Bee Sting Reactions & Allergies: Everything You Need to Know

If you have never been stung by a honeybee, hornet, wasp, or other flying insect, it's hard to tell how your body might react.

While some people have mild reactions to insect bites or stings, others are highly allergic and develop anaphylaxis, which can be fatal. Around 5% of all people will have a severe allergic reaction to a sting, so it's good to be prepared just in case.

This article covers the signs and symptoms of allergic reactions to flying insect stings along with how they are treated. It also breaks down the types of stinging insects you are most likely to come across.

Which insect stung me?

Verywell / Cindy Chung

Overview

When an insect stings, it uses its stinger to inject venom into your skin. That venom contains proteins, which trigger pain, swelling, redness, and itching around the sting area.

For most people, these mild symptoms stay contained to the sting area. But for people who are allergic to the venom, their immune system reaction can become systemic. In other words, it can affect other systems in the body, such as the respiratory system, making it hard to breathe.

According to the American College of Allergy, Asthma & Immunology (ACAAI), the number of people who have allergies to insect stings is on the rise.

Each year, thousands of people seek medical care for severe reactions to flying insect stings. What's more, the ACAAI reports that about between 90 and 100 people die from insect sting anaphylaxis each year. 

Anyone can have a severe allergic reaction to an insect sting. Those who have already had a severe reaction to a sting are at higher risk of a life-threatening reaction if they are stung again.

Signs and Symptoms

For someone who is allergic to insect venom, anaphylaxis can develop within minutes to hours after the sting. During an anaphylactic reaction, any or all of the following symptoms can occur:

  • Itching over the entire body
  • Hives or swelling spreading from the site of the sting
  • Flushing (reddening of the skin)
  • A runny nose, sneezing, or postnasal drip (mucus in the throat)
  • Itchy, watery eyes
  • Swelling of the lips, tongue, and/or throat
  • Shortness of breath, wheezing, and/or coughing
  • Stomach cramping, nausea, vomiting, and/or diarrhea
  • Lightheadedness, increase in heart rate, low blood pressure, or passing out
  • A sense of panic or sense of impending doom
  • A metallic taste in the mouth

When to Seek Medical Attention

Call 911 at the first sign of anaphylaxis. Don't wait for symptoms to get worse. If you have an EpiPen or AUVI-Q, inject it right away, then go to the hospital. Anaphylaxis can return, so you will still need to be monitored.

Insects That Cause Venom Allergies

Bees are some of the more well known flying insects that sting. But they aren't the only ones. Yellow jackets, hornets, wasps, and fire ants are also known to cause allergic reactions with their stings. These, along with bees, all belong to the insect order Hymenoptera.

Knowing which bugs can cause anaphylaxis and what those bugs' habits are can help you avoid them.

If you are having an allergic reaction to an insect sting, the first thing you need to do is get it treated. Don't delay medical care by trying to figure out which insect stung you.

Honeybees

Honeybees prefer to nest in tree hollows, logs, or buildings. They don't tend to be aggressive when they are away from their hive. They are much more likely to attack when they feel their hive is under threat.

Honeybees collect nectar from all kinds of plants. One of their favorites seems to be clover. This explains why people often get stung while walking barefoot through a lawn filled with clover.

One thing to note is that honeybees are the only stinging insect that routinely leaves a stinger in their victim's skin. Other insects can too, but it's far less common.

There are many different ways to remove a stinger. But the best way to remove it is the one you can do the fastest, within 30 seconds. The longer the stinger is in the skin, the more venom it can inject.

Aside from staying away from honeybee hives, one of the best ways to avoid their stings is to wear full-length pants and shoes that cover your whole foot when you walk outside.

Africanized (Killer) Honeybees

Killer honeybees live in small colonies, which means they can (and will) nest just about anywhere. They have been known to build hives in tires, flower pots, barbecue grills, mailboxes, and any other cavity they can find.

Killer honeybees are far more aggressive than normal honeybees, but their venom is not so different. So if you are allergic to honeybees, you will also be allergic to killer honeybees.

Killer honeybees come with a distinct risk, though. They tend to sting in groups of hundreds or more, making the chances of a lethal attack that much greater.

According to the U.S. National Park Service, if a colony of killer bees thinks you are a threat, they will send a few bees to "head butt" you as a warning before the full hive attacks.

If you notice a few bees hovering, don't flail your arms and don't try to fight them off. Killing a bee causes them to release a scent that warns their hive and attracts other bees.

Killer honeybees target your eyes, nose, and mouth when attacking. The best thing you can do in an attack is cover your head with your shirt or jacket and run.

