Insect Sting Allergy, Generalized

You are having an allergic reaction to an insect sting. This may occur after a sting by a wasp, honeybee, yellow jacket, fire ant, or other insect. This may cause an itchy rash and swelling in the face or other parts of the body. A more severe reaction may cause you to feel dizzy, faint, or have trouble breathing or swallowing. Other warning signs are listed below.

Symptoms can include:

  • Rash, hives, redness, welts, or blisters in places other than the sting site

  • Itching, burning, stinging, pain in places other than the sting site

  • Dry, flaky, cracking, scaly skin

  • Swelling in places other than the sting site 

  • Stomach pain or cramps

More severe symptoms are:

  • Swelling of the face or lips or drooling

  • Trouble swallowing, feeling like your throat is closing

  • Trouble breathing, wheezing

  • Dizziness or a sudden drop in blood pressure

  • Hoarse voice or trouble speaking

  • Severe nausea, vomiting, or diarrhea

  • Feeling faint or lightheaded

  • Rapid heart rate

Home care

Medicine

The healthcare provider may prescribe medicines to ease swelling, itching, and pain. Follow the provider’s instructions when taking these medicines.

  • If you had a severe reaction, the provider may prescribe an injectable epinephrine kit. Epinephrine will stop the progression of an allergic reaction. Before you leave the hospital, be sure that you know when and how to use this medicine.

  • Oral diphenhydramine is an over-the-counter antihistamine available at pharmacies and grocery stores. Unless a prescription antihistamine was given, diphenhydramine may be used to reduce itching if large areas of the skin are involved. It may make you sleepy. So be careful using it in the daytime or when going to school, working, or driving. Note: Don’t use diphenhydramine if you have glaucoma or if you are a man with trouble urinating due to an enlarged prostate. There are other antihistamines that cause less drowsiness and are good choices for daytime use. Ask your healthcare provider or pharmacist for suggestions.

  • Don’t use diphenhydramine cream on your skin. It can cause a further reaction in some people.

  • Calamine lotion or oatmeal baths sometimes help with itching.

  • You may use acetaminophen or ibuprofen to control pain, unless another pain medicine was prescribed. Note: If you have chronic liver or kidney disease or ever had a stomach ulcer or gastrointestinal bleeding, talk with your provider before using these medicines.

General care

Man lying face down with ice pack on shoulder.

Don't wear tight clothing. And stay away from things that heat up your skin (such as hot showers or baths, or direct sunlight). Heat makes the itching worse.

An ice pack will relieve local areas of intense itching and redness. Apply 5 to 10 minutes. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Don’t put ice directly on the skin.

Stings

Wasps, yellow jackets, and hornets don’t leave a stinger behind. But if a honeybee stings you, a stinger may stay in your skin. The stinger of a honeybee releases a substance that will attract other bees to you. So try to move away from the nest right away. Once you are away from the nest, then take out the stinger as quickly as possible by:

  • Scraping the stinger out with the edge of a dull knife or plastic card (credit card).

  • Don't use tweezers or your fingers to remove the stinger. That may squeeze more toxin from the stinger.

  • Wash the affected area with soap and warm water 2 to 3 times a day. Don't break a blister, if there is one.

  • Next apply an ice pack for 5 to 10 minutes. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Don’t put ice directly on the skin.

  • Contact your healthcare provider and ask what can be used to help decrease the swelling and itching to the affected area. 

  • To prevent an infection, don't scratch the affected areas. Always check the sting site for signs of an infection. These include increased redness, swelling, drainage, or pain.

Preventing future reactions

Future reactions could be worse than this one. So try to stay away from situations where you might be stung:

  • Don't walk in grass wearing sandals or without shoes. 

  • Don't leave food uncovered when eating outside. Sweet treats, watermelon, and ice cream attract insects.

  • Don't drink from uncovered sweetened drinks in cans when outside. Insects are attracted to soda drink cans. They can sometimes crawl inside of them.

  • Don't wear bright colored clothes with flowery prints and patterns when outside.

  • Don’t wear perfume when outside. Smell attracts insects.

  • Wear long pants, long-sleeved shirts, socks, and work gloves when working outside.

  • Be aware that honeybees nest in trees. Wasps and yellow jackets nest in the ground, trees, or roof eaves. Stay away from garbage cans when outside.

Auto-injectable epinephrine

  • If you are at high risk for another sting due to where you work or play, or if you had dizziness, fainting, or trouble breathing or swallowing from the sting, an auto-injectable epinephrine may be prescribed. If not, ask your healthcare provider for one. Always carry it with you. Learn how to use the device. If you start to feel the symptoms of another reaction in the future, use the auto-injectable epinephrine to inject yourself. Then call 911. Don't wait until symptoms become severe. 

  • Remember that the auto-injectable epinephrine is a rescue medicine only. You still need someone to take you to the hospital or call 911 after you have received the medicine.

Follow-up care

Follow up with your healthcare provider, or as advised if your symptoms do not keep improving.

Call 911

Call 911 if any of these occur:

  • Trouble breathing or swallowing, wheezing 

  • Cool, moist, pale skin

  • Hoarse voice or trouble speaking

  • Confusion

  • Very drowsy or trouble waking up

  • Fainting or loss of consciousness

  • Rapid heart rate

  • Low blood pressure or feeling dizzy or weak

  • Feeling of doom

  • Severe nausea, vomiting, or diarrhea

  • Seizure

  • Swelling in the face, eyelids, lips, mouth, throat, or tongue

  • Drooling

When to seek medical advice

Call your healthcare provider right away or seek medical care right away if any of the following occur:

  • Spreading areas of itching, redness, or swelling

  • Headache, fever, chills, muscle or joint aching

  • Increased pain or swelling

  • Signs of infection of the affected area:

    • Spreading redness

    • Increase in pain or swelling

    • Fluid or colored drainage from the site

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