About Insect Sting Allergies

Insects such as bees, wasps, and certain ants can inject venom when they sting. For most individuals, this causes temporary pain, redness, and mild swelling at the sting site. However, some have an exaggerated immune response to the venom whereby their immune system produces specific antibodies that increase the risk of an allergic reaction if they are stung again by the same type of insect.

Allergic reactions to insect stings are generally grouped into two categories:

Large Local Reactions

These reactions involve the following symptoms limited to the site of the sting:

• Significant redness

• Swelling

• Warmth

Large local reactions are very common in children. Although they can be uncomfortable and may last up to a week, they do not usually worsen over time and rarely progress to generalised allergic reactions with future stings.

Systemic (Generalised) Reactions

Less commonly, insect stings can cause symptoms distant from the sting site, such as:

• Widespread hives

• Swelling in other areas including the lips, around the eyes, or involving the whole face

• Vomiting or abdominal pain

• Breathing difficulties

• Dizziness or collapse

When these symptoms occur, the reaction is considered systemic, and in severe cases, anaphylaxis.

Children and adolescents who have experienced venom‑related anaphylaxis have over a 50% chance of a similar severe reaction if stung again.

Treatment for Insect Sting Allergies

Dr Sophie Willcocks uses a detailed history along with blood tests (serum specific IgE) and/or specialised skin testing (skin prick and intradermal testing) to help confirm an insect venom allergy.

Routine management involves:

• Strategies to reduce the risk of future stings, such as wearing long clothing and enclosed shoes and using appropriate insect repellents

• Correct first aid techniques, including scraping or flicking the insect off the skin rather than squeezing it

• Personalised ASCIA Allergy or Anaphylaxis Action Plans

• Prescriptions for emergency medications, such as antihistamines or adrenaline, when indicated

For children aged 5 years and older who have confirmed anaphylaxis to certain insect venoms (such as honey bee or wasp), Dr Willcocks may recommend Venom Immunotherapy (VIT). This long-term treatment involves regular subcutaneous injections of small doses of the relevant venom to build tolerance and significantly reduce the risk of severe reactions in the event of a future sting.