We are all at risk all summer long for bites and stings from insects and arachnids (spiders and ticks). Reactions to bites and stings range from zero to severe. Although rare, some insects and arachnids also carry diseases such as West Nile virus or Lyme disease. It is important to be aware of the risks and to learn how to avoid them. It is also important to know how to take care of bites and stings when they do occur.
What situations put you at higher risk for being stung or bitten?
- Spending time outdoors
- Living in warmer climates
- Not wearing proper protection
- Not using flea and tick preventive measures for pets
- Collecting insects as a hobby
- Not clearing up places that make good nesting and breeding sites
Is it a Bite? Or is it a Sting?
- Biting insects include mosquitoes, fleas, and bedbugs.
- Biting arachnids include ticks, spiders, and chiggers (the juvenile form of a type of mite).
- Stinging insects include bees, yellow jackets, hornets, wasps, and fire ants.
Signs, symptoms, and reactions – mild or severe?
Signs and symptoms of an insect bite or sting result from the injection of venom or other substances into your skin. A person’s immune system and sensitivity to the insect’s venom determine the severity of the reaction. Most people do not have serious reactions, even those with a history of allergies or asthma, although the risk of a more serious reaction is increased in these individuals. Bees, yellow jackets, wasps, hornets, and fire ants can cause anaphylactic reactions. You MUST have been stung previously to have an anaphylactic reaction.
- Mild reactions usually include itching or a stinging sensation and mild swelling and redness on the skin surface. The symptoms of a mild reaction usually disappear within one to two days. The severity of your reaction depends on your sensitivity to the insect venom or substance and whether you’ve been stung or bitten more than once.
- Severe reactions are less common and are referred to as anaphylaxis and are most often (in our area of the world) caused by bees, yellow jackets, hornets, wasps, and fire ants. Severe anaphylactic allergic reactions require prompt medical attention. You should seek emergency medical help immediately if the following symptoms appear:
- Nausea, vomiting, abdominal pain
- Facial swelling, swallowing problems
- Difficulty breathing, rapid breathing, significant coughing, hoarseness, and possibly chest discomfort
- Weakness, dizziness, cool/clammy skin, fainting, or unconsciousness
- Hives or itching all over the body
What is the most common treatment for bites and stings?
All stings and bites respond to the following treatments; see the next section for more information about severe anaphylactic reactions
- Move to a safe area to avoid more stings.
- Remove the stinger, especially if it’s stuck in your skin. It is very important to remove a bee stinger quickly, if it is still embedded in the skin, in order to prevent further venom from entering the skin. Gently scrape it off horizontally with the edge of a credit card or your fingernail. Avoid tweezers, as this may squeeze more venom into the wound. Wash area with soap and water. The swollen area may increase in size for two to three days after a bee sting or mosquito bite.
- To remove an imbedded tick, using tweezers, grasp the tick as closely to the skin as possible. Gently tug on the tick. Do not twist or “unscrew” the tick. Don’t worry if the head remains imbedded in the skin. It will eventually come out on its own. Clean the area with an antiseptic.
- See “What you need to know about Lyme disease” on this website.
- If necessary, to reduce swelling and pain:
- Take pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).
- Apply a cold pack or cloth filled with ice to reduce pain and swelling.
- To reduce itching and discomfort, apply one of the following to the bite or sting several times a day until symptoms subside:
- Hydrocortisone cream to any part of your body except the areas around the eyes or genitals (0.5 percent or 1 percent over-the-counter formulation)
- Calamine lotion
- A baking soda paste made in a ratio of 3 teaspoons baking soda to 1 teaspoon water
- Take an antihistamine (for children under age six, contact your provider for dosing.
- To avoid the risk of infection, do not scratch the area. The signs of infection include, but are not limited to, increasing redness, pain, swelling and heat to the site. You may also notice a red streak on the area and/or pus from the site. If you have any signs of infection, notify your health care provider for treatment.
What is the treatment for a severe reaction or anaphylaxis?
If this is your first anaphylactic reaction, seek immediate medical assistance – call 911.
If you have had an anaphylactic reaction in the past and have been prescribed an epinephrine kit (called an EpiPen®) by your health care provider, use the epinephrine immediately and call 911. Do not wait for signs of anaphylaxis.
If you have experienced anaphylaxis in the past:
- Carry your EpiPen with you at all times.
