How to Treat a Bug Bite or Sting

Treating a bug bite or sting will usually relieve symptoms of pain, itching, swelling, and minor irritation. The first step is to better understand the type of insects common to North America and what effects you might encounter. Then you'll have a better sense of the over-the-counter (OTC) products that can help.

You'll also have a better sense of insect bites or stings that require medical care because they may be serious or even life-threatening. Talk to your healthcare provider if you have questions about bug bite symptoms or stings, complications like infection, and the treatment you may need.

Identify the Insect

Insects, spiders, and scorpions are capable of causing painful reactions and other symptoms. It's helpful to know what did the biting or stinging and the risks involved:

• Mosquito bites can expose you to serious diseases like West Nile virus or Zika. Mosquitoes are usually found near standing water.
• Tick bites can expose you to Rocky Mountain spotted fever or Lyme disease. They are usually found in wooded areas.
• Lice, which cause symptoms of itching and often affect children
• Flea bites often occur in clusters and you can often pick them up when around pets.
• Bedbugs give itchy red bumps that are usually in a pattern of two to three in a row and occur at night.
• Spider bites, and especially, scorpion stings can be more worrisome, even potentially deadly.

The reality, however, is that most bites are from unidentified bugs. In the worst-case scenario, they can be immediately dangerous because of the possibility of anaphylaxis.

Ease the Pain

Once you've removed yourself from the source or setting of the bite, there are some basic steps you can take to ease the pain, itching, burning, or swelling from a bug bite or sting:

• If you've been stung, remove the stinger if it is still in your skin.
• Apply an ice pack or cold compress to the site of the sting. Alternate on and off to prevent tissue damage and don't place the ice directly on the skin (for example, 20 minutes on and then off).
• For pain relief, try topical treatments like sting swabs, calamine lotion, hydrocortisone lotion, or lidocaine preparations. Tylenol (acetaminophen) and Advil (ibuprofen) are good OTC options.
• You may want to use an antihistamine such as Benadryl (diphenhydramine) if you have swelling.

Keep an eye out for signs of illness over the first few days following a bug bite. Talk with your healthcare provider if you experience fever, jaundice (skin or eyes turning yellow), excessive sweating, or signs of infection such as pus oozing from the site of the bite.

Watch for Complications

The most serious concern is a bite that triggers an extreme reaction in a sensitive person, known as anaphylaxis. While the bite or sting is uncomfortable for most people, it can set off a life-threatening response with swelling, problems breathing, and heart rate changes. Without immediate treatment, there is a risk of death.

If you see or feel any of those symptoms, call 911 immediately. If the person who was bitten has a history of severe allergy and carries epinephrine, those signs and symptoms tell you that it's time to use the epinephrine. Call 911 first, then use the EpiPen (or whichever brand the person is carrying).

Other complications to watch for include:

• Black widow spider: These spider bites can cause muscle spasms. These bites also can cause nausea, vomiting, headache, heart rate changes, and sweating. Urgent care is required and hospitalization may be needed.
• Brown recluse spider: Most of these bites resolve on their own, but they can lead to tissue death (necrosis) in about 10% of cases. These wounds can take longer to heal and lead to scarring that can sometimes require surgical care. Antibiotics may be prescribed if an infection occurs.
• Scorpion stings: A scorpion sting can result in muscle spasms, nerve dysfunction affecting the eyes, severe swelling and high blood pressure, and ultimately organ failure.
• Wasps and hornets: These painful stings can become life-threatening if multiple bites occur in swarms. They can lead to kidney failure, heart attack, seizures, and other complications.

Cellulitis can follow a bug bite when bacterial infection occurs, typically group A Streptococcus or Staphylococcus aureus. Symptoms can affect the wound site but also lead to swollen lymph nodes and more systemic effects, like fatigue and fever. Impetigo (a contagious skin infection) also can occur.

Keep in mind that rare conditions also can follow an insect bite. Fleas can carry typhus and plague, and deer flies can carry anthrax in North America.

Summary

Mosquito bites and bee stings are common insect-related wounds that typically heal on their own and rarely cause symptoms beyond pain at the wound site, itching, or minor swelling. You can keep the wound clean to avoid infection, and use an OTC product like a pain reliever or calamine lotion to stop itching.

Some insects have more toxic and potentially life-threatening impacts, and severe allergic reactions can occur even with a basic bee sting. Call 911 if your symptoms require immediate care, and talk with your healthcare provider if you have concerns about symptoms that don't go away or suggest an infection.