Bumblebees

Bumblebees rarely sting people. They are not aggressive and typically mild-mannered. They will sting if provoked or if their nest is disturbed. But they are so loud and slow that a person usually has plenty of time to escape.

Bumblebees feed on insects and flower nectar. They nest on the ground, or in piles of grass clippings or wood. Once again, if you are walking around outdoors, make sure to wear shoes.

Yellow Jackets

Yellow jackets live in mounds built into the ground and tend to be aggressive. They are a common bother at picnics where there are lots of sugary drinks and food. You might also find them near trash cans.

Stings on the lip or inside the mouth or throat can occur after taking a drink from an open can of soda that a yellow jacket has crawled into. If you are eating outside and see a yellow jacket nearby, be sure to keep your food and drinks covered.

Yellow jackets can carry bacteria. That means if you are stung by one, you'll need to be on the lookout for signs of a skin infection.

Hornets

Hornets, including yellow and white-faced hornets, build paper-mâché type nests in trees and shrubs. These insects may be very aggressive. They will sting people because of a mild disruption, such as someone nearby mowing a lawn or trimming a tree.

Unlike honeybees, hornets will not leave their stinger in you. That means they can sting you multiple times. Hornets also aim for the eyes, so your best defense is to cover your face and run.

Wasps

Wasps build honeycomb nests under the eaves of a house, or in a tree, shrub or under patio furniture. They tend to be less aggressive than yellow jackets and hornets, and mostly feed on insects and flower nectar.

Recap

Flying insects have slightly different preferences for where they build their hives. They are most likely to attack when they feel their hive is under threat, but some (like hornets) can be more aggressive. If they attack you, your best defense is to run.

Prevention

Put simply, the best way to prevent an allergic reaction is to avoid being stung. Here are a few tips:

  • Hire a trained exterminator to treat any known nests in the area. Have them return periodically to survey for further infestation.
  • Bees navigate the world through odor. Avoid looking or smelling like a flower. Do not wear perfumes or other scents that will attract them.
  • Always wear shoes when walking outside, particularly on grass.
  • Wear pants, long-sleeved shirts, gloves, close-toed shoes, and socks when working outdoors.
  • Use caution when working around bushes, shrubs, trees, and trash cans.
  • Always check open food and drinks before consuming. Be extra careful at pools and picnics, where yellow jackets are known to be present.

Allergy Testing

There are two ways to test for insect allergy: skin testing and blood testing (serum allergen specific IgE testing).

Skin testing is typically the go-to method. It's the most reliable way to test for allergens and similar to testing for pollen or pet allergies. However, you might be given a blood test if you have a skin condition or take a medication that would interfere with the skin test.

For the skin test, a healthcare provider will place a small drop of insect venom just under the surface of your skin. You will feel a little prick when this happens. Then, after about 15 minutes, the provider will check for redness, hives, or other signs of a reaction.

A blood test works a little differently. Whereas a skin test looks for your skin's reaction to the venom, a blood test measures the antibodies your body makes in response to the venom.

For the blood test, a lab technician draws a sample of your blood. Then, at a testing lab, the allergen in question is added to your blood sample and the amount of antibodies your blood produces to attack the allergen is measured.

Studies show that most people can't identify which type of insect stung them. So, allergists usually test for all stinging insects, from bees to wasps and more.

Who Should Be Tested

In general, you don't need to be tested for insect allergies if you have never been stung by an insect, or you have never had any severe symptoms due to a sting.

Someone who has a large local reaction (such as swelling at the sting site), without signs of anaphylaxis, usually doesn't need venom testing.

There are two min scenarios in which you should be tested for insect allergy: you have previously had symptoms of anaphylaxis after a sting. Or, you have a high risk of getting stung, for example, if you are a beekeeper.

If you have had anaphylaxis symptoms after being stung, there is a 30% to 60% chance that you will have a similar (or worse) reaction to an insect sting in the future.

Recap

If you have had symptoms of anaphylaxis caused by a sting before, or you are around bees often, it's best to be tested for insect allergies. You may be tested with either a skin test or a blood test.

Sting Treatment

Treatment for venom allergy involves managing allergic reactions when they occur, and preventing them in the future.

Immediate Treatment of Acute Reactions

When it comes treating anaphylaxis in the moments after a sting, epinephrine is the treatment of choice.

Epinephrine is the drug form of the hormone adrenaline. Your body produces this hormone on its own. Injecting epinephrine in an allergic emergency reverses the symptoms of anaphylaxis. It increases blood flow, opens your airways, and more.

