Allergic reactions to insects may be due to either stinging or biting insects. In stinging insects, such as bees, wasps and yellow jackets, the reaction can vary from a mild local reaction to a severe life threatening reaction, anaphylaxis. Evaluation for reactions beyond a local reaction is necessary as future systemic reactions can be severe. Identifying the stinging insect(s) is crucial as treatment in many cases will require allergy immunotherapy. Having available epinephrine is also critical for treatment of any subsequent insect stings, but this alone is not recommenced as long term treatment. Prevention of the systemic reaction with allergen immunotherapy is the recommended treatment.
Fortunately, biting insects such as mosquitos, rarely cause severe systemic reactions. Typically the reactions are local to the site of the insect bite. In some cases the bite reaction while local can result in a prolonged local reaction. Treatment for in most cases is with an oral antihistamine and topical steroids. In severe prolonged reactions a short course of oral steroids is usually sufficient to treat the reaction.