Bee and wasp sting allergy testing and treatment

What is bee and wasp sting allergy testing and treatment?

Most people who are stung by a bee or wasp get pain, redness and swelling around the sting that settles by itself. A small number have a whole-body (systemic) allergic reaction — such as widespread hives, swelling, breathing trouble or feeling faint — which can be dangerous.

If you have had a systemic reaction to a sting, a specialist allergy clinic can test whether you are truly allergic, usually with skin prick or blood (specific IgE) tests, and assess how high your risk is. Testing also helps work out whether it was a bee or a wasp.

For people at higher risk, venom immunotherapy (VIT) is the only treatment that reduces the chance of another serious reaction to a future sting. It is a course of injections of venom, given in a specialist clinic over several years, with the dose built up gradually. It is very effective, especially for wasp venom, but it is a long commitment and carries its own risk of a reaction during treatment.

Venom immunotherapy is not usually offered for ordinary large local swelling at the sting site, which is unpleasant but not dangerous.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your treatment

• Bring a clear account of what happened after the sting — the symptoms, how fast they came on, and how they were treated.
• If you can, find out whether it was a bee or a wasp; photos or where it happened can help.
• Tell the team about asthma, which must be well controlled before any immunotherapy.
• List all your medicines; some, such as beta-blockers and ACE inhibitors, can make a reaction harder to treat and may need review.
• Tell them if you are or might be pregnant, as a new course of immunotherapy is not usually started in pregnancy.
• Avoid antihistamines for a few days before skin testing if asked, as they can affect the result.
• Be ready for the time commitment if immunotherapy is recommended: regular visits over several years, with a wait in clinic after each injection.

What happens

At the clinic, the specialist takes a detailed history of the reaction and arranges testing — skin prick tests, blood tests, or both. A blood test for a marker called tryptase is sometimes done, as a raised level can affect risk. Results are discussed together with your history to decide how high your risk is and whether immunotherapy is worthwhile.

If venom immunotherapy is recommended, you have a build-up phase of injections of increasing strength, then maintenance injections, usually monthly, continued for about three to five years. Each injection is given just under the skin in a specialist clinic.

After every injection you wait in the clinic, usually for about an hour, so staff can watch for and quickly treat any reaction. Adrenaline and resuscitation equipment are kept ready. You are only allowed home once the team is satisfied you are safe.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Venom immunotherapy is highly effective but carries a real risk of a reaction during treatment, especially in the build-up phase, with bee venom, and with rapid dose schedules. This is why every injection is given in a clinic with monitoring and emergency treatment ready. Even after a successful course, a small risk of reaction to a future sting can remain. Ask about your personal risk, whether bee or wasp, and whether you should carry an adrenaline auto-injector.

Published figures to discuss

Venom immunotherapy is one of the most effective allergy treatments, but reaction rates during treatment vary with the venom, the dose schedule and how fast the dose is increased. Protection is high but not absolute, and is somewhat lower for bee than for wasp venom. The figures below are drawn from published reviews and vary between clinics.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Testing has no real recovery. Immunotherapy has no physical recovery either, but you must be watched in clinic after each injection, and the treatment is a long commitment over several years.

• A small itchy bump after skin testing that fades within hours
• Redness, itching or swelling at the injection site during treatment
• Feeling tired or mildly flu-like for a few hours after an injection
• Gradually growing confidence as protection builds over months

Aftercare

• Stay in the clinic for the full monitoring period after every injection.
• Avoid vigorous exercise, hot baths and alcohol for a few hours after an injection.
• Use a cool compress and, if advised, an antihistamine for local swelling.
• Carry your adrenaline auto-injector if you have been prescribed one, and keep it in date.
• Take sensible steps to avoid stings, such as care around food and drink outdoors and not disturbing nests.
• Keep your asthma medicines up to date and take them as prescribed.
• Attend all appointments — missing doses can mean the dose has to be reduced and built up again.

• Clear account of the sting reaction written down
• Whether it was a bee or wasp noted if known
• Asthma reviewed and well controlled before immunotherapy
• Medicines checked, including beta-blockers and ACE inhibitors
• Adrenaline auto-injector collected and you know how to use it
• Time set aside for several years of regular visits with monitoring
• Clinic contact number saved for a delayed reaction

Scars and how they heal

Skin tests and injections leave only tiny needle marks that fade. A red, itchy or swollen patch at the injection site during treatment is common and usually settles within a day or two; it is not a scar.

