How to Avoid or Treat Bee Stings this Summer

As families spend more time outdoors during summer months, parents and other caregivers should be aware of the hazards related to bee stings, and how they can help prevent a child from being stung, a CHOC pediatric allergist says.

Bee stings can be quite common, and don’t usually lead to a serious reaction, says Dr. Wan-Yin Chan. However, there are several things parents can do to help prevent bee stings:

  • Keep food and drink containers closed when outdoors.
  • Wear shoes, socks and gloves when working outdoors.
  • Hire an exterminator to remove hives and nests around your home.
  • Avoid wearing brightly colored clothing or perfume.
  • Remain calm and walk away if you spot stinging insects.

If your child is stung by a bee, remove the stinger as soon as possible because venom can continue to be released for several seconds, says Chan. There is no special technique, but you can try flicking the stinger out as this prevents compressing the venom sac.

The most common reaction from a bee sting is a local reaction that consists of redness and swelling at the site of the sting that usually resolves within a few hours, but may last up to a day or two.

About 10 percent of people develop large local reactions, characterized by redness and swelling that increases in size over 1 to 2 days and can measure as large as 10 centimeters in diameter.  This type of reaction typically resolves over five to 10 days.

There are several ways to treat bee stings at home, says Chan. For small local reactions, try cold compresses.

For large local reactions, in addition to the cold compresses, you can elevate the limb if the sting is on an extremity.  Nonsteroidal anti-inflammatory drugs such as ibuprofen can help relieve pain, and oral antihistamines or topical steroids can help relieve itching.

Anaphylaxis, a severe and potentially life-threatening allergic reaction in response to insect stings, occurs in less than one percent of children and in three percent of adults.

Seek emergency medical attention if your child experiences any of the following symptoms of anaphylaxis:

  • Hives
  • Flushing
  • Swelling of the face, throat or tongue
  • Hoarse voice
  • Difficulty breathing
  • Shortness of breath
  • Wheezing
  • Dizziness
  • Nausea
  • Vomiting
  • Diarrhea
  • Loss of consciousness

Also seek immediate medical attention if there are any signs of infection, which include fever, redness, swelling at the sting site, or worsening pain three to five days after the sting. For infection, your child’s pediatrician might prescribe antibiotics.

For anaphylaxis, the patient will be given at least one dose of epinephrine, also called adrenaline, which can help constrict blood vessels in order to increase blood pressure, reduce wheezing, improve breathing, and work to reduce hives and swelling, says Chan.  A second dose may be required if the first dose is not effective. Because a severe allergy reaction can last for hours, patients should be monitored for several hours after administration of epinephrine.

A commonly prescribed epinephrine injection, is typically only prescribed when there is a history of anaphylaxis.  If the reaction was a local reaction, it is not necessary to carry an epinephrine injection.

If your child has a history of anaphylaxis to bee or other insect stings, ask your pediatrician about a referral to an allergist/immunologist, who can provide further evaluation and allergy testing.  If allergy testing is positive, patients may be treated with allergy shots, which can almost completely eliminate the chance of a severe reaction if they get stung again.

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Choosing the Right Over-the-Counter Medicine for your Child’s Allergies

By Melody Sun, clinical pharmacist at CHOC

Allergy season is a time of stuffy noses, itchy eyes, and lots of sneezing. When these symptoms cannot be managed with lifestyle habits, non-prescription or over-the-counter medications may help. However, there can be an overwhelming variety of over-the-counter medications for the same issue, so how do you choose one? Here are some tips on finding the appropriate non-prescription medication to manage allergy symptoms. For children, you should check with your provider or pharmacist prior to starting any new medication.

  1. How to read the Drug Facts label.

The Drug Facts label is the black and white box on the back of the packaging. The information is broken down into:

Section What does it mean?
Active ingredient(s) The medication name for specified symptoms.
Purpose This is the active ingredient’s action. For example, “antihistamine” helps with allergy symptoms.
Uses The product may help treat some of the general symptoms listed under this section. For example, sneezing and itchy eyes.
Warnings This includes when to avoid this medication. Certain activities or other substances require you to be more careful due to side effects of the medication, which are also listed in this section.
Directions Details on who, how much, and how often to take the product.
Other information How to store the medication appropriately.
Inactive ingredients These ingredients do not treat the symptoms. Avoid this medication if you are allergic or have restrictions to any of these components.
  1. What active ingredients are used for allergies?

There are oral products, nasal sprays, and eye drops that are available to manage allergy symptoms.

Active ingredient Purpose Symptoms treated
Itchy eyes Runny eyes Itchy nose Runny nose Stuffy nose Itchy throat
Oral products
Chlorpheniramine, Diphenhydramine Antihistamine

(more sedating)

Cetirizine, Loratadine, Fexofenadine Antihistamine

(less sedating)

Phenylephrine, Pseudoephedrine Nasal Decongestant
Nasal sprays
Oxymetazoline* Nasal Decongestant
Budesonide, Fluticasone, Triamcinolone Glucocorticoid, Allergy symptom reliever
Cromolyn sodium** Nasal allergy symptom controller
Eye drops
Ketotifen, Naphazoline with Antazoline/Pheniramine Antihistamine

*Prolonged use can lead to worsening congestion.

** Takes 4-7 days to work. Not for immediate relief of symptoms. Must be taken regularly.

  1. Choosing the product.

When reading the drug facts label, make sure that the listed active ingredients treat a symptom you have. Avoid selecting a product that contains an active ingredient for a symptom you are not experiencing. Depending on the extent of your symptoms, a certain type of product may be more useful. Oral products work throughout the body, whereas nasal sprays and eye drops are great for local symptoms. Additionally, if local symptom management (for example, eye drops) still does not control the itchy eyes, using both eye drops and oral products can be more helpful.

