The warmer months have arrived. The flowers are blooming and everyone is spending more time outdoors. This is also the time of year when stinging insects become active.
Bees, hornets, wasps and yellow jackets are responsible for the majority of serious allergic sting reactions in our region of the country. These insects generally sting people in self-defense or to protect their nests or hives. Their stings are usually painful but most people develop only minor local reactions. However, people with stinging insect venom allergy can experience life threatening allergic reactions, known as anaphylaxis.
Bees (and occasionally yellow jackets) have a barbed stinger that becomes lodged in the skin and rips away, along with the venom sac from the insect's body, following a sting. If possible, these stingers should be removed as quickly as possible right after a sting, because venom can continue to be released for several seconds. After the first few seconds, however, the venom sac is empty.
There are 3 types of stinging insect allergic reactions:
1. Small local reactions: redness and an area of painful swelling (1 to 2 inches) at the site of the sting that develops within minutes and resolves within hours or 1-2 days. These reactions may be treated with cold compresses.
2. Large local reactions: exaggerated redness and swelling at the site of the sting that gradually enlarges over 1-2 days. The swelling usually peaks at approximately 48 hours, and then gradually resolves over 5 to 10 days. The area of swelling may be up to 6 inches in diameter. In addition to cold compresses, treatment may require antihistamines, anti-inflammatory drugs such as ibuprofen or even prescription steroid medication such as prednisone.
3. Generalized allergic reactions (Anaphylaxis): this most severe type of reaction is a medical emergency and responds best to the prompt treatment with epinephrine by injection. Examples of epinephrine auto-injectors include the EpiPen or Auvi-Q.
It’s great to spend time outdoors during the warmer months of the year. However, stinging insects can make it less pleasant. Fortunately, if you are at risk for generalized allergic insect sting reactions, there is a very effective treatment called venom immunotherapy that can make a life threatening sting reaction much less likely. Venom immunotherapy is a series of shots of very small amounts of the venom of the insect or insects that, over time, can reduce the severity of your reaction to insect stings.
If you suspect that you might have a worrisome allergic reaction following a bee, hornet, wasp, or yellow jacket sting, an allergist can help you determine if you are a candidate for venom immunotherapy.