When to Seek Medical Attention

Any signs of a severe allergic reaction, such as difficulty breathing, swelling of the face or throat, or rapid heartbeat, require immediate medical attention. Call 911 or your local emergency number right away.

Even if symptoms seem to improve after using epinephrine, you should still go to the emergency room. The reaction could return or get worse, and you may need further treatment.

For milder reactions, contact your allergist or healthcare provider. They can help determine if you need any additional treatment or follow-up care.