- Make those around you aware of your severe reactions.
- Wear an allergy bracelet.
What is the best way to prevent insect bites and stings?
Avoiding high-risk areas or situations is the best way to prevent bites and stings, and is especially important for those with anaphylaxis.
- Use insect repellents. These work more effectively against biting insects such as mosquitoes than they do against stings. If you use insect repellents, be sure to strictly adhere to the manufacturer’s instructions, and follow these guidelines:
- Do not use insect repellents (especially those containing DEET) on young children, especially on their hands.
- The most common insecticide is DEET, which should not be applied more than once a day. Using DEET more than once a day could cause a toxic reaction. Concentrations vary from less than 10% to over 30%. The higher the concentration, the longer the duration of action. Never use any preparation that contains more than 30% DEET. Select the lowest effective concentration based on the amount of time you will be outdoors.
- Do not use products that combine repellant with sunscreen, as sunscreen needs to be reapplied every few hours.
- Be sure to wash off repellant with soap and water at the end of the day.
- Picaridin is an alternative to DEET that is widely used in Europe. Concentrations of 5-10% are appropriate for use. These repellants are effective in preventing bites by mosquitoes, ticks, fleas, chiggers, and biting flies, but are ineffective in preventing stings.
- Dress appropriately:
- Reduce the amount of skin exposed when you are outdoors – dress in long pants, lightweight, long-sleeved shirt, and a hat. Tuck pants into boots, shoes, or socks.
- Don’t go barefoot.
- Wear gloves when gardening.
- Avoid wearing bright colors.
- Avoid sweet-smelling perfumes, deodorants, lotions, hair sprays, and colognes.
- Treat pets and help keep areas of your home bug free:
- Use flea and tick control for pets.
- Regularly treat your home for fleas during warmer months.
- Vacuum frequently in corners and under and behind furniture (where spiders like to lurk).
- Keep outside areas free of leaf and brush refuse.
- Tidy up under porches.
- Treat fire ant mounds with insecticides.
- Cover outdoor garbage cans with tight-fitting lids.
- Remove all sources of standing water (where mosquitoes like to breed).
- Make outside dining as bug-free as possible
- Keep foods covered.
- Avoid eating sweets outside.
- When drinking beverages outside, be careful of what can fly into your cup. Wide, open cups may be your best option because you can readily see what’s in them.
- Be careful when outdoors:
- Use caution around areas where insects nest, such as walls, bushes, trees, stagnant water, gardens, open garbage cans, undisturbed piles of wood, under-porch areas, and seldom-opened containers.
- Stay away from areas where mosquitoes breed, such as areas around still water.
- Stay inside at dawn and dusk when mosquitoes are most active.
- Do not disturb bee or wasp nests.
- Never swat at a flying insect. They will try to attack and bite or sting if you swat them.
What are the most common insect bites and stings and what are the symptoms they cause?
|Insect or arachnid||Where we encounter them||Symptoms of bite or sting|
|Mosquitoes||Near water /attracted by bright colors and sweat||Bites cause stinging sensation followed by a small, red, itchy mound. In young children, the bite can become large and even cause a bruise.|
|Biting flies||Found near food, garbage, animal waste, woods (deerflies), and marshy areas (greenheads)||Bites cause painful, itchy bumps that can turn into small blisters. Symptoms usually resolve within 1-2 days.|
|Bedbugs||In walls, floors, bed frames, and crevices of furniture||Bites cause itchy red bumps, often 2-3 in a line, and often occur at night. They are less active in cold weather.|
|Fire ants||Underground; dirt mounds give away their presence||Bites cause immediate pain, burning, and are very itchy. Swelling can be significant and a cloudy fluid bubble often occurs centrally.|
|Fleas||On the floor, in rugs / most likely to be problematic in homes with pets||Bites usually occur in clusters or lines, often where clothes fit tightly (waist, buttocks, or ankles).|
|Bees / wasps / yellow jackets / hornets||Found near flowers, shrubs, picnic areas or beaches / attracted by food, especially sweets||Stings cause immediate pain and rapid swelling. Anaphylaxis can ensue, if previously stung (see above).|
|Ticks||In wooded areas||Ticks attach themselves to the skin and feed on blood. After they are removed, the bite area can become red and itchy. See “What you need to know about Lyme disease” on this website.|