If you have questions about the product, talk to your doctor, pharmacist, or other health care professional.

For more information, visit Understanding Over-the-Counter Medications from the FDA.

Related articles:

  • How to Avoid or Treat Bee Stings this Summer
    As families spend more time outdoors during summer months, parents and other caregivers should be aware of the hazards related to bee stings, and how they can help prevent a ...
  • The Three Key Asthma Symptoms Every Parent Should Look For
    Diagnosing asthma can be tricky. There is no simple test. Instead, evaluating three key symptoms helps doctors make a diagnosis, explains Dr. Stanley P. Galant, an asthma, allergy and immunology ...
  • Kids and Living with Food Allergies
    A food allergy usually occurs in the first two years of life, says Dr. Ellis, a CHOC Allergy and Immunology Specialist. “It’s important to know that allergic reactions to food ...

The Three Key Asthma Symptoms Every Parent Should Look For

Diagnosing asthma can be tricky. There is no simple test. Instead, evaluating three key symptoms newasthmapic_iStock_000010686472Mediumhelps doctors make a diagnosis, explains Dr. Stanley P. Galant, an asthma, allergy and immunology specialist at CHOC Children’s and the medical director of the CHOC Breathmobile.

Children experiencing cough, shortness of breath – especially during and after exercise or when suffering from a cold, and wheezing should be checked for asthma.

“Asthma is a condition associated with a chronic or intermittent cough that generally comes on in the middle of the night and with exercise,” says Dr. Galant. “One big clue to help diagnose asthma versus another condition or illness has to do with this chronic cough. A diagnosis of asthma is suggested when the cough responds well to medication that opens the airways and dilates the bronchial tubes.”

Asthma symptoms can be triggered by environmental factors, like second-hand smoke, and allergens. In fact, children with asthma—roughly 70 percent—have allergies, which play a big role in diagnosing and controlling the condition.

If a child has persistent asthma – roughly defined as trouble more than twice a week during the day in terms of coughing and wheezing and trouble more than twice a month at night, the child should have skin testing or blood testing for allergies. Allergy testing helps pinpoint triggers for asthma so families can make changes at home to reduce or eliminate them.

Avoiding triggers is a key factor to managing asthma. Second is medication. Allergy shots can also be helpful in certain patients. Parents should discuss the appropriate options with their child’s physician.

Learn more about allergy and immunology services at CHOC.

For more asthma and allergy tips, please go to

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Kids and Living with Food Allergies


A food allergy usually occurs in the first two years of life, says Dr. Ellis, a CHOC Allergy and Immunology Specialist. “It’s important to know that allergic reactions to food typically occur immediately or within two hours of eating the food,” Dr. Ellis explains. “The child might have skin issues like hives (itchy red spots) or develop itchy skin, or the child might throw up. All the organ systems can be involved. The child might wheeze or become short of breath. In severe cases, the cardiovascular  system can be involved and the child could have a drop in blood pressure, feel light headed and faint.”

There is no cure for food allergies and the best way to avoid getting sick is avoiding the food. “You have to find out what the child is allergic to. This comes from the family history and then we take a blood test or a skin test to confirm what the family has told the doctor,” says Dr. Ellis. With a serious reaction, an adult should inject the child with epinephrine (adrenaline that reverses the symptoms) and call 9-1-1. “Always have an epinephrine auto-injector. Learn how to read food labels and be careful at high-risk eating areas such as buffets, ice cream parlors and Asian restaurants.”

Any food can cause an allergy but a small number of foods are most commonly associated with food allergies. In fact, eight foods/food types account for 90 percent of all allergic reactions. They are: milk, eggs, peanuts, tree nuts (such as walnuts and almonds), soy, wheat, fish and shellfish. Even trace amounts of a food allergen can cause a reaction, including a severe or life-threatening reaction. Peanuts, tree nuts and fish are the most common causes of severe reactions, says Dr. Ellis.


  • Estimated number of American children and adults with food allergies: 15 million
  • Annual cost to the U.S. economy related to children’s food allergies: Almost $25 Billion
  • Percentage of children under the age of six with food allergies: 6 – 8

View the full feature on Kids and Living with Food Allergies

Dr. Mark Ellis
Dr. Mark Ellis
CHOC Allergy and Immunology Specialist


Dr. Ellis completed his residency at the University of Arizona Health Sciences Center in Tucson and a fellowship in Allergy-Immunology at the University of California, Irvine, Medical Center. Dr. Ellis is chief of the CHOC Children’s Specialists Allergy & Immunology Division and is the Director of the Allergy, Asthma & Immunology program at CHOC. Dr. Ellis specializes in the treatment and management of allergies and asthma. He is a principal investigator for many clinical research studies for adults and children concerning new treatments for asthma and allergies.

Dr. Ellis’ philosophy of care: “I like to identify the problem and educate the family on ways to prevent disease.”

Tulane University School of Medicine in New Orleans

Allergy and Immunology

More about Dr. Mark Ellis

This article was featured in the Orange County Register on April 7, 2014, and was written by Amy Bentley.

Tips for Keeping the Home Safe for Kids with Food Allergies

Raising a child with a food allergy can be challenging enough, but what should families do when they have children with and without food issues? That’s a question CHOC Radio host Bryan Mundia recently asked Shonda Brown, a CHOC Children’s clinical dietitian who works in the hospital’s Eosinophilic Esophagitis Clinic.

There are many things a family should consider before deciding to rid the house of one child’s food allergens, thereby restricting the diet of the entire family. The ease of removing particular items from the home and the severity of the allergy are just two things to keep in mind, says Shonda.

In this podcast, Shonda offers tips for keeping the home safe for kids with allergies, without preventing other members of the family from enjoying foods they enjoy.