Symptoms and Signs of Insect Sting Allergy

Medical Author:
Medically Reviewed on 12/18/2021

Doctor's Notes on Allergy: Insect Sting

Insect stings to which some individuals are allergic include bees, hornets, wasps, yellow jackets, and fire ants. Allergic individuals may develop signs and symptoms that range from mild to severe. Mild symptoms and signs may include itching, pain, and swelling beyond the area of the sting; it may slowly increase over the next few hours. Severe allergic reactions are a medical emergency so call 911. Signs and symptoms include a rapid occurrence, sometimes within minutes, of hives and/or swelling in major body parts like the face, head, neck, arms, hands, legs, or feet. Nausea, vomiting, or diarrhea may occur. Difficulty breathing, dizziness, fainting, chest pain, and tachycardia with a low blood pressure suggests the patient is in anaphylactic shock; if it continues, the patient can die.

The cause of allergic reactions to insect stings is an overreaction of the body's response to the stinger or venom (most likely a protein component) it interprets as a foreign substance. Part of the allergic response is the release of histamine that helps mediate the body's response to foreign substances; too much can participate in producing an anaphylactic reaction (shock).

What Are the Treatments for Insect Stings?

Emergency treatment to those who are allergic to these stings is as follows:

  • Quickly but safely move the patient away from the stinging insects to stop additional stings. Ask the patient if they are allergic to any insect stings and their reactions to the stings.
  • Remove the stinger, if possible, with tweezers or by skin scraping (some caregivers suggest scraping the skin with a credit card).
  • At the same time, have someone call 911 and administer an EpiPen dose or diphenhydramine, if possible, if the person starts to develop a severe allergic reaction (shortness of breath, general swelling of body parts like lips, tongue, for example).
  • EMS transport to an ER; emergency airway (intubation), if necessary


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.