Introduction:
Insect bites or stings can be from a number of insects including bees, spiders, fleas, hornets, wasps, and mosquitoes. Some cause itching; others cause pain. The itching and pain occur because the insect has injected venom or another irritating substance into your skin, which causes an allergic reaction. In most cases, this reaction is bothersome but not dangerous. However, a severe reaction can cause anaphylaxis, resulting in shortness of breath and tightening of your throat. Anaphylaxis can be fatal, even on the first reaction. Severe reactions can affect the whole body and may occur in minutes. This is a medical emergency and you should call 911. Another type of allergic reaction is called angioedema, which involves swelling throughout your body, especially the face, lips, and around the eyes. More people have allergic reactions to stinging insects than to biting insects.

Signs and Symptoms:
* Red, swollen, warm lump
* Hives
* Itching, tenderness, pain
* Sores from scratching; can become infected
* Serious allergic reactions (called anaphylaxis) when symptoms spread. These can include difficulty breathing, dizziness, nausea, fever, muscle spasms, or loss of consciousness. Call for emergency medical help right away.

Causes:
Stinging insects include bumblebees, yellow jackets, hornets, wasps, and fire and harvester ants. Biting insects include conenose bugs, mosquitoes, horseflies, deerflies, spiders, ticks, bedbugs, and black flies.

Prevention
* Try not to provoke insects. For example, avoid rapid, jerky movements around insect hives or nests.
* Avoid perfumes, lotions, and scented soaps.
* Avoid areas where you know insects are.
* Use insect repellants and protective clothing. (See more details below.)
* Be careful when eating outdoors, especially with sweet drinks (such as sodas) or in areas near garbage cans.
* Make sure you have screens on all windows.
* To keep mosquito eggs from hatching, remove any standing water.
* Mosquitoes are most active at dawn and dusk, so avoid being outside during those times.
* Use citronella, linalool, and geraniol candles. In one study, citronella candles reduced the number of female mosquitoes cuaght in traps by 35%; linalool candles reduced female mosquitoes by 65%; and geraniol candles reduced female mosquitoes by 82%.

If you know that you have a serious allergy to an insect, carry an emergency epinephrine kit. Your doctor can prescribe one. Make sure that friends and family members know how to use an Epi-pen if you have had a reaction in the past. Wear a medical ID bracelet. For those with allergies, venom immunotherapy is up to 98% effective in preventing sting anaphylaxis.

If you are traveling to an area where malaria is common, ask your doctor about a malaria vaccine.

You can prevent insect bites and stings with proper clothing:

* Cover your head. Wear a full brimmed hat to help shield your neck as well.
* Wear long-sleeved shirts and long pants.
* Tuck pant cuffs into socks. This helps protect your ankles -- a common spot for bites or stings.
* Check your clothes and hair periodically for bugs.
* Use protective netting when sleeping or eating outdoors.

Applying insect repellent to your clothes instead of your skin can help prevent any skin irritation. When in an area infested with mosquitoes, sand flies, or ticks, use a chemical insect repellent such as DEET. DEET has been the most effective and broadly used insect repellent for the past 6 decades. Don't apply insect repellent to sunburned skin. When applying both sunscreen and bug repellent, apply the sunscreen first. Wait 30 minutes before applying the bug repellent.

Don't use bug repellent on children's hands because they may rub their eyes or put their hands in their mouths.

Treatment Approach:
In most cases, bites and stings can be easily treated at home. However, don't try to treat a suspicious bite on your own; when in doubt, call your doctor. In the case of a severe allergic reaction such as anaphylaxis, you must seek emergency medical help. Do not try to treat anaphylaxis with complementary therapies alone. If such an emergency occurs:

* Check the person's airway, breathing, and pulse. If necessary begin CPR and call 911.
* Use the person's epinephrine pen or other emergency kit if they have one. (Anyone who has had a serious allergic reaction to an insect sting should carry an Epi-pen or its equivalent at all times.)
* Try to keep the person calm.
* Remove any rings and other constricting items in case of swelling.
* Stay with the person until medical help arrives.


 

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