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Shine Magazine

Insect bites

Main symptoms:

Itchy insect bites: Bites of mosquitoes, chiggers (harvest mites), fleas, and bedbugs usually cause itchy, red bumps.
Painful insect bites: Bites of horseflies, deer flies, gnats, fire ants, harvester ants, blister beetles, and centipedes usually cause a painful, red bump. Within a few hours, fire ant bites can change to blisters or pimples.
A severe life-threatening allergic reaction is called anaphylaxis.
See also bee or yellow jacket stings, tick bites, spider bites, fire ant bites

Call 911 now if:

There are symptoms of anaphylaxis (your child may need an ambulance.)
Symptoms of anaphylaxis include difficulty breathing or wheezing; hoarseness or cough with rapid onset; difficulty swallowing or slurred speech with rapid onset.
Previous severe allergic reaction to same insect bite.
Note: Anaphylaxis can occur with bee, yellow jacket, wasp, or fire ant stings but rarely with other insects.Onset usually occurs within 20 minutes.

First aid advice for anaphylaxis:

Give epinephrine injection if you have an anaphylactic kit.
Inject it into the muscle of the upper outer thigh.

Call your doctor now if:

Your child looks or acts very sick
Hives or swelling elsewhere on the body
More than 20 fire ant stings in a child less than 1 year old

Call your doctor during regular office hours if:

You think your child needs to be seen
Severe pain is not improved after two hours of pain medicine
New redness or red streak occurs around the bite after the first 24 hours
Scab that looks infected (drains pus or increases in size) not improved after applying antibiotic ointment for two days

Call your doctor during weekday office hours if:

You have other questions or concerns.
Scab that looks infected (drains pus or increases in size) not improved after applying antibiotic ointment for 2 days.

Parent care at home if:

Normal insect bite and you don't think your child needs to be seen

Home care advice for insect bites:

1. Itchy insect bites (including all mosquito bites): Apply calamine lotion or a baking soda paste. If the itch is severe, use a non-prescription 1percent hydrocortisone cream. Apply four times a day until the itch is less severe, then switch to calamine lotion. Also apply firm, sharp, direct, steady pressure to the bite for 10 seconds. A fingernail, pen cap, or other object can be used. If the bite is very itchy after local treatment, try an oral antihistamine (e.g. Benadryl). Sometimes it helps, especially in allergic children.

2. Painful insect bites: Rub the bite for 15 to 20 minutes with a cotton ball soaked in a meat tenderizer solution. This will usually relieve the pain. (Caution: don't use near the eye) If not available, use a baking soda solution on a cotton ball. If neither is available, apply an ice cube for 20 minutes. Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief. Antihistamines don't help.

3. Antibiotic ointment: If the insect bite has a scab on it and the scab looks infected, apply an antibiotic ointment 4 times per day. Cover the scab with a Band-Aid to prevent scratching and spread. Repeat washing the sore, the antibiotic ointment and the Band-Aid four times per day until healed. Caution: For spreading infections (redness or red streaks), your child needs to be seen by a health care professional.

4. Expected course: Most insect bites itch or hurt for one to two days. The swelling may last a week.

Call your doctor if:

Severe pain persists for more than two hours after pain medicine

Infected scab doesn't clear after 48 hours of antibiotic ointment.
Bite looks infected (redness, red streaks, increased tenderness)
Your child becomes worse or develops any of the "Call Your Doctor" symptoms.