Bee and Wasp Sting Allergy: Warning Signs You Should Never Ignore

A bee or wasp sting is usually painful, irritating and temporary. For some people, however, an insect sting can trigger a serious allergic reaction that requires immediate medical treatment.

Knowing the difference between a normal sting reaction and anaphylaxis could be lifesaving. NHS guidance states that anaphylaxis is a potentially life-threatening allergic reaction that can develop very quickly after exposure to an allergen, including insect venom.

With bees and wasps particularly active during warmer months, it is worth knowing what symptoms to look for, what to do after a sting and when to seek urgent medical help.

What does a normal bee or wasp sting look like?

Most bee and wasp stings cause a local reaction around the affected area. This can include immediate pain, followed by a small swollen lump, redness and itching.

The NHS says insect stings are generally not serious and often improve within a few days. The appearance of redness can vary between people and may be harder to see on black or brown skin, although swelling or a raised area should still be noticeable by touch.

A normal local reaction can be uncomfortable without being dangerous. Cooling the area with a wrapped ice pack or a clean cloth soaked in cold water can help reduce swelling. Keeping the affected area raised may also provide relief.

Painkillers such as paracetamol or ibuprofen may help with discomfort, while antihistamines can be used to relieve itching when appropriate. The NHS also advises against scratching the affected area because this can increase the risk of infection.

When does a bee or wasp sting become an emergency?

The main concern after a sting is anaphylaxis, a severe allergic reaction that can develop rapidly.

Symptoms can include swelling of the lips, mouth, throat or tongue, difficulty breathing, wheezing, coughing, trouble swallowing, dizziness, confusion or fainting. A person may also develop a raised or itchy rash.

Other possible symptoms include feeling suddenly weak or extremely unwell.

The important point is that a severe reaction may progress quickly. Someone who initially appears relatively well can become seriously ill within minutes.

The NHS advises calling 999 immediately if someone develops signs such as sudden swelling of the mouth or throat, serious difficulty breathing, a tight throat, severe dizziness, collapse or loss of consciousness.

What should you do after a bee sting?

If a bee has left its stinger in the skin, it should be removed carefully.

The NHS recommends brushing or scraping the stinger sideways using a fingernail or the edge of a bank card. It advises against using tweezers to pull out a stinger because squeezing it could release more venom. Once removed, wash the area with soap and water.

However, removing a stinger should never delay emergency treatment if serious allergy symptoms are developing.

Anyone who has previously experienced a severe allergic reaction to an insect sting should be particularly cautious and follow the emergency plan provided by their healthcare professional.

What to do if you have an adrenaline auto-injector

People who have been prescribed an adrenaline auto-injector because they are at risk of anaphylaxis should carry it with them.

If symptoms suggest anaphylaxis, the NHS advises using the adrenaline auto-injector and calling 999 immediately. The person should then lie down with their legs raised where possible. If breathing is difficult, they can raise their shoulders or sit up slowly. Pregnant people should lie on their left side.

If symptoms have not improved after five minutes, the NHS advises using a second adrenaline auto-injector if one is available.

Importantly, a person experiencing anaphylaxis should not stand or walk, even if they begin to feel better. They still require emergency medical assessment.

Anyone prescribed an adrenaline auto-injector should also check its expiry date regularly and learn how their particular device works. Friends, relatives and colleagues should ideally know about the allergy and understand where the injector is kept.

When should you contact NHS 111?

Not every sting requires an ambulance, but there are situations where medical advice is appropriate.

The NHS recommends seeking urgent advice from NHS 111 if symptoms are worsening or not improving, if the sting occurred inside the mouth or throat or near the eyes, if someone has stomach pain and is being sick, feels dizzy or has been stung more than once.

Medical advice is also recommended if someone has previously experienced a serious allergic reaction to an insect sting.

If you are unsure whether symptoms could indicate a serious allergic reaction, it is safer to seek urgent medical advice rather than ignore rapidly changing symptoms.

How to reduce the risk of bee and wasp stings

There are several practical steps people can take when spending time outdoors.

Wearing closed shoes instead of walking barefoot can reduce the risk of accidentally stepping on a bee or wasp. Long sleeves and trousers can also provide additional protection, particularly when walking through grass, woodland or areas with flowering plants.

It is also sensible to be aware of nests and areas where large numbers of insects are present.

If a bee or wasp flies nearby, avoid sudden movements or attempts to swat it. Staying calm and moving away slowly can help prevent the situation from escalating.

Food and drinks can also attract wasps, especially during outdoor meals. Keep food covered where possible and dispose of leftovers and rubbish promptly.

Open cans, bottles and cups deserve particular attention because insects can crawl inside unnoticed. Check drinks before taking another sip, particularly if they have been left unattended.

After eating, washing your hands and cleaning food residue from around the mouth can also reduce the attraction for insects.

What if you have never been stung before?

One of the challenges with insect sting allergies is that people may not know they are allergic until a reaction occurs.

A first sting may cause only a local reaction, but anyone who develops unusual or worsening symptoms should monitor their condition carefully.

The presence of a swollen or itchy area around the sting does not automatically mean anaphylaxis. However, symptoms affecting breathing, swallowing, circulation or consciousness are much more concerning.

If there is any doubt about the seriousness of a reaction, NHS guidance should be followed and emergency help sought when appropriate.

The key warning signs to remember

A normal bee or wasp sting usually causes pain, local swelling, itching and a small raised area.

A potentially dangerous allergic reaction can involve symptoms away from the sting site, particularly:

• Swelling of the lips, mouth, tongue or throat
• Difficulty breathing or wheezing
• Tightness in the throat or difficulty swallowing
• Severe dizziness or fainting
• Confusion or unusual drowsiness
• A widespread raised or itchy rash
• Sudden collapse

These symptoms can develop rapidly and should not be ignored.

Sources

This article is guidance from the NHS on insect bites and stings and anaphylaxis.

Disclaimer: This article is for general information only and is not a substitute for medical diagnosis or treatment. If you or someone else develops symptoms of anaphylaxis after a bee or wasp sting, use a prescribed adrenaline auto-injector if available and call 999 immediately. For non-life-threatening but urgent concerns about an insect sting, contact NHS 111.