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For most people, a bee sting only produces temporary pain and irritation at the site of the sting.

For others, bee stings cause an allergic reaction that can range from mild to severe. In extreme cases, a bee sting can cause life-threatening anaphylaxis.

In this article, we discuss the causes, symptoms, and treatment of bee sting allergies and how to avoid getting stung during the summer months.

How common are bee sting allergies?

According to the Journal of Asthma and Allergy, approximately 5 to 7.5 percent of people will experience a severe allergic reaction to insect stings in their lifetimes. In beekeepers, this risk rises to 32 percent.

Many people who react to insect stings will experience a mild to moderate allergic reaction in the form of localized redness and swelling.

For a small minority of people, the allergic reaction can be much more severe, requiring emergency medical treatment. Fatal reactions are rare.

The venom of honeybees, paper wasps, and yellow jackets tend to cause the most severe allergic reactions.

Bees, wasps, and fire ants most commonly cause systemic allergic reactions, which spread all over the body, including the skin and respiratory system.

Causes of the allergic reaction

When a bee stings, its sharp, barbed stinger remains lodged in the skin. This stinger can release venom for up to a minute after the bee has stung.

Bee venom contains proteins that affect the skin cells and immune system, resulting in pain and swelling at the site of the sting, even if a person is not allergic to the venom.

In those who are allergic to bee stings, the venom triggers a more severe immune system reaction. These people may not have an allergic reaction the first time they are stung but may have an allergic reaction to a second bee sting.

If a person is allergic, the bee sting will cause the immune system to produce antibodies called Immunoglobulin E (IgE). Usually, IgE protects the body from dangerous substances, such as viruses and parasites.

However, in response to a sting, the body produces IgE that causes an inappropriate immune responses, such as hives, swelling, and respiratory problems, the next time a person is stung.

The symptoms of a bee sting allergy vary depending on how allergic the person is. A person can have a mild, moderate, or severe reaction shortly after being stung by a bee:

Mild reaction

The majority of bee sting symptoms are very mild and do not require medical attention. They are limited to the site of the sting itself, and include:

  • a sharp, burning pain
  • an area of raised, red skin
  • slight swelling

Moderate allergic reaction

In a person with a moderate bee sting allergy, the body has a stronger response to bee venom, called a large local reaction (LLR). In such cases, the symptoms can take over a week to heal completely.

Symptoms include:

  • severe redness around the sting
  • swelling around the sting, which may gradually increase in size to a diameter of 10 cm or more over a period of 24–48 hours

If a person experiences a LLR, there is a 5 to 10 percent risk that they will develop a systemic reaction to a sting in the future.

Severe allergic reaction

In certain individuals, a bee sting can cause anaphylaxis, which is a life-threatening allergic reaction requiring emergency medical treatment. The following symptoms of anaphylaxis develop rapidly:

  • itchy, red hives on the skin
  • pale or flushed skin
  • a swollen throat or tongue
  • difficulty breathing
  • abdominal pain
  • nausea and vomiting
  • dizziness
  • a weak, rapid pulse
  • loss of consciousness

Those who are allergic to bee stings can take the following precautions to reduce their risk of being stung when outdoors:

  • avoiding walking in sandals or bare feet
  • ensuring arms and legs are covered
  • avoiding wearing clothing that is brightly colored or has a floral print
  • avoiding wearing strong perfumes
  • checking outdoor areas for bees and other flying insects before eating outside
  • when eating outdoors, keeping food covered and pay attention to foods and drinks that bees could land on
  • keeping windows closed when driving

If you come into contact with bees:

  • Do not swat at bees as they may sting in defense.
  • If a bee flies near to you, try to move slowly and calmly away.
  • If a bee lands on you, try to remain calm as they will usually fly away within seconds.
  • If you find a bee or wasp nest in your house or garden, call a local pest control expert. Never attempt to remove a nest yourself.

Outlook

Most bee stings will produce only mild and temporary symptoms that people can treat at home.

Even those who experience moderate allergic reactions do not usually need to seek urgent medical attention. However, they may wish to speak with a doctor if they are concerned about future reactions to bee venom.

A person who experiences anaphylaxis after being stung by a bee is more likely to experience anaphylaxis when stung in future. Doctors should prescribe an EpiPen for these people to use in emergencies. They may also wish to speak with their doctor about the possibility of venom immunotherapy treatment.

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