Elizabeth Otero, M.D.

Insect Bites and Stings

For most people, a minor insect bite or sting may cause a little swelling and itching. The site may be painful for a few hours. Mosquitoes, biting flies, bedbugs, and some spiders usually cause mild reactions. Yellow jackets, honeybees, paper wasps, hornets, and fire ants cause more severe sting reactions.               
Everyone reacts to the toxic effects of insect venom, for example, from a bee sting. Most people have mild reactions, which may appear in a few minutes or up to 48 hours after the bite or sting.

A mild to moderate reaction may cause:  



  ► mild to severe itching in the area bitten   
  ► redness and swelling in the area bitten
  ► pain in the area bitten

Some people have insect allergies, which may cause mild to severe allergic reactions. Symptoms of a bite depend on how severe your reaction is.

A mild allergic reaction may cause hives with intense itching and pain around the site as well as eye itching. It may cause blisters in the area of the bite.

A severe allergic reaction to a bite or sting mostly happens within minutes of the bite/sting. The symptoms may include:

► swelling of the lips, tongue, or throat
► trouble breathing
► nausea, cramping, diarrhea, or vomiting
► hives
► dizziness
► loss of consciousness.

If you are stung by a bee, remain calm and brush away the insect. Bees leave a stinger in your skin, but hornets, wasps, and yellow jackets typically do not. Remove a stinger within 30 seconds by scraping it with a fingernail. Do not squeeze the stinger, or it will likely release more venom.

When you are bitten by a tick, remove the tick right away using fine-tipped tweezers to grasp it firmly close to the skin. Do not squeeze the tick's body. You may want to save the tick for identification in case you become ill. This may help make an accurate diagnosis. Place the tick in a sealable plastic bag and put it in your freezer. Wash your hands after touching the tick. Wash the bite area and put an antiseptic on it. Call 911 if you or your child start having more generalized symptoms.

If you have a mild reaction to an insect bite or sting:


► Put a cold, moist cloth or bag of ice wrapped in a towel on the bitten area 3 to 4 times a day for 15 to 20 minutes. Never put ice directly on your skin. This could cause frostbite.

► Put hydrocortisone cream or calamine lotion on the area to help reduce itching and swelling. If the bite is still itchy, take an oral antihistamine such as Benadryl.

► Rest the bitten area on a pillow above the level of the heart to help prevent swelling.

If you know you are allergic to some insect stings you must carry an injection kit of epinephrine, such as EpiPen 2-pak. With the kit you can give yourself a shot of medicine to counteract the allergic reaction until medical help arrives. Wear a Medic Alert ID that warns of your allergy and tells what to do in case of an emergency. Tell your family, friends, and co-workers what they should do if you have a severe allergic reaction.

A severe allergic reaction is life-threatening. Call 911 immediately if someone is bit or stung and has the symptoms of a severe reaction or they have a history of severe reactions. If the person carries an injection kit, use it right away. Cardiopulmonary resuscitation (CPR) may be necessary if the person has stopped breathing or his or her heart has stopped beating.

How can I help prevent insect bites?

Follow these guidelines to help prevent insect bites:

► Avoid walking barefoot or wearing open-toe shoes when outdoors.
► Do not wear clothing that is loose or brightly colored.
► Avoid wearing perfume or using scented lotions.
► Do not disturb beehives or hornet nests.
► Keep food and soft drinks covered, and keep garbage cans tightly covered.

To avoid mosquito bites or tick bites, keep the body covered with long-sleeved shirts, long pants, and closed-toe shoes. Stay away from places where mosquitoes breed. Use an insect repellent whenever you are outdoors. Don't use more repellent than recommended in the package directions. Don't put repellent on open wounds or rashes. Do not apply it to your eyes or mouth. When using sprays, do not spray it directly on your face. Spray the repellent on your hands first and then put it on your face. Then wash the spray off your hands. Be careful with children because repellents can make them ill.
It is also important to prevent the possibility of getting a tetanus infection. The skin broken by an insect bite could become infected with tetanus bacteria. You can prevent this type of infection by keeping up to date with tetanus booster shots.


Paper Wasp Nest