Allergy to insect stings: treatment
For people with a confirmed allergy to insect stings, a distinction needs to be made between treatment of acute problems and long-term treatment. Whether it is a purely local or systemic reaction also plays a role. Targeted therapeutic measures include avoidance of the allergen , self-help measures in the event of another sting, or even specific allergen immunotherapy (in patients with a type I immunopathological reaction ).
Treatment of acute problems
Various drugs are used to treat acute problems . In the most severe cases, it is necessary to inject adrenaline .
Local reaction: Acute problems can be treated with a strong, locally acting cortisone-type drug (in the form of a cream or gel), or even with a cool, moist compress, which is left on for about 20 minutes and which can be repeated once or twice after a few hours. In addition, you can also use cooling gels, ointments or gels with e.g. camphor or menthol, which are sold over the counter in pharmacies, to alleviate allergic symptoms. These agents activate cold receptors and thus induce a cooling sensation. In addition, antihistamines in tablets are given , and cortisone in tablets for a short time in case of an intensified local reaction .
Systemic reaction: In severe reactions to insect stings, cortisone is usually given as a supplement to antihistamines, either in the form of tablets or infusions ; this can alleviate local problems. In extreme cases, it is necessary to inject adrenaline. Poisoning symptoms can be expected from 50 or more stings, their treatment depends on the clinical picture .
Long-term treatment
Patients with an allergy to insect stings need long-term care. This consists in avoiding the allergen , self-help measures in the event of the next sting, or even in specific allergen immunotherapy or SAIT (for patients with a type I immunopathological reaction ). SAIT lasts at least 3-5 years and can protect almost all sufferers from another systemic reaction to an insect sting (75-85% of patients allergic to bee venom and about 90-95% of patients allergic to wasp venom). However, allergy sufferers who have undergone SAIT should continue to avoid the allergen and know self-help measures.
In special cases, the doctor may also indicate SAIT in people who are in frequent professional contact with insects (eg beekeepers, farmers, gardeners, agricultural assistants, truck drivers, etc.) and who have repeatedly experienced intensified local reactions to insect stings.
There are two ways to administer allergen extracts ; both are briefly described in the following paragraphs.
Sublingual Immunotherapy ( SLIT )
The patient uses allergens year-round in the form of drops, which he drips under his tongue once a day . This treatment is prescription and can be done at home. In rare cases, side effects such as itching of the tongue and palate and slight swelling of the mucous membranes may occur . These problems often improve after just one year of treatment.
Subcutaneous immunotherapy ( SCIT )
The doctor injects allergens into the upper arm. Injections with a gradually increasing concentration of allergens are administered to the patient every week. Once a maintenance dose is reached after several weeks, the patient receives an injection of this dose once a month. After the application of each such injection, the patient must remain in the doctor’s waiting room for at least 30 minutes, because with this form of treatment, an intensified reaction to anaphylactic shock can occur . In addition, the patient should not consume alcohol and avoid heavy physical exertion on the days of subcutaneous immunotherapy .
Who can I contact?
If other problems appear after an insect sting than just a skin reaction around the injection site, you should definitely consult a doctor. If a medical examination confirms an allergy to insect stings, the patient will receive an emergency kit that will provide first aid in the event of another sting in the future. Family, friends and acquaintances should be informed about both the allergy and first aid in case of an emergency.
