Bites: Insect

Bees, wasps, hornets, yellow jackets, mosquitoes, flies, chiggers, ticks, gnats, fleas and other insects can all produce painful stings or bites from venom, or other substances, injected into the skin. Most insect bites are harmless, but some can be very dangerous, even fatal.

Symptoms

Most reactions to bites are mild. It may be difficult to determine if you have been bitten or stung -- and by what. The reaction to minor bites may be immediate or delayed and is usually confined to the area around the bite. It may be red or have slight swelling. It may itch. Pain and swelling usually improve in 24 hours.

Swelling can vary from a small dot to half an inch in size. A large swelled area doesn't mean you are allergic to insect bites. The size of the swelling doesn't necessarily mean the bite is serious.

Mosquito and gnat bites near the eye or ear can become very swollen. It also is not unusual for lymph nodes located near the bite to become swollen as a reaction to insect bites.

Anaphylaxis, or a dangerous, life-threatening reaction to some insect bites, occurs usually within 20 minutes following the bite. Anaphylaxis affects the entire body regardless of the sting site. These are symptoms of anaphylaxis:

• Hives, intense itching or swelling all over the body

• Shortness of breath

• Wheezing

• Swelling of the throat that causes difficulty swallowing

• Nausea

• Stomach cramping

• Vomiting

• Loss of bowel and bladder control

• Weakness

• Dizziness or fainting

• Drop in blood pressure

• Shock or unconsciousness

First Aid

• Remove the stinger when stung by a bee. Scrape over the stinger, which looks like a splinter, with a credit card, fingernail, knife blade or other rigid object. Don't try to pull it out with your fingers or a tweezers; you might end up squeezing more venom into the skin.

• Wash the site of the bite and the surrounding area thoroughly with soap and water.

• Apply cold quickly. Cool compresses or ice packs will help ease the pain and prevent swelling from most insect bites. The longer you wait to apply a cold treatment, the less benefit it will have. Apply cold packs for no more than 20 minutes at a time to avoid frostbite.

• Don't scratch that itch. Apply calamine lotion, hydrocortisone cream or baking soda and water. Take the antihistamine Benadryl if itching or more local swelling occurs. Benadryl will help reduce symptoms but is not an effective emergency treatment. It can also cause sleepiness or hyperactivity in children.

Special Care for Children With Insect Bites

• Trim child's nails to prevent injury from scratching.

• Protect babies from insects, especially those younger than a year old, because they can't swat them away.

• Note that bites on young children and babies will be more swollen in general and may form hard lumps that last for several months.

Prevention

Don't use perfumes, aftershave, scented hairsprays or scented deodorants. Wear insect repellent, light-colored clothing, long-sleeved tops, long pants, socks and shoes. Floral patterns attract bees, as do food, beverages and garbage cans. If a bee comes near you, avoid sudden movements. Stay still or move away slowly.

Using Insect Repellents

• DEET (N-diethyl-m-toluamide) and two other recently approved products, picaridin and oil of lemon eucalyptus, are effective insect repellents. Adults should apply insect repellent containing 20 to 30 percent DEET to skin or clothing. DEET should not be used on children younger than 2 months. Insect repellents containing 30 percent DEET appear to be as safe as products with a 10 percent concentration when used according to the directions on the product labels. Talk to your child's health care provider if you have questions about using insect repellents on your child. Parents should apply DEET to their children, avoiding the child’s hands, eyes and mouth. DEET will only last a few hours before you need to reapply. DEET at concentrations higher than 30 percent is not recommended, especially for young children and those with sensitive skin.

• Permethrin insecticide can be applied to shoes and clothing, but not skin. It will kill ticks and provide protection for several days.

• Repellents applied to skin are less effective when the temperature is warm because they evaporate.

Prevention for People with Serious Sting Reactions

People who have had a serious reaction to a bee sting can take the following steps to prevent a serious reaction in the future:

• Carry a bee-sting kit at all times. A doctor can prescribe one and show you how to use it. These kits contain injectable adrenaline, also called epinephrine, which can be lifesaving.

• Carry a card or wear a bracelet that alerts others to the condition.

• Ask your doctor if venom desensitization injections will help. (Desensitization is a process of making you less sensitive to venom.)