Bug Bite Treatment

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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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I hate bugs, especially the ones that "bite." For me, I lump all stinging and biting creatures into this bug category, so I choose to use the general definition of "bugs" to include all insects and insect-like invertebrates that bite or sting. Some people are more susceptible to bug bites than others. I am one of those unlucky people that mosquito populations must have a personal vendetta against. Consequently, I have had some experience with bug bites.

In general, most bug bites are simply an annoyance. Common symptoms of benign bug bites include:

• redness,
• mild burning,
• localized and minor swelling or pain, and
• itching.

Most bug bite symptoms last for about a day or so, and then slowly resolve.

Bites from the more benign category include:

• most mosquitos;
• bed bugs;
• many ticks;
• some biting flies and ants;
• fleas;
• chiggers;
• lice;
• mites (for example, scabies, dust mites, and chiggers); and
• some non-poisonous spiders.

Bites or stings from bees, hornets, fire ants, wasps, yellow jackets , some spiders (brown recluse and black widow, most notably) and scorpions produce symptoms that can range from mild to severe.

With some "bugs" (for example, mosquitos, ticks, flies, and "kissing bugs") the bites themselves are not the problem, but the infectious agents that are transmitted by the bite (for example, bacteria, viruses, and parasites) that cause diseases are the real problem. There are specific articles on these diseases and infectious agents; however, in this article, I will briefly discuss the treatment of common "bug bites," and what to be aware of in case the bite or sting causes more than the common irritating symptoms listed above. Because of their smaller body mass and developing immune system, children may have more intense reactions to bug bites than adults.

The best way to "treat" bug bites is to avoid being bitten. The CDC has published guidelines on how to avoid bug bites and stings. Essentially, the CDC recommends that individuals dress in long pants and wear shirts with sleeves, use insect repellent appropriately, and avoid areas where "bugs" live (for example, high grass, old wood piles, dark and damp areas). The reality is that during the spring and summer months, most people will not follow these guidelines, and even if they do, some people (like me) will still get bites or stings.

If you (or a child) has been bitten or stung, the first line of treatment is to:

• quickly check to see what caused the sting or bite such as a mosquito, ant, or bee; and
• get away from the situation to avoid further bites or stings.

Next steps include

• If a stinger is lodged in the skin, remove it by pulling, brushing or scraping it out of the skin. Tweezers, credit cards, tape, and fine brushes can be used because the stingers are usually not embedded deep in the skin.
• Wash the sting or bite area with mild soap and water.
• If possible, without endangering anyone, capturing and/or killing the "bug" may be useful in identifying the "bug".

Reducing swelling and pain

I have used the following methods to treat myself and others, including children, with success.

• Immediate treatment that may reduce swelling and pain consists of ice packs wrapped in a towel applied to the site of the bite or sting (frozen peas or corn can be used instead of ice as it will conform to the injured area).
• Use acetaminophen or ibuprofen containing over-the-counter medications to reduce the pain. Avoid aspirin use in children due to the risk of Reye's syndrome.
• A paste or watery mixture of baking soda applied topically may help reduce itching; calamine lotion or creams containing hydrocortisone or agents like lidocaine will also reduce itching and pain.
• Over-the-counter medication containing diphenhydramine (Benadryl) can be taken orally to reduce itching.