Quit Bugging Me!
How to prevent and treat bites and stings
By Katherine Reeves, Pharm. D and Tara Storjohann, Pharm D., BCGP, FASCP
Summer is here! This means hot weather, days at the pool and, unfortunately, more of those annoying (and painful!) bug bites and stings. Often, these can be treated with over-the-counter medications. However, in other cases, it may be more appropriate to seek medical attention. So, do you know what to do if you, your child or a friend is stung? Keep reading to find out!
Perhaps one of the most common insect bites during the summer months are mosquito bites. The best way to deal with these pesky insects is to prevent them from biting in the first place. Avoiding mosquito bites is also key at preventing mosquito-borne diseases such as the Zika, West Nile and Chikungunya viruses, dengue fever and malaria. One way to prevent these bites is to avoid outdoor activities from dusk until dawn, because this is the time mosquitos are most active.
Insect repellents are also helpful when it comes to preventing these bites. It is important to confirm that the repellent you choose to use has at least one of the following ingredients: DEET, icaridin or oil of lemon eucalyptus. Make sure to apply the repellent outdoors and away from food. If you are also wearing sunscreen, apply the repellent first, about 20 minutes prior to sunscreen application.
Despite our best efforts, mosquitoes sometimes seem to persevere. Fortunately, most of the time these bites are simply uncomfortable, and you will want a treatment option to help subside the annoying urge to itch. Treatment options may include calamine lotion or over-the-counter hydrocortisone cream, a cool compress and/or an oral antihistamine, such as diphenhydramine (Benadryl).
Systemic allergic reactions to mosquito bites are possible, although uncommon. Hives, shortness of breath, fever or necrotic skin at the bite site are symptoms of a systemic allergic reaction. In the case that any of these occur, emergency medical help should be contacted immediately.
Most spider bites are harmless. Cleaning the bite wound with soap and water and applying a topical over-the counter antibiotic, like bacitracin/neomycin/polymyxin B ointment (Neosporin) is usually sufficient treatment. Applying a cool compress to the bite, and elevating the site itself, may help to reduce swelling and inflammation. If the wound is especially painful, an over-the-counter pain reliever such as ibuprofen (Advil), naproxen (Aleve) or acetaminophen (Tylenol) may be beneficial. Patients who believe to have been bitten by a brown recluse spider or black widow spider should seek emergency medical care immediately due to the possibility of life-threatening effects.
It may be difficult to determine if the culprit was a spider or a mosquito because the wound they leave behind often looks very similar. Mosquito and spider bites usually manifest as small red, mounds. However, mosquito bites have one tiny puncture mark at the center, whereas spider bites have two puncture marks due to their fangs. Another way to determine who the perpetrator was is to evaluate symptoms. Mosquito bites are usually itchier in general, where spider bites are typically more painful and associated with more swelling.
When it comes to tick bites, the main treatment is to remove the tick promptly. To do this, use clean, fine-tipped tweezers to grasp the tick as close to your skin as possible. Gently pull out the tick, using a steady, upward motion. The goal is to remove the entire tick, without leaving the mouth parts (yuck!). Upon removing, if the mouth parts are still left in the skin, remove with clean tweezers. If this isn’t possible, simply allow the skin to heal. Wash your hands and bite site itself with rubbing alcohol or warm, soapy water.
Bee stings are often painful and may cause a minor or moderate reaction. In the case of a sting, the stinger should be removed immediately with clean tweezers or forceps. The area should be washed with warm, soapy water and a cool compress should be applied to help with inflammation. Over-the-counter medications such as ibuprofen, naproxen or acetaminophen may be used for pain relief. Calamine lotion or over the counter hydrocortisone cream may also help with irritation and pain and can be used in conjunction with an oral pain reliever. Scratching the area should be avoided to prevent further swelling or irritation.
When to seek help:
Any insect bite or sting has the potential to elicit a systemic allergic reaction. Signs that someone may be experiencing a severe allergic reaction include hives, swelling of skin away from the area that was stung, nausea, vomiting or diarrhea, shortness of breath, difficulty breathing, lightheadedness or dizziness. In these cases, call 9-1-1 immediately.
Most bug bites or stings are self-limiting and over-the-counter treatments are usually sufficient for symptomatic relief. However, it is important to recognize when to seek medical attention in order to protect yourself and loved ones. Your friendly neighborhood pharmacist is always there as well to help as well answer any questions you have. So, enjoy that popsicle with your kids at the pool, because hopefully now you are more prepared to handle any bug bite or sting that comes your way!