⚠ Get urgent help if…

• Difficulty breathing, wheeze or a tight chest after an injection or a sting
• Swelling of the lips, tongue or throat, or trouble swallowing
• Widespread hives, flushing or severe itching
• Feeling faint, dizzy or collapsing
• A fast heartbeat with feeling unwell or anxious
• Any reaction that comes on after you have left the clinic — use your adrenaline auto-injector if advised and call 999

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A normal or low-risk result may mean you do not need immunotherapy, though you may still be advised to carry an adrenaline auto-injector. A result confirming significant allergy guides whether treatment is worthwhile. A good treatment result means a future sting is far less likely to cause a serious reaction. Protection is generally high, especially for wasp venom, but it is not an absolute guarantee, and a small risk can remain. Your specialist will explain what your results mean for you.

After a full course of about three to five years, protection is usually long-lasting. A small risk of a serious reaction to a future sting can remain, and studies suggest this residual risk is somewhat higher for bee than for wasp venom. Your specialist will advise whether you should continue to carry an adrenaline auto-injector after stopping.

Related tests, treatments or support

Testing and immunotherapy go together with practical sting-avoidance advice and, where needed, an adrenaline auto-injector and an allergy action plan. If you react to both bee and wasp, or have a raised tryptase level, the specialist may arrange extra tests before deciding on treatment.

Follow-up & long-term care

You are reviewed at each visit and at intervals through the course, with checks on your symptoms, asthma control and how you tolerated previous injections. Towards the end of about three to five years, the specialist discusses stopping, your residual risk, and whether to keep carrying an adrenaline auto-injector.

• Regular maintenance injections, usually monthly, for about three to five years
• Keeping and replacing your adrenaline auto-injector before it expires
• Ongoing review of asthma control during the course
• Continued sensible sting-avoidance measures
• A clear plan for what to do if you are stung again

Repeat, follow-on and what comes next

• If you react to a dose, the dose may be reduced and built back up more slowly, lengthening treatment.
• Tests are sometimes repeated to help decide when it is safe to stop.
• A small number of people remain at higher risk and may be advised to continue treatment for longer.
• Missed appointments can require the dose to be restarted at a lower level.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A monitoring period in clinic after every injection, with adrenaline and resuscitation equipment ready.
• An adrenaline auto-injector and a written allergy action plan, with training in how to use them.
• Clear instructions on what to do if a reaction starts after leaving the clinic.
• Regular review of symptoms, asthma control and tolerance of injections.
• An honest discussion at the end of the course about residual risk and whether to keep carrying adrenaline.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The specialist assessment and ongoing review fees
• The allergy tests used (skin prick, blood tests, component-resolved tests, tryptase)
• The cost of the venom extract used for immunotherapy
• The number of visits, which is high during the build-up phase and continues for years
• Nursing time and the monitoring period after each injection
• Any extra treatment needed to control asthma before and during the course

• The consultant and clinic fees for assessment and review
• Which tests are included and their cost
• The cost of the venom extract and the full length of the course
• Whether the price covers the whole multi-year course or is charged per visit
• What happens, and what it costs, if you react during treatment or need a slower schedule
• Whether an adrenaline auto-injector and action plan are included

On the NHS? Specialist assessment and venom immunotherapy are available on the NHS for people who have had a systemic reaction to a bee or wasp sting; private care may be used for faster access or choice of clinic.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Was my reaction a dangerous whole-body reaction or a large local swelling?
• Am I allergic to bee or wasp venom, and how high is my risk?
• How much would immunotherapy reduce my risk, and how well does it work for my venom?
• What is the chance of a reaction during treatment, and how is it managed here?
• Should I carry an adrenaline auto-injector, now and after treatment?
• How long would treatment last, and what is my risk after I stop?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for bee and wasp sting allergy testing and treatment

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NICE QS119 — Specialist assessment for venom immunotherapy BSACI — Venom allergy guideline Anaphylaxis UK — Insect sting allergy Hymenoptera venom allergy and immunotherapy review — PMC Venom immunotherapy for preventing reactions to stings — Cochrane (PubMed)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.