Insect Allergy: Treatment

Prevention:  The first step in treatment of insect stings, whether they are mild or severe, is to avoid being stung.  Prevention can be accomplished by wearing protective clothing when outside, such as shoes, long-sleeved shirts and pants, and gloves.  

Risks for stings include:

  • Summer season
  • Involvement in outdoor activities including yard work, bicycling, boating, swimming and camping. 
  • Wearing scented perfumes, lotions, soaps, and other personal hygiene products
  • Eating or drinking outdoors, or being near or handling garbage
  • Rapid or jerking movements.  Remain still when stinging insects are present because insects usually do not sting unless they feel threatened.

Mild reactions:  these reactions are treated mainly to relieve the pain and itching involved.  The area should be cleaned, and if the stinger remains in the skin, it should be flicked off.  Avoid using tweezers for removal.  Ice may be applied to the area, and using topical and/or oral antihistamines for the itch is recommended.  Topical corticosteroid creams may also be used. 

If a large local reaction occurs, treatment with oral steroids may be needed.

Venom Immunotherapy is recommended for any patient with a history of previous systemic reactions (anaphylaxis) to stings.  

  • Allergy shots for insects work in the same way that they do for nasal allergies.  The patient is injected with venom extracts that are determined based on which skin tests were positive during the evaluation.  
  • These injections are extremely successful in the treatment and prevention of severe reactions.  
  • It is generally recommended that injections should be continued indefinitely, although studies have demonstrated that in some patient these may be stopped after five years.

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