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Bee Sting Treatment

Bee Sting Treatment

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Updated June 30, 2014

Bee Sting Treatment

The treatment of venom allergy involves the management of an acute reaction, as well as the prevention of future reactions.

Immediate treatment of acute reactions. Epinephrine is the treatment of choice for anaphylaxis. People with venom allergy are encouraged to carry a self-injectable form of epinephrine, such as an Epi-Pen or Twin-Ject device. If this medication is required, immediate medical attention is also needed, and the person should call 911 or go to the emergency room.

If itching or hives is the only symptom, an oral antihistamine may be all that is required, although seeking emergency medical attention is still advised. If symptoms worsen or swelling of the skin affects the ability to breathe, then epinephrine will be required.

If a stinger remains in the skin, such as with a honeybee sting, it should be removed quickly so that more venom is not injected into the sting. Do not squeeze the stinger or the site of the skin -- instead pull the stinger out with tweezers or scrape the stinger out with the edge of a credit card. Put ice or a cold-compress at the sting site to reduce local swelling.

Treatment of future reactions. To prevent reactions to future insect stings, avoid being around stinging insects. If a person has experienced anaphylaxis, or whole-body skin symptoms (hives, itching, flushing, swelling away from the sting site) in those 16 years and older, then venom and testing is required.

Immunotherapy, or allergy shots, using purified venom from the type of insect to which a person is allergic, can cure venom allergy. Allergy shots using pure venom is given in much the same way as allergy shots for pollen allergy. After a person is receiving appropriate doses of venom allergy shots, the chance of a reaction with future stings is reduced to less than 5%. After a series of venom allergy shots for at least 3 to 5 years, most people can stop the shots without a significant increase in the chance of allergic reactions.

However, some people with severe, life-threatening reactions from insect stings, or those who have had anaphylaxis from the venom allergy shots themselves, may require life-long venom allergy shots. This is because a person’s chances of a reaction with future stings may slowly increase to as high as 20% many years after venom allergy shots are stopped. This topic is an evolving area of venom allergy research, and requires careful discussion between a person and their allergist.

Some allergists perform venom allergy testing, either with skin testing or RAST, after venom immunotherapy has been given for a period of time. Venom immunotherapy can be stopped in the majority of people whose allergy test turns negative, although the test does not always turn negative, even in people who have received venom allergy shots for years.

All people with a history of allergic reactions to insect stings, including children with skin-only reactions and even those with large local reactions, should consider wearing a Medic-Alert bracelet identifying their medical condition, as well as having an injectable form of epinephrine available for immediate use.

Sources:

  • Moffett JE, Golden DBK, Reisman RE, et al. Sting Insect Hypersensitivity: A Practice Parameter Update. J Allergy Clin Immunol. 2004;114:869-886.
  • Golden DBK. Insect Sting Allergy and Venom Immunotherapy: A Model and a Mystery. J Allergy Clin Immunol. 2005;115:439-47.
  • The American Academy of Allergy, Asthma and Immunology. Accessed June 24, 2007.

DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.

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