People with a known venom allergy are encouraged to carry a self-injectable form of epinephrine, such as an Epi-Pen or AUVI-Q. Since anaphylaxis can return after you use an auto-injector, you will still need to call 911 or go to an emergency room right away.

When itching or hives are your only symptoms, an oral antihistamine may be all you need. Since a mild allergic reaction can rapidly progress to anaphylaxis, you should still get to the hospital if you suspect you are having an allergic reaction.

Any time a stinger is left in your skin, it should be quickly removed. Do not squeeze the stinger or skin around it. Instead, 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

The only way to fully prevent reactions to insect stings is to avoid being around stinging insects. Granted, this is easier said than done, especially for people who work or live near them.

The first-line treatment for insect allergy is venom immunotherapy (VIT). These allergy shots contain purified venom from the type of insect to which a person is allergic. They are given in much the same way as pollen allergy shots, generally over the course of four to six months.

Once a person starts venom allergy shots, their chance of a reaction from future stings is reduced to less than 5%. After taking allergy shots for at least three to five years, most people can stop taking shots without any major increase in their chances of having an allergic reaction.

There are some cases in which a person will need to take venom allergy shots for the rest of their life. This includes people who have severe, life-threatening reactions from insect stings, and those who have had anaphylaxis from the venom allergy shots themselves.

VIT is widely considered safe and effective. Still, there is a small chance that a person could have an allergic reaction to the shots themselves. Reactions to VIT are usually mild and contained to the injection site. As of 2017, no deaths due to VIT-induced anaphylaxis have been reported.

For those with severe allergies who have a higher risk of getting stung, rush immunotherapy (RIT) should be considered. RIT works similarly to VIT. But whereas VIT shots are spread out over the course of several months, RIT shots are condensed into a program that lasts four to six weeks.

RIT does come with an increased risk of allergic reactions. But it can also get a venom allergy under control much faster than VIT. These are factors you will need to discuss with your allergist.

After Allergy Shots for Bee Allergy

Studies suggest that many children who begin allergy shots for bee stings do not complete their therapy.

For this reason, some allergists order venom allergy tests after venom immunotherapy has been given for a period of time. This is to ensure that the full course of therapy has been done and the allergy is under control.

Allergy shots can reduce the chances of a life-threatening allergic reaction in the future. But in order for this to happen, the full course of treatment needs to be completed.

Recap

During an allergic reaction, an EpiPEn or AUVI-Q can reverse anaphylaxis symptoms. Even when the shot is taken, it's still important to get to the hospital for observation in case anaphylaxis returns. For prevention, venom immunotherapy can reduce and even cure the insect allergy.

Summary

The only surefire way to prevent getting stung is to avoid stinging insects completely. But since stings can't always be prevented, you should still be prepared if you encounter one. Remember, your best defense is to cover your face and run.

Whether you have a known insect allergy or not, you should also know the symptoms of anaphylaxis and what to do if it occurs. The moment you notice symptoms starting, call 911 and use your EpiPen or AUVI-Q if you have one.

Most people with mild reactions will not need allergy shots. But if you have a severe insect allergy or have a high risk of getting stung, ask your allergist if venom immunotherapy is right for you.

Most fatalities due to bee sting allergy occur in those who do not have a known allergy. Everyone should be familiar with the signs and symptoms of anaphylaxis and how to contact emergency help if needed.

A Word From Verywell

All people with a history of allergic reactions to insect stings should have some form of medical alert. This could be a bracelet, wallet card, or scroll I.D. that states their medical condition. It should also state that they have an injectable form of epinephrine on them that needs to be used.

If you have an EpiPen, you should carry it with you wherever you go. The Transportation Security Administration (TSA) generally allows you to carry your EpiPen with you in your carry-on if you fly, but check ahead to make sure.

Frequently Asked Questions

  • When should I be concerned about a bee sting?

    Minor swelling, redness, burning, and pain at the sting site is normal and can last up to a week. Call 911 if you develop any signs of anaphylaxis, even if it's just one or two symptoms. You should also call 911 if there are multiple stings.

  • How do you know if you are allergic to bee stings?

    Allergic reactions can start within minutes to hours after a sting. You will know you are allergic if you develop itching, hives, or swelling that goes beyond the sting site. Systemic symptoms, like trouble breathing, are a sign of anaphylaxis that require immediate medical attention.

  • Can you outgrow a bee sting allergy?

    It is possible to outgrow a bee sting allergy, but it doesn't happen for everyone. Allergy shots, known as venom immunotherapy, are a safe and effective treatment for insect allergy that may even cure it.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Daniel More, MD
Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and currently practices at Central Coast Allergy and Asthma in Salinas, California.