Most insect bites are done out of self-defense. Don’t provoke a bug that bites or stings. Honeybees and Wasps and the least likely to sting if unprovoked.

Mosquitoes usually do not give severe illness when they bite, unless they transmit malaria or West Nile virus. Mosquito bites present with a red itchy bump. They often are raised in the center. They can be as large as ½ of an inch.

Fire ant bites produce a pimple-like sore that is painful and itchy. They may turn into a blisters. They bite multiple times, most commonly on the legs and feet.

Bee stings present with redness, itch, pain and swelling. Rarely is there a severe reaction. Honeybees leave the stinger behind that you can tell because there is a black dot in the center of the sting. Removing the stinger will help the symptoms from worsening. Use a credit card to scrape it out – do not pull the stinger or squeeze it.

Bedbug bites are not painful, but become itchy later. They usually bite at night.

Spider bites rarely cause a serious reaction. Two spiders in the United States can cause serious reactions: the brown recluse and the black widow. The black widow has a red/orange hourglass shape on its abdomen. The brown recluse has violin shaped markings on its back. Most bites are only mildly irritating, but serious reactions occur within 3-12 hours. Serious reactions are associated with muscle pain, sweating, headache nausea and vomiting.

Reactions that remain localized to where the bite occurred are rarely serious.

• When there is any difficulty breathing, dizziness, hives, sweating, chest tightness, sensation of the throat closing or wheezing, 911 should be called. This reaction usually occurs within 30 minutes
• Stings in the mouth or on the tongue can cause swelling and compromise breathing.
• Infected bites. Bites that are scratched too often may become infected (redness, heat, fever, a spreading red streak) should be evaluated by a doctor. The initial reaction is often confused for an infection. The initial reaction occurs within 24 hours. If the area becomes infected there is increased redness, streaks and fever noted after the first 24 hours.

Those who are stung on the arm or leg should lower the limb below the level of the heart. This will slow the spread of venom. If there is swelling in the area, the area may be elevated a couple of hours after the sting.

The next step is to wash the area with soap and water.

Ice application to a insect bite that is red and painful should be done after the area is cleaned with soap and water. Ice can be applied every hour for the first 6-8 hours to help reduce pain and swelling. Ice should be left on about 15 minutes. The use of a cool-compress can also be tried to relieve discomfort.

Do not itch wounds as this may lead to infection. A multitude of OTC medications can be used to provide comfort and reduce the drive to itch (see anti-itch medications at the end of the chapter).

• Topical corticosteroids can bring down inflammation and reduce itching
• Topical antihistamines
• Calamine lotion
• First-generation oral antihistamines such as diphenhydramine (Benadryl)

Infected wounds may need antibiotics and will require a visit to the doctor. Increasing pain, redness, swelling, or a thick discharge indicates an infected wound.