I've had severe swelling from bee stings and mosquito bites. Am I allergic?

Question: I've had severe swelling from bee stings and mosquito bites. Am I allergic?

Answer: I am often asked by patients about localized swelling at the site of an insect sting or bite. Some people are convinced that they have a “severe allergy” to mosquito bites because of the localized swelling that occurs as a result. Others are concerned about a possible “life-threatening reaction” to bee stings because the last time they were stung on the foot, their foot swelled to the point of not being able to put on their shoe.

The truth is, however, that neither of the above examples is considered dangerous. Local reactions to insect stings and bites, meaning that the symptoms of swelling, itching, rash or pain, only occur at or immediately around the site of the bite or sting. These reactions are very common with mosquito bites and bee/wasp/hornet/yellow jacket stings, and may or may not be caused by allergies.

People with these types of reactions to mosquitoes may find that taking oral antihistamines a few hours before outdoor activities minimizes these local reactions. Using a good mosquito repellent would likely prevent the bites from occurring in the first place. Most people notice a reduction in the severity of reactions to mosquito bites over the course of the summer, as the body slowly builds up immunity to the mosquito saliva. A severe allergic reaction, such as anaphylaxis, as a result of mosquito bites is relatively rare but does occur.

For a person who has severe local reactions as a result of an insect sting, the chances of progressing to anaphylaxis from a future sting is only about 5 To 10 percent. Therefore, no testing or specific treatment is required for these reactions. However, if a person is stung frequently, as the swelling is severe enough to interfere with daily activities, venom allergy testing and treatment with venom immunotherapy does work to lessen the severity of future stings. In addition, for those people concerned about the small chance of anaphylaxis from a future sting, having an Epi-Pen available in case of anaphylaxis is always prudent.

Learn more about mosquito allergy and stinging insect allergy.

Source:

Moffett JE, Golden DBK, Reisman RE, et al. Sting Insect Hypersensitivity: A Practice Parameter Update. J Allergy Clin Immunol. 2004;114:869-886.

Simons FER, Peng Z. Mosquito Allergy. In: Levine MI, Lockey RF, editors. The Monograph on Insect Allergy. 4th Edition. Pittsburgh: Dave Lambert Associates; 2003. pp 175 - 204.

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