• Insect Bites and Stings


    Insect bites and stings may be caused by a variety of bugs. You may or may not know what bit you. A bite or sting may go unnoticed or can cause irritating skin reactions. Most bites and stings can be safely treated at home.
    For some people, insect bites or stings can cause severe allergic reactions. These reactions will require prompt medical attention. If you think that you are having a severe allergic reaction, call for emergency medical services right away.


    Insect bites and stings are caused by:
    • Biting insects (such as mosquitoes, fleas, and ticks)
    • Stinging insects (such as bees, yellow jackets, hornets, wasps, and fire ants)
    Mosquito Bite
    Mosquito bite
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    Risk Factors

    Your chance of being bitten or stung by an insect is increased if you:
    • Work or spend a lot of time outdoors
    • Live in warmer climates
    • Fail to use proper protection
    • Forget to use flea and tick preventive measures for pets
    • Collect insects as a hobby


    Most insect bites and stings will cause a reaction in the skin around the bite. The most common symptoms include:
    • Mild swelling
    • Redness
    • Pain
    • Heat
    • Itching
    Symptoms of a severe allergic reaction include:
    • Shortness of breath
    • Wheezing
    • Swelling, redness, or hives covering most of your body
    • A feeling that your throat is closing up
    • Nausea or vomiting
    • Chills, muscle aches, or cramps
    • Weakness
    • Fever
    • Abdominal pain
    • Headache sweating
    If you have or suspect a severe allergic reaction, call for emergency medical services right away.


    Not all insect bites or stings require medical attention.
    If you have had a severe reaction, your doctor will ask about your symptoms and medical history. A physical exam will be done. You will be asked about the type of insect that bit or stung you. If possible, try to obtain a sample of the insect.
    Your doctor will use this information to understand what is causing your symptoms and how to treat them.


    Home Care

    Most insect bites and stings can be safely treated at home. If you know you already have a tick allergy, do not remove the tick. Instead, seek medical attention. Removing the tick may cause it to inject more allergen-containing saliva.
    After a bite or sting, consider the following steps:
    • Wash the affected area with soap and water.
    • Place an ice pack or cold compress on the affected area. Use the ice for about 15 minutes every few hours. Do not place the ice directly on the skins
    • To help relieve itching consider:
      • Use calamine lotion
      • Antihistamines
      • Topical steroid cream, such as hydrocortisone
    • Acetaminophen or ibuprofen can be used to reduce pain or swelling.
    Sometimes the insect or part of the insect may be left behind in the skin. Removing them will help the area heal and avoid further irritation or infection.
    • To remove a stinger—Use a sharp edge, such as a credit card. Gently scrape the edge over the site to push the stinger out.
    • To remove a tick—Use tweezers to grasp the tick by the head. Pull the tick gently but firmly up and away from the skin. Hold the tick just above the skin until it releases its bite.
      • Ticks can carry infections like Lyme disease or Rocky Mountain spotted fever . The sooner you remove the tick the smaller the chance of infection.
      • Note: If the tick's mouth breaks off in the skin, generally, it can be left there. The mouth will be pushed out during normal skin growth.

    Medical Attention

    Medical help is needed for severe allergic reactions. Once you arrive at the hospital, treatment may include:
    Medical help is needed for severe allergic reactions. Once you arrive at the hospital, treatment may include:
    • Emergency treatment to stabilize life-threatening symptoms
    • Medications to reduce swelling and other allergic reactions
    • IV fluids


    To help reduce your chances of insect bites and stings:
    While outdoors, in areas with insects:
    • Use insect repellents. These work against biting insects like mosquitoes.
    • Reduce the amount of exposed skin. Wear long sleeve shirts and pants when possible.
    • Avoid sweet-smelling perfumes, deodorants, lotions, hair sprays, and colognes.
    • Avoid wearing bright colors.
    • Wear gloves when gardening.
    Avoid areas or times when insects are most active:
    • Stay inside at dawn and dusk. Mosquitoes are most active during these times.
    • Stay away from areas where mosquitoes breed, such as areas around still water.
    • Use caution around areas where insects nest. Areas include walls, bushes, trees, and open garbage cans.
    • Be cautious in areas where spiders might be hiding. Areas include undisturbed piles of wood, seldom-opened containers, or corners behind furniture.
    • Do not disturb bee or wasp nests.
    Control pests around your home:
    • Keep foods covered as much as possible when eating outdoors.
    • Cover outdoor garbage cans with tight-fitting lids.
    • Remove any areas of still water from around your house. This may include turning over lids or pots around your yard that have collected rainwater.
    • Use flea and tick control for pets. Regularly treat your home for fleas during warmer months.
    • Treat fire ant mounds with insecticides.


    American College of Allergy, Asthma, & Immunology http://www.acaai.org

    National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov


    Allergy Asthma Information Association http://www.aaia.ca

    Canadian Centre for Occupational Health and Safety http://www.ccohs.ca


    Bites and stings. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T181055/Bites-and-stings. Updated August 6, 2014. Accessed November 7, 2016.

    Bug bites and stings. Nemours Kid's Health website. Available at: http://www.kidshealth.org/teen/safety/first%5Faid/bug%5Fbites.html. Updated February 2014. Accessed November 11, 2015.

    Clark S, Camargo CA Jr. Emergency treatment and prevention of insect-sting anaphylaxis. Curr Opin Allergy Clin Immunol. 2006;6(4):279-283.

    Foex BA, Lee C. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Oral antihistamines for insect bites. Emergency Med J. 2006:23(9):721-722.

    Goldman L, Ausiello D, eds. Cecil Textbook of Internal Medicine. 23rd ed. Philadelphia, PA: Saunders; 2008.

    Graft DF. Insect sting allergy. Med Clin North Am. 2006;90:211-232.

    Hymenoptera sting allergy. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114226/Hymenoptera-sting-allergy#anc-462114242. Updated November 1, 2016. Accessed November 7, 2016.

    Lewis FS, Smith LJ. What’s eating you? Bees, part 1: Characteristics, reactions, and management. Cutis. 2007:79(6):439-444.

    Lewis FS, Smith LJ. What’s eating you? Bees. Part 2: Venom immunotherapy and mastocytosis. Cutis. 2007:80(1):33-37.

    Marx JA, et al. Rosen's Emergency Medicine.7th ed. St. Louis, MO: Mosby, Inc.; 2009.

    11/7/2016 EBSCO DynaMed Plus Systematic Literature Surveillance Update http://www.dynamed.com/topics/dmp~AN~T181055/Bites-and-stings: Australian and New Zealand Committee on Resuscitation. ANZCOR Guideline 9.4.3—Envenomation from tick bites and bee, wasp, and ant stings. 2016 Jan. Available at: http://anzcor.org/assets/Guidelines/First-Aid/ANZCOR-Guideline-9-4-3-Ticks-Bites-Stings-Jan16.pdf. Accessed November 7, 2016.

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