For most, summer and the warmer months of spring and fall are a favorite time of year. Unfortunately, it is also a favorite time for insects. Insect stings or bites can put a damper on even the best summer vacation. Mosquitoes, ants, no-see-ums, gnats, flys, bees, wasps and many other insects can not only cause a lot of pain when they bite or sting us but can lead to itching and swelling for hours or up to a day or two. Tick bites are a whole different ball game and will be discussed in a separate article.

Why do they itch so much?

It’s no mystery why the initial bite or sting of an insect can cause sharp pain. Anything that is trying to take a bite out of our skin or plunge a sharp pointed stinger into it is not only the ENEMY, but is going to cause us some sharp pain for a few seconds to a few minutes or longer. Even after the initial sting wears off, we are often plagued with constant itching and scratching in the same area for hours at a minimum. Whether it’s a foreign body like a sting from a bee or saliva from a mosquito’s bite, insects leave some substance behind that causes an immune response from our bodies. This is caused by histamines and other inflammatory pathways associated with an allergic reaction. Most often this reaction remains localized to the site of the sting or bite. Occasionally, our body’s response is so vigorous that it spreads over our entire body in the form of a rash or even sometimes a more severe reaction called anaphylaxis. Anaphylaxis can be life threatening and can result in swelling of the lips, tongue and airway among other potentially serious symptoms. If you experience any symptoms of anaphylaxis you should call 911 immediately.

What to do for a local reaction from an insect bite or sting?

If you have something remaining in your skin such as a stinger from a bee, remove it ASAP. Grab a credit card and use the edge to scrape the surface of the skin. This is the easiest way to get it out of your skin and hopefully minimize the amount of swelling and itching you experience afterwards.

First, put some ice in a bag and apply it to the area. This will decrease the amount of swelling and itching that is expected after the sting or bite. Ice should be applied for up to 20 minutes at a time every 2-3 hours for 24-48 hours as needed. Ice is often under utilized and can result in significant symptom relief.

Second, it is good to remember that topical medications, such as creams, ointments, and liquids can be very helpful. Topical forms of the medication can help you avoid side effects that come with the oral form. Topical Diphenhydramine (Benadryl) and Hydrocortisone cream can be very helpful at reducing your body’s overzealous immune response.

Finally, drugs called NSAID’s like Naproxen (Aleve) or Ibuprofen (Advil, Motrin) can be helpful due to their anti-inflammatory properties. These drugs are most helpful for swelling and pain. However, it’s important to remember that NSAID’s can have interactions with some prescribed medications and should be used with caution if you have kidney disease. If you take medication that is prescribed or have medical problems, you should talk to your medical provider before taking them.

What to do for local reactions to insect bites:

· Apply Ice

· Topical Benadryl

· Topical Hydrocortisone

· NSAID’s (Ibuprofen or naproxen)

The recommendations above should dramatically reduce the swelling and itching associated with almost all insect bites.  Occasionally, the reaction to an insect bite will be much more pronounced and may require the use of prescription medications. If the severity of your symptoms is concerning to you or the symptoms remain for more than 2 days then consider seeking medical attention.

Take care-

Shoreline Health