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Insect Bites and Stings

Definition

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, get medical help immediately.

Causes

Insect bites and stings are caused by:
Mosquito Bite
Mosquito bite
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Risk Factors

Your chance of being bitten or stung by an insect is increased if you:

Symptoms

Most insect bites and stings will cause a reaction in the skin around the bite. The most common symptoms include:
Symptoms of a severe allergic reaction include:
If you have or suspect a severe allergic reaction, call for emergency medical services right away.

Diagnosis

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.

Treatment

Home Care

Most insect bites and stings can be safely treated at home. 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
  • To reduce swelling or pain, consider acetaminophen or ibuprofen.
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, it can be left there. It does not pose an infection risk. 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:

Prevention

To help reduce your chances of insect bites and stings:
While outdoors, in areas with insects:
Avoid areas or times when insects are most active:
Control pests around your home:

RESOURCES

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

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

CANADIAN RESOURCES

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

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

References

Bites and stings. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 16, 2012. Accessed September 27, 2012.

Bug bites and stings. Nemours Kid's Health website. Available at: http://www.kidshealth.org/teen/safety/first%5Faid/bug%5Fbites.html. Accessed September 27, 2012.

Bug bites and stings. Nemours Kid's Health website. Available at: http://kidshealth.org/PageManager.jsp?dn=KidsHealth&lic=1&ps=107&cat%5Fid=20812&article%5Fset=22987. Accessed September 25, 2012.

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

Foex BA, Lee C: Oral antihistamines for insect bites. Emergency Med J. 2006:23:721-722.

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;90:211-32.

Lewis FS, Smith LJ: What’s eating you? Bees, part 1: Characteristics, reactions, and management. Cutis. 2007:78:439-444

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

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

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