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Insect bites and stings – NHS

Most insect bites and stings are not serious and will get better within a few hours or days.

But occasionally they can become infected, cause a severe allergic reaction (anaphylaxis) or spread serious illnesses such as Lyme disease and malaria.

Bugs that bite or sting include wasps, hornets, bees, horseflies, ticks, mosquitoes, fleas, bedbugs, spiders and midges.

Symptoms of insect bites and stings

Insect bites and stings will usually cause a red, swollen lump to develop on the skin. This may be painful and in some cases can be very itchy.

The symptoms will normally improve within a few hours or days, although sometimes they can last a little longer.

Some people have a mild allergic reaction and a larger area of skin around the bite or sting becomes swollen, red and painful. This should pass within a week.

Occasionally, a severe allergic reaction can occur, causing symptoms such as breathing difficulties, dizziness and a swollen face or mouth. This requires immediate medical treatment.

What to do if you’ve been bitten or stung

To treat an insect bite or sting:

  • remove the sting or tick if it’s still in the skin
  • wash the affected area with soap and water
  • apply a cold compress (such as a flannel or cloth cooled with cold water) or an ice pack to any swelling for at least 10 minutes
  • raise or elevate the affected area if possible, as this can help reduce swelling
  • avoid scratching the area, to reduce the risk of infection
  • avoid traditional home remedies, such as vinegar and bicarbonate of soda, as they’re unlikely to help

The pain, swelling and itchiness can sometimes last a few days. Ask your pharmacist about medicines that can help, such as painkillers, creams for itching and antihistamines.

Read more about treating insect bites and stings.

When to get medical advice

Contact your GP or call NHS 111 for advice if:

  • you’re worried about a bite or sting
  • your symptoms do not start to improve within a few days or are getting worse
  • you’ve been stung or bitten in your mouth or throat, or near your eyes
  • a large area (around 10cm or more patch of skin) around the bite becomes red and swollen
  • you have symptoms of a wound infection, such as pus or increasing pain, swelling or redness
  • you have symptoms of a more widespread infection, such as a high temperature, swollen glands and other flu-like symptoms

When to get emergency medical help

Dial 999 for an ambulance immediately if you or someone else has symptoms of a severe reaction, such as:

  • wheezing or difficulty breathing
  • a swollen face, mouth or throat
  • feeling sick or being sick
  • a fast heart rate
  • dizziness or feeling faint
  • difficulty swallowing
  • loss of consciousness

Emergency treatment in hospital is needed in these cases.

Prevent insect bites and stings

There are some simple precautions you can take to reduce your risk of being bitten or stung by insects.

For example, you should:

  • remain calm and move away slowly if you encounter wasps, hornets or bees – don’t wave your arms around or swat at them
  • cover exposed skin by wearing long sleeves and trousers
  • wear shoes when outdoors
  • apply insect repellent to exposed skin – repellents that contain 50% DEET (diethyltoluamide) are most effective
  • avoid using products with strong perfumes, such as soaps, shampoos and deodorants – these can attract insects
  • be careful around flowering plants, rubbish, compost, stagnant water, and in outdoor areas where food is served

You may need to take extra precautions if you’re travelling to part of the world where there’s a risk of serious illnesses. For example, you may be advised to take antimalarial tablets to help prevent malaria.

Read more about preventing insect bites and stings.

Page last reviewed: 08 July 2019
Next review due: 08 July 2022

Bug Bite or Sting (Pediatric) Condition, Treatments, and Pictures for Parents – Overview

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Information for
ChildInfant

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Images of Bite or Sting, Arthropod (Pediatric)

Overview

Bites or stings from insects (arthropods) are very common. Most reactions are mild, and symptoms are caused by an allergic reaction to either the insect or the irritating substances (toxins) the insect makes and injects along with the bite or sting.

Some people have severe reactions to the stings of:

  • Bees
  • Wasps
  • Hornets
  • Yellow jackets

Get medical help immediately for severe stings. The bites of most insects (such as ants, mosquitoes, flies, spiders, ticks, bugs, and mites) do not cause such a severe reaction.

Sometimes, it may be hard to tell which type of insect has caused the skin reactions, as many insect reactions look the same. Flying insects tend to bite or sting uncovered (exposed) skin areas, while bugs such as fleas tend to bite the lower legs and around the waist, often with several bites grouped together.

Some people are far more sensitive to insects and have more severe reactions, so the fact that no one else in your family seems to be affected does not mean that your child has not suffered an insect bite.

Who’s at risk?

Insect bites and stings are a problem in all regions of the world for people of all ages. In the Midwest and East Coast regions of the US, mosquitoes, flying insects, and ticks cause most bites. In drier areas of the Western US, crawling insects are more likely to cause bites.

There is no proven connection to race or sex in terms of how a person reacts to bites. However, some individuals clearly seem more attractive to insects, perhaps related to body heat, odor, or how much carbon dioxide they give off when they breathe.

