Illnesses & Symptoms
Bug bites and stings treatment
Bug bites and stings are very common in children, especially during the spring and summer months. Prevention is the best treatment, see Bug Safety for full prevention details.
Symptoms can vary from mild swelling, pain, itchiness and redness to large blisters or life threatening anaphylactic reactions.Reactions that stay localized to the site of the bite or sting are usually not serious, even if they are larger than usual or bumpy in texture. Scalp bites tend to become very crusted, and often are misdiagnosed as impetigo.
More Serious Reactions (not all necessarily requiring medical attention):
- Certain body parts (ears, eyes, genitals) tend to have more severe swelling. If symptoms are not relieved by oral antihistamine, topical hydrocortisone, and other treatments as below, an office visit is indicated. If swelling surrounds the entire finger, penis, arm, or leg, it can compromise blood flow, and medical attention should be sought.
- Papular urticaria is a delayed hypersensitivity type reaction to many bites and stings. Children, usually between the ages of 2 and 7 years, with this condition will commonly develop multiple small, red itchy bumps in clusters on the upper arms, shoulders and other exposed areas. New crops of bumps commonly appear and each last about 2-10 days.
- Anaphylaxis is the most serious reaction to insect bites, most commonly from bees and wasps. Symptoms can include trouble swallowing, throat and chest tightness, low blood pressure (hypotension), sweating, dizziness, weakness, itching, hives, wheezing and difficulty breathing. These symptoms usually develop fairly quickly and usually within 30 minutes of being stung. You should seek immediate medical attention (call 911) if your child has these symptoms following an insect bite or sting. If epinephrine is available, it should be used. Always call 911 in this situation, whether or not epinephrine is used and regardless of its response (people can seem 100% better, but symptoms often return quickly).
Types of Bites:
Mosquito bites commonly cause itchy red bumps, which can vary in size from being very small to about an inch. They usually also have a central raised area.
Spider bites rarely cause serious reactions in children. Only two spiders in the United States, the black widow spider and the brown recluse spider, usually cause poisoning. These spiders can be readily identified by their characteristic markings, including the red or orange hour glass shape on the abdomen of the black widow spider and the violin shaped markings on the back of the brown recluse. These bites are usually painless or cause mild irritation. More serious reactions usually occur quickly and within 3-12 hours and can include muscle pain, sweating, nausea, vomiting, headache and high blood pressure.
Bees, wasps, yellow jackets, and hornets
Bees, wasps, yellow jackets, and hornets usually cause painful red bumps. Honey bees have a barbed stinger and usually leave it behind at the site of the sting. The stinger will usually appear as a black dot inside the bite if it has been left behind. Proper removal of this stinger following a honey bee sting can help prevent worsening symptoms.Do NOT pull the stinger out with tweezers or pinch it out with your fingers, since this can inject more venom and cause a worsening reaction. Instead, use a credit card or dull blade to scrape it out. More serious local reactions can cause swelling of an entire limb.
Chiggers are found in grasses and bushes. Chigger bites usually occur on the legs and along the belt line and can appear as small red bumps and are extremely itchy but typically small.
Tick bites are painless and usually don't itch. See our page on on bug safety by clicking here
Fire ants (found in the Southern US and elsewhere, but not in the KC area) are notorious for causing severe local reactions, including pustules or pimples and red, swollen, and extremely itchy areas, which may turn into blisters. They often bite multiple times, most commonly on the feet and legs. A large number of bites, more than 10-20, in a young infant can lead to serious reactions and may require medical attention.
Bedbugs also usually cause painless bites, which then become itchy. Since they usually only come out to feed at night, and they feed infrequently (often just weekly), they can be hard to detect.
Flea bites also commonly affect children, causing multiple, grouped red bumps with a central area of crusting.
Oak mites are 8 legged microscopic creatures. They blow from oak trees and land on people. They bite when they land and leave very itchy red bumps. The bumps can last for 1-2 weeks. Insect repellents do not help prevent these bites because the mites are literally blown onto people, the cannot be repelled.
- Choose from the following whatever relieves symptoms best in each child:
- Wash the area with soap and water (always!)
- Apply an ice pack or cool compress
- Apply a meat tenderizer solution, which can be made by mixing one part meat tenderizer and 4 parts of water. This is especially helpful for painful stings from bee, wasp or ant. For best effect, soak a cotton ball in the meat tenderizer solution and use it to rub the area of the bite for 15-20 minutes. Apply a baking soda paste
- Apply topical ammonia (After Bite) Apply a topical steroid (hydrocortisone) or other topical anti-itch cream, such as Calamine lotion, to the area. Do not use topical antihistamines, such as Benadryl cream
- Oral antihistamine for itching, such as diphenhydramine (Benadryl), cetirizine (Zrytec), or loratidine (Claritin), can help prevent more severe reactions if used before the rash starts, and can help control the itching for the duration of the rash.
- Use the weight/age recommended dose.
- Severe reactions (anaphylaxis, severe swelling) may sometimes require a short course of an oral steroid, but require medical attention and prescription.
- Symptoms of infection may include fever, red streaks from the site, pus, and / or pain. Antibiotics may be needed if the bite becomes infected and an office visit and prescription are required.
- If your son has a very swollen penis or scrotum from bug bites, see Summer Penile Syndrome.