Insect Stings

What are insect stings?

An insect sting occurs when an insect uses its stinger on you. The insect may be a bee, wasp, hornet, or yellow jacket. You may have an allergic reaction to the venom.

Stings can happen anywhere on the body. They can be painful and frightening. But most insect stings cause only minor discomfort. The site of the sting may sometimes become swollen, red, and inflamed. Sometimes this is an infection, other times it is just inflammation after the sting. Some people who are allergic may have a severe reaction (anaphylaxis) that can be fatal.

What causes insect stings?

Bees, wasps, yellow jackets, and hornets belong to a class of insects called Hymenoptera. Most stings are from these insects, particularly honeybees or yellow jackets. Yellow jackets are scavengers and are attracted to food at picnics. They can be aggressive when disturbed. Honeybees are less aggressive. But they are attracted to bright colors and perfumes.

Fire ants can sting multiple times. They are often found in southern states. These stings typically are painful, itchy, and cause small pimples with yellow fluid (pustules) at the sites of the stings.

What are the symptoms of an insect sting?

The following are the most common symptoms of insect stings. But each person may have different symptoms. You may have local reactions at the site, such as:

• Pain

• Swelling

• Redness

• Itching

• Warmth

• Raised, itchy skin bumps (hives)

Symptoms of a serious allergic reaction are:

• Coughing or wheezing

• Tickling in the throat

• Tightness in the throat or chest

• Breathing problems

• Nausea or vomiting

• Abdominal pain

• Hoarse voice

• Trouble swallowing

• Dizziness or fainting

• Sweating

• Anxiety

• Hives over a large part of the body

How are insect stings diagnosed?

You will likely know when you get an insect sting. If you think you may be allergic to the venom from a certain insect, talk with your healthcare provider. You may have allergy testing, such as:

• Blood tests

• Skin tests

How are insect stings treated? 

Large reactions at the sting site and hives without any other symptoms don’t often lead to more serious generalized reactions. But they can be life-threatening if the sting happens inside the mouth, nose, or throat area. Swelling in these areas can cause problems breathing.

To treat a local skin reaction:

• Remove the stinger (if it is there) by gently scraping across the site with a blunt-edged object such as a credit card, dull knife, or fingernail. Don’t squeeze or try to pull it out, as this may release more venom.

• Wash the area well with soap and water.

• Apply a cold pack or ice pack wrapped in a clean, thin cloth to help reduce swelling and pain. Apply it for 10 minutes on and 10 minutes off for a total of 30 to 60 minutes. To make an ice pack, put ice cubes in a plastic bag that seals at the top.

• If the sting is on an arm or leg, keep the arm or leg raised to help reduce swelling.

To help reduce the pain and itching, you can:

• Use an over-the-counter product made for insect stings.

• Apply an antihistamine or corticosteroid cream or calamine lotion.

• Take acetaminophen or ibuprofen for pain.

• Take an over-the-counter antihistamine, if approved by your healthcare provider.

Watch closely for the development of more serious symptoms. If you have a serious reaction, you need emergency medical treatment right away. Types of treatment you may get in the ER include:

• Epinephrine

• IV (intravenous) antihistamines

• Corticosteroids or other medicines

• Breathing support

What are possible complications of insect stings?

The two greatest risks from most insect stings are allergic reaction (which can be fatal in some people) and infection (more common and less serious).

How can I help prevent insect stings?

To reduce the possibility of insect stings while outdoors, try the following:

• Limit your use of perfumes, hair products, and other scented items.

• Don’t wear brightly colored clothing.

• Don’t go outside barefoot and don’t wear sandals in the grass.

• Use insect repellent.

• Stay away from places where hives and nests are present. Have any nests removed by professionals.

• If an insect comes near, stay calm and walk away slowly. Don’t swat away stinging insects, especially yellow jackets.

• Keep food and drinks covered when eating outside. Insects may crawl into open beverage cans.

If you have a known or suspected allergy to stings, you should:

• Carry 2 doses of epinephrine medicine at all times and know when and how to use them. These are available by prescription from your healthcare provider.

• Wear a medical alert bracelet or necklace with your allergy information.

• Wear long-sleeved shirts and long pants when outdoors.

• Talk with your healthcare provider about seeing an allergist for allergy testing and treatment. Venom allergy shots (venom immunotherapy) can be a lifesaving treatment for people with a venom allergy.

When should I call my healthcare provider?

Get emergency medical care if the sting is in the mouth, nose, or throat area, or if any other serious symptoms happen, such as trouble breathing.

Key points about insect stings

• An insect sting occurs when an insect uses its stinger on you. The insect may be a bee, wasp, hornet, or yellow jacket. The stinger may inject venom into your body.

• You may have an allergic reaction to the venom and may need to use emergency medicine like epinephrine if you have a serious allergic reaction.

• Most insect stings cause only minor discomfort, like pain, swelling, and redness near the site of the sting.

• Some people may have a serious reaction (anaphylaxis). Symptoms include coughing, tightness in the throat or chest, and breathing problems.

• Over-the-counter medicines can help with itching and pain.

• Seek emergency medical care if you have a serious reaction, which can be fatal.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.