By Dr Ananya Mandal, MD
Insect bites usually cause mild irritations and can be managed safely at home. The bites and stings lead to small localized reactions that remain confined to the area around the bite or sting. However, large localized reactions or generalized allergic reactions need to be seen and treated by physicians. 1-5
The first step is to move to a safer area to avoid more stings or bites.
Removal of an insect sting
When visible a bee or wasp sting may be removed carefully. Bees usually leave the sting behind but a wasp or hornet may not leave the sting behind and may sting again. If attacked by a wasp or hornet one should walk away calmly to avoid being stung again.
Care should be taken not to rupture the venom sac within the sting that results in spread of the venom and severe pain and allergic reaction. The sting can be removed by scraping it out with long finger nails or with a hard edged card.
The sting should not be squeezed of held with tweezers as it may rupture the venom sac and release the venom into the skin. If a child has been stung, an adult should remove the sting.
Basic home measures to treat insect bites and stings
Minor bites and stings with localized reactions may be treated with basic home measures. The local area should be washed with soap and water to remove the allergenic saliva. Thereafter a cold compress may be placed over the area to ease the pain and swelling.
The bitten child or person is advised not to scratch as this may lead to infections. The fingernails should be kept clean and short and filed to avoid skin injury.
Avoiding infections from insect bites
Blisters and bullae should not be burst as these may develop infections and open sores. An adhesive bandage or plaster may be used to protect the area.
Treating infected insect bites
If the bites are infected antibiotics may be prescribed. Severe infections may need antibiotic pills prescribed by a doctor.
Relieving pain caused by insect bites
For painful stings an ice pack may be applied. Pain relievers like Paracetamol, Ibuprofen etc. may be taken for the pain and inflammation. Some over the counter sprays or creams with antihistaminics (reduce the allergic reaction), local anesthetic (numbs the area) or steroid (hydrocortisone 1% for inflammation) may be used to prevent itching and swelling.
Crotamiton ointment (available at pharmacies), calamine lotion, or a baking soda paste are soothing as well. Antihistaminic or allergy reducing tablets may be taken to reduce the allergic reactions.
Treatment for a large localized reaction
Those with a large localized reaction may require a prescription of a short course of steroids like prednisolone pills to be taken for three to five days. Those with severe generalized reactions like anaphylaxis may need adrenaline injections, oxygen and fluids.
Treatment for severe allergic reactions
Those with a severe allergic reaction that extends with a redness and swelling of over 10cm (4 inches) in diameter may need evaluation at an allergy clinic. These patients may be advised Immunotherapy (desensitisation or hyposensitisation) to reduce their risks of developing an allergy to the sting.
The tick usually clings to the skin. Ticks are removed using tweezers after wearing gloves to avoid exposure of the fingers to the tick. The tick should be removed as a whole and while removing care should be taken not to break it off so as to leave behind the mouthparts of the tick within the skin.
If this does not work petroleum jelly, alcohol or a lit match may be used to remove the tick.
After removal hands should be washed with soap and water and the area should be washed with soap and water or an antiseptic. Those with a rash or fever may have acquired Lyme disease that are carried by ticks and may need evaluation and treatment.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)
Last Updated: Sep 11, 2012