About 0.5–5% of people living in the US are likely to have severe allergic reactions to stings.

Signs and Symptoms

Insect bites usually appear as small, itchy, red bumps, occasionally with a blister. Very young children may be more prone to developing blisters than older children. Some insects, such as fire ants, can cause a painful and itching raised area containing pus (a pustule).

Flying insects tend to bite exposed areas not covered by clothing, while some bugs (such as fleas) focus on the lower legs. Bedbugs prefer the head and neck area, often biting several times in the same area and leaving a group of lesions.

Common reactions to arthropod stings may include:

  • Redness, pain, and swelling
  • Severe reactions such as facial swelling, difficulty breathing, and shock
    (anaphylaxis)
  • Fever, hives, and painful joints (although these reactions are not as common)

Very few spiders cause severe reactions. The black widow spider may cause only a mild reaction at the bite site, but pain, stiffness, chills, fever, nausea, and abdominal pain may follow within a few hours. Similarly, the brown recluse spider bite may cause a severe skin reaction after a few hours, with redness, pain, blistering, and ulcers forming, as well as fever, nausea, and fatigue.

Self-Care Guidelines

For stings:

  • Bees may leave a stinger behind. Try to gently scrape the stinger off with a blunt object, such as a credit card.
  • Wash the wound with soap and water.
  • Apply an ice pack or cold water for a few minutes.
  • Take acetaminophen (Tylenol®) for pain and an antihistamine (diphenhydramine or
    chlorpheniramine) for itching, as needed.

For insect bites:

  • Wash with soap and water.
  • Apply cool compresses.
  • Use antihistamines to relieve itching, and take acetaminophen (Tylenol) for pain.
  • Apply 1% hydrocortisone cream to help reduce the itching.

For ticks (still attached):

  • Using tweezers, grasp the tick as near the skin as possible and pull firmly
    until it releases.
  • Swab the area with alcohol or wash with soap and water.
  • Save the tick for identification, if needed.
  • Apply 1% hydrocortisone in case a reaction occurs.

When to Seek Medical Care

Some insect bites/stings are more dangerous than others. If you suspect your child might have a black widow or brown recluse spider bite, apply ice to the area and seek medical help immediately.

Symptoms of these bites include:

  • A deep blue or purple area around the bite, often with a surrounding white
    area and a red outer ring
  • Abdominal pain
  • Headache
  • Fever
  • Fatigue
  • Nausea
  • Muscle stiffness

If the area of a tick bite becomes red or swollen, or if the affected area spreads outward, seek medical help to check for Lyme disease.

When dealing with stings, watch out for symptoms such as:

  • Hives, itching, or swelling in areas beyond the sting site
  • Swelling of the lips or throat
  • Tightness in the chest or difficulty breathing
  • Hoarse voice or tongue swelling
  • Dizziness or loss of consciousness

Treatments Your Physician May Prescribe

Depending on the type of insect bite and how your child reacts to it, your child’s doctor might treat you in a number of ways.

For insect bites:

  • Prescription topical corticosteroids
  • Muscle relaxants
  • Pain medicines
  • An antidote against the specific toxin (antivenin)
  • Antibiotics
  • Sometimes surgery at the affected area, if the insect bite is severe

For stings:

  • Antihistamines or corticosteroids
  • Epinephrine
  • Antihistamines
  • Corticosteroids
  • Injected (intravenous) fluids and oxygen for shock (anaphylaxis)
  • Injectable epinephrine if your child is known to have severe allergic reactions
  • Procedures to stimulate the immune system (immunotherapy) to reduce the chance of repeated severe reactions

Trusted Links

MedlinePlus: Insect Bites and Stings
Clinical Information and Differential Diagnosis of Bite or Sting, Arthropod (Pediatric)

References

Bolognia, Jean L. , ed. Dermatology, pp.405. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6th ed. pp.2289, 2291, 2295-2298. New York: McGraw-Hill, 2003.

FAQ’s on Insect Bites: After Hours Kids: Physician Assistants

FAQ’s on insect bites!

Today we are talking about insect bites! Kids are very curious and interested by insects and love playing outside. Most bites are self-limited and benign, but there are occasions that warrant a trip or call to the pediatrician. Read below for information on some common questions we hear.

General Questions

What can I do at home to treat insect bites?

The first thing to do is to clean the bite well with soap and water. Using a cold compress and elevating the bite can help with pain and swelling. For young children with bites on the hands, playing in a bowl of cool water can have a similar effect as using a cold compress. Putting a topical antihistamine (ex. Hydrocortisone cream) on a bite can help decrease the itching. Talk to your pediatrician before putting anything on the bite if you have a very young child. It is important to monitor insect bites especially in children because they often itch, which can break the skin and lead to infection. Tylenol or ibuprofen can also be beneficial if your child is in pain.

Why do my child’s hands and feet get so swollen after they get a bite?

