Most stings from bees, wasps and hornets cause pain and slight swelling, but have little other effect. But, some people are allergic to stings and can develop reactions that can be life-threatening. Call an ambulance immediately if you suspect an allergic reaction soon after being stung. If you are stung by a bee and the stinger remains in the skin, then scrape out the stinger as quickly as possible. Do not pluck it out as this may squeeze more venom into the skin. Insect bites (not stings) rarely cause serious allergic reactions but can cause small itchy lumps to appear on the skin. Itch may be eased by a soothing ointment, antihistamine tablets, or steroid cream. Some insects infest pets, furniture, etc, and can cause repeated bites.
Insects, stings and bites
What may happen after an insect sting or bite?
A small local skin reaction - most cases
Most people will be familiar with the common local skin reactions caused by insects.
Occasionally, small skin reactions following an insect bite persist for weeks or months. A persistent skin reaction is particularly likely following a tick bite. Severe allergic reactions (described below) are rare after insect bites - they are more common after insect stings.
A localised allergic skin reaction - occurs in some cases
Some people have an allergic reaction to the venom in a sting. A localised reaction causes swelling at the site of the sting. This becomes larger over several hours, and then gradually goes away over a few days. The size of the swelling can vary, but can become many centimetres across. The swelling may even extend up an entire arm or leg. The swelling is not dangerous unless it affects your airway. However, if it is severe, the skin may break out in blisters.
A generalised (systemic) allergic reaction - rare but serious
The venom can cause your immune system to react more strongly. This may cause one or more of the following:
A generalised reaction will usually develop within 10 minutes of a sting. It can be fairly mild; for example, a generalised itchy rash and some mild facial swelling. In some cases it is severe and life-threatening; for example, severe difficulty breathing and collapse. A severe generalised allergic reaction is called anaphylaxis and is a medical emergency.
If you have many bee or wasp stings at the same time, this can also cause serious illness. This is usually directly due to the high dose of venom, rather than to an allergy.
Occasionally, a skin infection develops following a bite, particularly if you scratch a lot, which can damage the skin and allow bacteria (germs) to get in. Infection causes redness and tenderness around the bite. Over a period of several days, this may spread and, sometimes, can become serious.
Most insects in the UK do not transmit other diseases. The main exception is a type of tick which carries a germ called Borrelia burgdorferi which causes Lyme disease. If this germ gets into your skin it can travel to various parts of your body and cause arthritis, meningitis, and other problems. In hot countries, mosquito bites transmit certain germs which can cause diseases such as malaria.
What is the treatment for an insect sting or bite?
If stung by a bee and the stinger is still in place - scrape it out:
Note: wasps, hornets or yellow jackets do not leave a stinger in the skin when they sting.
If any symptoms of a generalised allergic reaction develop (see above) then:
If there is a localised allergic reaction (swelling around the site of the sting) then:
If there is no allergic reaction (most cases) then:
The tick usually clings to the skin. Remove the tick as soon as possible after the bite, using fine tweezers or fingernails to grab the tick as close to the skin as possible. Pull it gently and slowly straight out, and try not to squeeze the body of the tick. Clean the site of the bite with disinfectant. (Traditional methods of tick removal using a burned match, petroleum jelly, or nail polish do not work well and are not recommended.)
See a doctor if you develop a rash which spreads out from a tick bite over the next week or so. Also, if you develop an unexplained high temperature (fever) within a month of the tick bite. These symptoms may be the first sign of Lyme disease and need checking out.
If the skin around a bite or sting becomes infected then you may need a course of antibiotics. This is not commonly needed.
What are my chances of having a serious allergic reaction?
Some points about allergies to insect stings
In short, if you have an allergic reaction to a sting, you cannot predict what will happen next time you are stung. Therefore, your doctor may refer you to an allergy clinic.
Advice and treatment following an allergic reaction
Your doctor may refer you to an allergy clinic if:
An allergy clinic will be able to do tests to confirm which type of venom or insect you are allergic to. There are then two possible options which may be considered.
To give you a supply of emergency medication to use when necessary
Some people are given a preloaded syringe of adrenaline together with a written treatment plan to cope with any future reactions. You (and relatives) can be taught how and when to use the treatments provided.
This is where you are given injections of tiny amounts of venom from the type of insect that causes your allergic reaction. Repeated doses of venom over several weeks can 'desensitise' your immune system, and so you will not react severely next time you are stung. This treatment involves some risk of causing a severe reaction, so it is not undertaken lightly. It is only available in certain specialised centres.
Preventing insect bites and stings
When out and about
Bites and stings most commonly occur when outside, particularly in the countryside.
The following measures are recommended to reduce the risk of stings from bees and wasps:
Ways to avoid bites include:
There is no evidence that eating garlic, vitamin B1 or other foods will repel insects.
Various types of fleas, mites, and bedbugs can infest (live on) pets, furniture, bedding, etc. These can cause recurring bites. You may realise that if you develop itchy spots or weals they are due to insect bites. However, some people do not realise that their 'skin rash' is caused by insect bites. They think they have some other skin disease. It may come as a surprise to find that their itchy spots are due to fleas living on their favourite pet!
If you have recurring insect bites, you should try to identify the source of the infestation and deal with it - for example, have pets checked for fleas. Your pet and/or your soft furnishings may need treatment with insecticide. See a vet for advice if you suspect that your pet is infested with fleas.