Avoid & Treat Insect Stings
Picnickers, hikers, gardeners and outdoor sportsmen have to contend with stings by yellow jackets, yellow hornets, wasps and honeybees and ants. Insect bites and stings can cause reactions ranging from minor irritation, to serious allergic or toxic reactions. More than 1 million Americans report allergic reactions to insect stings; about 50 people each year die from the stings.
The most common stinging insects include honeybees that live in beehives, wasps, and hornets that tend to live in bushes and trees, and sometimes nests in the side of a building. Yellowjackets, which live in the ground, you can find them in older logs, in the walls of a home, and fire ants that live in open mounds of dirt.
There's a number of things that can attract stinging insects. And this would include dark clothing, fragrances, food can certainly attract them, garbage can attract them as well.
There are three different types of reactions to insect stings that we describe. The first are small local reactions, which can be a little red, a little painful, and potentially even a little swollen. These tend to be about two inches in size or less.
The second type of reaction are large local reactions. So, they look a little bit angrier, a little bit more red and swollen than the small local reactions. And these reactions can increase in size over two days with it being at a peak at 48 hours and then the swelling starts to improve.
The third type of reaction are severe allergic reactions and the symptoms can vary from person to person, but this could include difficulty breathing, swelling of the lips, the tongue, or the throat, hives all over the body outside of where you were actually stung, nausea, vomiting, or overall just feeling like you're about to pass out.
We recommend pain control with acetaminophen or ibuprofen. Cool compresses or ice can be helpful too. Anti-histamines can also be used if there's itching. Now, with the severe allergic reactions, we want to act on these fairly quickly. We recommend taking an antihistamine like Zyrtec or Benadryl, and either calling 911 or getting to your closest emergency department. If you have a known allergy to a stinging insect and have previously had severe life-threatening reactions, you should have been prescribed an EpiPen. And we do recommend using that in the event of one of these life-threatening reactions.
If you have been treated in the emergency room for a severe reaction to an insect sting, we do recommend that you follow up with your primary care provider or an allergist. If you see allergy, what we usually recommend is testing based on your history. So, this could include skin testing or blood work and with those results, then we can determine the best treatment options, including the possibility of allergy shots.
Most Common Stinging Insects
- Honeybees
- Wasps and hornets
- Yellow jackets
- Fire Ants
- Harvester Ants
Tips to Help Take the Sting Out of Summer
| What Attracts Insects | How to Protect Yourself | |
Clothing | Dark clothing, flowery designs | Wear white or light-colored clothing. Wear long sleeves, pants, shoes and gloves when outdoors. |
Deodorant | Sweat Scented products | Rinse off perspiration. Use unscented products. |
Food | Fruit, sweet drinks, juices | Cover food and drinks. |
Fragrances | Strong smelling perfume, cologne, hair products and lotions | Use fragrance free products. Wear repellant. |
Garbage | Uncovered trash cans, open bags of trash | Cover trash cans tightly and secure trash bags with ties. |
Treat Insect Stings
Small local reaction: Use a cold compress with ice and take pain medicine.
Large local reaction: Elevate the sting and use a cold compress with ice, take pain medicine and antihistamine for itchiness.
Severe reaction: If you have swelling in the face, throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea or diarrhea, or itchy hives in large areas, take antihistamine and call 911 or go to the nearest emergency department.
More Resources
What's Buzzing? How to Identify Insect Sting Allergy
Review How to Use an Epipen
Protect Against Mosquito, Tick and Flea Bites
This information has been approved by Kanao Otsu, MD, MPH, and Carah B. Santos, MD (May 2017).