Hands and feet are often held below the heart. Children also have small hands and feet, so due to gravity and their size, swelling can be significant. Using cold compresses and elevating can help with swelling. If this does not help and the swelling is severe, please bring your child to see their provider.

What are signs of a bite becoming infected or other complications?

An insect bite that becomes infected is usually red, warm and tender to touch, and may have purulent (pus) drainage. It can be helpful to mark redness around a bite so it is easier to monitor if it is getting bigger. If you have any concern about infection after a bite, please give your child’s provider a call. To help prevent infection, clean the bite well with soap and water and remind your child not to scratch.

Some children may have more than a localized reaction to an insect bite. This most commonly is characterized itchy rash (hives) on the whole body. If this happens, it is important to call your child’s provider. Some children may have an anaphylactic reaction, in which they could have swelling around their mouth, lips, or tongue, difficulty breathing, coughing, turning blue around the lips, wheezing, dizziness, nausea/vomiting or are not acting themselves. If you see any of these signs, call 911 immediately, as these are signs that your child needs immediate medical care.

When should I bring my child to the doctor?

We never want you to worry  about your child at home; if at any point you are concerned about what is going on with your child, please let us know. With that being said, we recommend bringing your child in if the insect bite has redness around it that is spreading, it is very hard, warm, and very tender to the touch, or if there is purulent (pus) drainage from it. This could indicate there is an infection.

We also would like to see your child if there is significant swelling that is not improving, especially on the face, near the mouth, or in the genital area. Insect bites can cause significant swelling, especially in hands and feet.

Spider Bites

What are the characteristics of a spider bite?

Most spider bites do not cause as significant reaction. Usually there is a small localized reaction, and usually the only care needed is  to clean the wound and use e a cold compress. If it is on the arm or leg then elevating the extremity can help as well (if your child will cooperate). If you have a young child, talk with your pediatrician before giving medication for the bite. An antihistamine for older children can help with itching. Monitor the site closely as children tend to itch bites and this can cause a secondary infection.

What types of spider bites can cause significant problems?

There are two types of spiders that can be harmful to your child are  the black widow and brown recluse, both of which are found in central Texas. Black widows have a red hourglass marking on its body. Signs of black widow bite start with slight swelling at the site with red marks. Then there can be intense pain, stiffening, abdominal pain and cramping. Children may also have a fever, chills or nausea.

Brown recluse spiders have a violin-shaped marking on its body (but this is often hard to see). Signs of this bite start with mild pain, which then progress to redness and intense pain. There may be black, dark blue, or purple coloration around the bite. If you know your child was bitten by either of these spiders, or has any of these signs and symptoms, it is important to seek medical care immediately.

Chiggers

What are chiggers?

Chiggers are tiny red mites that do not cause painful bites, but do cause very itchy skin.  Chiggers are so small that you need a magnifying glass to see them. Chiggers pierce the skin with small claws, then they inject saliva which dissolves skin cells for the chiggers to consume. They then fall off the skin a few days later, leaving  red itchy bumps. They are usually in groups on the wrists, ankles or in skin folds.

Most of the time these bites do not cause significant problems (other than being very uncomfortable and itchy). It is important to wash this area with soap and water (this can help remove any chiggers still on the skin). Using cool compresses and anti-itch cream can help with the itchiness. Monitor the sites closely for any signs of infection and encourage your children not to scratch.

If your child has bites in their genital area, often causing swelling, it is important to bring your child in to see their provider, as this can cause pain or difficulty with urinating.

Wasps and Bees

What can I do to care for my child who was stung by a bee or wasp?

The first thing to do after a sting is to attempt to remove the stinger if it is still in the body. This should be done by a scraping motion as opposed to grabbing the stinger to remove it. Grabbing it can cause the venom to be released into the body. After removing the stinger, clean the site with soap and water to help prevent infection. Like other bites, a cool compress can be helpful as can anti-itch lotion.  

If the bite was near or in the mouth, it is important to seek medical care, as these places can cause swelling.  Many people are allergic to bees, so if you notice any of the above signs of an allergic reaction, seek medical care immediately. If your child has a known allergy and is exhibiting signs of an allergic reaction, you can also use the child’s epi-pen as instructed by their provider.

Prevention

What can I do to prevent insect bites for my kids?

If possible, dress kids in lightweight, long sleeve shirts and pants that are tucked in when playing outside (especially when hiking or playing in fields). Using insect repellant can also help.  For children be sure the amount of DEET in the insect repellant is no more than 30%. The percentage of DEET actually shows how long the insect repellant will be effective, and does not increase the effectiveness. No insect repellant should be used on infants less than 2 months old. Products with DEET may also be applied to clothes, strollers and shoes.

References:

https://kidshealth.org/en/parents/chiggers.html

https://kidshealth.org/en/parents/insect-bite.html

Insect Bites and Stings | What to do | Treatment & Advice