Tips for Preventing and Treating Insect Bites and Stings

Author: Madeline Ellis

Ahhhh.... It's summertime again! It's also BUG time! That's right, those pesky mosquitoes, ticks, and bees are on the move, and attracted to some people like bears are to honey. Insect bites cannot only be painful, but they can also make us sick. Infected mosquitoes can transmit West Nile virus, and a tick bite can lead to Lyme disease or other diseases, such as Rocky Mountain spotted fever. Even allergic reactions to bees and other stinging insects can be deadly.

There are things you can do to help keep the bugs away, and more importantly, things you need to know about treating those bites should they occur. A consumer update issued by the U.S. Food and Drug Administration, titled ‘Beware of Bug Bites and Stings,' has a myriad of information on the subject, which we have condensed for our readers.

How can you keep those bugs away? First of all, it's best if you don't wear heavily scented soaps and perfumes, and avoid wearing bright colors, which attract bees. Instead, stick with light, neutral colors, which also make it easier to spot ticks. Wear long pants and long-sleeved shirts when possible, and tuck your pant legs into your socks or shoes. Wear a hat for extra protection, and use insect repellent (see proper use below). You should also avoid wooded, brushy, and grassy areas when possible.

When camping, treat your gear, clothes and shoes with permethrin, which repels and kills ticks, mosquitoes and other insects. Pre-treated clothing is also available commercially.

On the home front, make sure to get rid of containers with standing water, such as flower pots and outdoor pet dishes that give mosquitoes a breeding ground. And when eating and drinking outside, be careful not to leave drinks and garbage cans uncovered.

How and when should you use insect repellent? If you find that non-chemical methods are ineffective and you spend time in tall grass and woody areas, it's likely you will need an insect repellent. Always use the repellent according to the labeled instructions, and store it out of children's reach. To ensure that the repellent doesn't pose harmful effects to people and the environment, use one that contains active ingredients that have been registered with the Environmental Protection Agency (EPA). The product should have an EPA registration number on the product label. DO NOT USE insect repellent on babies. Repellent used on older children should contain no more than 10 percent DEET, and oil of eucalyptus products should be not be used in children under 3 years. Also, you should not use insect repellent meant for people on your pets.

Spray the insect repellent on clothes or skin, but NEVER on the face. Avoid applying it to children's hands, around the eyes, or to areas where there are cuts and irritated skin. Be sure to wash skin with soap and water to remove the repellent after returning indoors. And, if you or your child experiences a reaction to insect repellent, wash the repellent off with soap and water and contact a Poison Control Center (1-800-222-1222).

What can you do for pain and itching from bites and stings? Oral over-the-counter antihistamines (such as Benadryl) can bring relief from itching and over-the-counter ibuprofen and acetaminophen (such as Tylenol) can provide relief from the pain. In addition, there are many topical over-the-counter drugs that are applied directly to the skin and can provide itch and pain relief. These drugs are labeled as "external analgesics" or "topical analgesics" and contain ingredients such as hydrocortisone, pramoxine, and lidocaine. There are also topical over-the -counter drugs labeled as "skin protectants" that contain ingredients such as colloidal oatmeal and sodium bicarbonate, which provide itch relief for insect bites and stings. Keep children's nails short so they are less likely to scratch the area and break the skin, leading to a bacterial infection that will require treatment with antibiotics.

How should you remove a bee stinger? Don't use tweezers, because it may push more venom into the skin. Instead, it's best to scrape a stinger away in a side-to-side motion with a straight-edged object like a credit card. After removing the stinger, wash the area with soap and water. You can also apply ice or another cold compress to help reduce swelling.

What about ticks? Early removal of a tick is important because a tick generally has to be on the skin for 36 hours to transmit Lyme disease. Check for ticks as soon as you return from outdoor activities. If you find one, remove it with tweezers. Grasp the tick as close to the skin as possible and pull it straight out. Then drop it in a plastic bag, seal it up and throw it away. After removing the tick, cleanse the area of the tick bite with antiseptic, such as rubbing alcohol, or soap and water. People who want to get a tick tested for disease or other information could check with their local health departments to see if they offer that service.

When do you need medical attention? Most bites and stings are minor and can be treated at home. It is normal for a bite or sting to result in redness of the affected area and minor swelling. But if a bite or sting becomes infected, a fever may develop or the redness or soreness may worsen. In cases of infection, an antibiotic is the typical treatment.

Some people, however, can experience anaphylaxis, a severe and life-threatening allergic reaction. This is a medical emergency that warrants calling 9-1-1 immediately. The signs of an allergic reaction, which may occur within seconds to minutes, include sneezing, wheezing, hives, nausea, vomiting, diarrhea, sudden anxiety, dizziness, difficulty breathing, chest tightness, and itching or swelling of the eyes, lips, or other areas of the face.

If you or your child has ever had an allergic reaction to a sting or bite, you should be evaluated by an allergist. In some cases, you may be advised to wear a medical identification tag that states the allergy, and to carry epinephrine, a medication used to treat serious or life-threatening allergic reactions. Sometimes, allergy shots may also be recommended.

West Nile virus, transmitted by infected mosquitoes, can produce symptoms similar to the flu, including fever, headache, body aches, and skin rash. While most infected individuals have mild cases and recover quickly, infection can be serious or even fatal. There is no specific treatment for West Nile; all you can do is treat the symptoms.

Lyme disease, transmitted by infected ticks, can cause fever, headaches, fatigue, and a skin rash that looks like a circular red patch, or "bull's-eye." Left untreated, infection can spread to the joints, heart, and nervous system. It is rarely, if ever, fatal. Patients treated with antibiotics in the early stages of the infection usually recover rapidly and completely. Antibiotics commonly used for oral treatment include doxycycline, amoxicillin, or cefuroxime axetil (Ceftin). People with certain illnesses related to the heart or the nervous system require intravenous treatment with drugs such as ceftriaxone or penicillin.

The initial symptoms of Rocky Mountain spotted fever, also transmitted by ticks, may include fever, nausea, vomiting, severe headache, muscle pain, and lack of appetite. The characteristic red, spotted rash is usually not seen until the sixth day or later after symptoms begin, but as many as 10 to 15 percent of patients never develop a rash. Rocky Mountain spotted fever is also treated with antibiotics.