Venom allergies

The severity of insect venom allergy varies from person to person but can range from localised or mild, to life-threatening.

Overview

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How common is insect venom allergy?

0.3 to 7.5% of the general population exhibits immediate systemic reactions to insect stings. Around 20% of severe anaphylaxis cases in adults are caused by insect stings.

Some people are at a higher risk of developing insect venom allergy (beekeepers, gardeners, pest controllers etc). Patients who have insect venom allergy and also have an underlying cardiac condition or mastocytosis are at higher risk of having a severe reaction.

What are the symptoms of insect venom allergy?

The symptoms of venom allergy vary depending on the severity:

Localised reaction: The site of the sting may become swollen, red, itchy and uncomfortable. The swelling should be no more than 10cm in diameter and will often go down within 24 hours.

Mild systemic reaction: Swelling and hives will appear in areas other than the site of the sting. This type of reaction can last for a few days.

Severe allergic reaction (anaphylaxis): This type of reaction is life-threatening and should always be treated as a medical emergency requiring immediate treatment. Symptoms of anaphylaxis include:

  • Difficulty breathing
  • Swelling of the tongue and throat
  • Difficulty swallowing or speaking
  • Large hives on the body
  • Flushed, red skin
  • Abdominal cramps, nausea and vomiting
  • Dizziness and fainting
  • Collapse and unconsciousness
  • Anaphylactic death resulting from insect sting can occur within 15-20 min after exposure.

A patient with a history of a severe allergic reaction to insect venom should be reviewed by an allergist and undergo venom skin and/or blood tests to confirm the diagnosis.

What are the treatment options for venom allergy?

Insect venom anaphylaxis is a medical emergency. Adrenaline should be administered as soon as possible. Antihistamines and corticosteroids are often given but they are not life-saving.

Subcutaneous (injectable) venom immunotherapy (desensitisation) can be used in patients with wasp, hornet or bee venom anaphylaxis (serious reaction) where anti-allergic treatment has not been effective. This consists of a series of injections given over a number of years that work to change the natural reaction to the venom and reduce symptoms of severe reactions.

Mild and localised sting reactions can be self-treated by:

  • Scraping (not pulling) the stinger off the skin to limit the amount of venom released
  • Applying a cold compress or an ice pack on the affected area
  • Taking an antihistamine such as cetirizine, loratadine or fexofenadine for a few days
  • Applying a topical antihistamine preparation, hydrocortisone cream, or calamine lotion
  • Taking over-the-counter painkillers such as paracetamol or ibuprofen to help ease discomfort

Desensitisation (Immunotherapy)

How to avoid stings and bites to prevent venom reactions

There are a number of things you can do to help limit your exposure to insects and help reduce your risk of being bitten or stung.

  • Avoid eating outside, especially on the ground or in spaces with an abundance of plants and trees
  • Wear closed shoes whenever possible and avoid walking barefoot on grass
  • Stay calm around insects – rather than swatting them, slowly move away, gently brush them off or wait still for them to leave
  • Check food and drink before each bite or sip to make sure an insect hasn’t landed
  • Avoid using sweet-smelling fragrances and toiletries as this can attract bees
  • Keep car and house windows closed to keep insects out
  • Wear clothes that cover the arms and legs and avoid wearing bright-coloured or floral clothing as these can attract insects
  • Address any insect problems, hives or nests in and around your home

Condition overview
Insect Venom Allergy

How common is it?

Symptoms

Treatment options

Avoiding reactions

Venom allergies Specialists

By having a complete and integrated team of sub-specialty experts under one roof we ensure that patients are seen by the right consultant at every appointment. Our skin health specialists cover a wide range of dermatological conditions, and our dedicated allergy specialists are recognised leaders in their field.

Dr Chris Rutkowski

Consultant Allergist

Specialist expertise: Adult Allergy, Drug Allergy, Urticaria, Angioedema, Anaphylaxis, Allergy, Food Allergy, Provocation Food Challenges, ISAC Test, Anti IgE Treatment, Immunotherapy, Hay fever, Rhinitis.

Dr Sophie Farooque

Consultant Allergist

Specialist expertise: Allergy, Drug Allergy, Skin Prick Testing, Anaphylaxis, Food Allergy, Hay fever, Rhinitis, Urticaria, Allergic Asthma.

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