The venom injected by a bee or wasp after a sting may not seem like much, yet a bee sting allergy is a potentially fatal reaction. Individuals with bee sting allergies may endure severe and even fatal reactions, while the majority of people just feel localised pain, redness, and swelling where they are stung. Everyone should be aware of bee sting allergies because it can mean the difference between life and death.1
Causes of bee sting allergies
Exposure to bee venom
Bee sting allergies occur when the immune system overreacts to proteins found in bee venom. These proteins trigger an immune response, which varies in severity from person to person. Sensitisation to bee venom can happen gradually, and an individual may not experience an allergic reaction until after several stings. This means that even if you were fine the first couple of times you got stung, it doesn’t guarantee that you will have the same reaction to a bee sting later on in life.1
Reactions to bee venom
Reactions to bee venom can range from mild to severe. Most people experience only mild symptoms, but some individuals can develop a life-threatening condition called anaphylaxis due to the over-reaction of the immune system.1
Symptoms of bee sting allergies
- Localised pain and swelling at the sting site: This is the most common immediate reaction to a bee sting
- Redness and itching: The affected area may become red and itchy
- Minor discomfort: Some people may experience minor discomfort that typically subsides within a few hours
- Swelling beyond the sting site: Swelling may extend beyond the sting site, affecting a larger area of the body
- Hives or welts: Raised, itchy welts or hives can appear on the skin
- Nausea or vomiting: Moderate allergic reactions can also involve stomach symptoms such as nausea and vomiting
- Headaches or dizziness: Some individuals may experience headaches or dizziness as part of their allergic reaction
Severe Symptoms (Anaphylaxis)
If you think that someone is having an anaphylactic reaction, seek help immediately. Symptoms include:2,3
- Difficulty breathing/shortness of breath: Anaphylaxis can cause rapid and severe airway constriction, making it hard to breathe
- Swelling of the face, throat, or tongue: Swelling in these areas can obstruct the airway
- Rapid heartbeat: A dangerously fast heart rate can occur
- Drop in blood pressure: Anaphylaxis can lead to a significant drop in blood pressure, causing shock
- Loss of consciousness: In severe cases, anaphylaxis can lead to loss of consciousness and even death if not treated promptly
Diagnosis and treatment
Seeking medical advice for symptoms
If you suspect a bee sting allergy, seek immediate medical attention if you experience moderate or severe symptoms.
Diagnosis through skin tests or blood tests
Allergists can diagnose bee sting allergies through skin or blood tests to identify specific allergens. A tiny amount of allergen extract (in this case, bee venom) is injected under the skin of your arm or upper back during a skin test. The test is safe because the amount being administered is so little and won't result in any negative effects. The development of a raised lump on the skin at the test location, which would indicate a robust immune reaction to the minute amount of bee venom, may be seen if the person is allergic to bee stings.4
Allergy prevention and management1
- Avoiding bee stings: Prevention is key. Therefore, wear protective clothing, avoid perfumes (they might attract bees due to the floral scent), and be cautious in general around bee-infested areas.
- Carrying epinephrine auto-injectors (EpiPen) for emergencies: Individuals with known bee sting allergies should carry an EpiPen to self-administer in case of a severe reaction resulting from a sting
- Medication options: The doctor may prescribe Antihistamines and corticosteroids to manage symptoms in cases where the reaction is mild to moderate.5
Allergen immunotherapy may help some people become less sensitive to bee venom over time. In allergy immunotherapy, allergen extracts are repeatedly administered in progressively higher dosages for years. Patients can get immunotherapy as an injection, as tablets, sprays, or drops placed beneath their tongues (sublingual immunotherapy).4,5
Ultimately, you develop an immunity to the allergens, enabling you to tolerate them with fewer or no symptoms. Allergen immunotherapy is not a panacea for illness, however. For allergen immunotherapy to be effective, patients must commit to the course of medication for three to five years, and they must work with their doctor to reduce the likelihood of side effects.
What to do in case of a bee sting allergic reaction
- Remove the stinger: If stung, remove the stinger by scraping it off gently with a credit card or your fingernail. Do not squeeze it, as this can release more venom
- Call the emergency services: If you suspect an allergic reaction, call emergency services immediately
Administering self-treatment with an epinephrine auto-injector
If you have been prescribed an epinephrine auto-injector, administer it as directed and then call emergency services. This can help counteract the severe symptoms until medical help arrives.
Monitoring symptoms and seeking further medical assistance
Even if you administer epinephrine, seek immediate medical care. Symptoms can return or worsen, requiring further treatment.
A bee sting allergy is a serious medical condition that demands awareness and preparedness. While most stings result in minor discomfort, for those with allergies the consequences can be life-threatening. Building an emergency action plan and carrying necessary medications can save lives. Bee sting allergy awareness is not only essential for affected individuals but for everyone, as they might encounter someone who has a stinging insect allergy in their daily lives and might just save their lives simply by knowing what steps to take.
- Arif F, Williams M. Hymenoptera stings. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Sep 17]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK518972/
- McLendon K, Sternard BT. Anaphylaxis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Sep 17]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK482124/
- Song TT, Lieberman P. Who needs to carry an epinephrine autoinjector? CCJM [Internet]. 2019 Jan [cited 2023 Sep 17];86(1):66–72. Available from: https://www.ccjm.org//lookup/doi/10.3949/ccjm.86a.17123
- Hockenhull J, Elremeli M, Cherry MG, Mahon J, Lai M, Darroch J, et al. Background. In: A Systematic Review of the Clinical Effectiveness and Cost-Effectiveness of Pharmalgen® for the Treatment of Bee and Wasp Venom Allergy [Internet]. NIHR Journals Library; 2012 [cited 2023 Sep 17]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK97565/
- Randall KL, Hawkins CA. Antihistamines and allergy. Aust Prescr [Internet]. 2018 Apr [cited 2023 Sep 17];41(2):41–5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895478/