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Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What are stinging insects?
• Who is at risk for insect sting allergies?
• What types of insect sting reactions occur?
• How is a severe allergic reaction immediately treated?
• How can I avoid insect stings?
• What can I do about becoming immune to insect allergy?
• Stinging Insect Allergies At A Glance
• Find a local Asthma & Allergy Specialist in your town
• Insect Sting Allergies Index

Obviously, the best treatment is avoiding the insect sting. Certain precautionary measures will greatly decrease your chances of being stung. Honeybees are not aggressive and will usually not sting unless disturbed or injured. The majority of honeybee stings are on the bottom of the bare foot while stepping on the bee. Avoid walking barefoot on lawns where honeybees or other stinging insects may be present. Yellow jackets nest in the ground and in walls. Caution should be used with unusual forms in walls and mounds in the ground. Hornets and wasps often nest in bushes, in trees, and under roofs. Use caution too in these areas and in selecting employment requiring exposure to these conditions.

Bright colors attract insects seeking nectar. Stinging insects are attracted to food and strong smells. Avoid open food in garbage cans, dumps, and open picnic areas. Do not wear perfumes, hair sprays, and colognes. Keep the body covered as much as possible with light-colored clothing. Insect repellents are not effective against stinging insects.

All people who have had a significant reaction to a stinging insect should be evaluated by an allergy specialist for possible venom immunotherapy (allergy shots that develop an immunity to insect allergy). Selected patients with significant sensitivity to insect venom and specific symptoms can undergo allergy injection therapy for stinging-insect allergy. Allergy immunotherapy against stinging insects in these selected patients is almost 100% effective.

This type of treatment usually involves a gradually increasing dose of the venom over 10-20 weeks. Then a "maintenance" dosage every four to eight weeks is given. After approximately three to five years, discontinuation of the venom shot is considered. Therapy for three to five years confers long-term protection in most people. The risk of severe adverse reactions from this venom therapy is minimal (less than 0.2%), and no deaths have been reported to date.

The U.S. Department of Agriculture recommends the following:

• Avoid disturbing likely beehive sites, such as large trees, tree stumps, logs, and large rocks.



• If a colony is disturbed, run and find cover as soon as possible. Running in a zigzag pattern may be helpful.



• Never stand still or crawl into a hole or other space with no way out.



• Do not slap at the bees.



• Cover as much of the head and face as possible, without obscuring vision, while running.



• Once clear of the bees, remove stingers and seek medical care if necessary, especially if there is a history of allergy to bee venom.

• Severity of reactions to stings varies greatly.
• Most insect stings do not produce allergic reactions.
• Anaphylactic reactions are the most serious reactions and can be fatal.
• Avoidance and prompt treatment are essential.
• Epinephrine (available in portable, self-injectable form) is the treatment of choice for anaphylactic reactions.
• In selected people, allergy injection therapy is highly effective in preventing future reactions.
• The three "A's" of insect allergy are adrenaline, avoidance, and allergist.