TL;DR:
Most insect bites and stings are painful or itchy but can be treated at home with simple first aid. Wash the area, use a cold pack to reduce swelling, and watch for signs that the reaction is getting worse. Trouble breathing, swelling of the face or throat, widespread hives, dizziness, or fainting may signal a severe allergic reaction. If that happens, use epinephrine if available and call 911 right away.
Insect bites and stings are common, especially during warmer. Most cause nothing more than temporary pain, itching, redness, or swelling and can easily be treated at home. However, some bites and stings are more serious and require immediate medical attention.
Knowing how to treat a minor reaction and how to recognize the signs of a medical emergency can help you respond quickly.
What’s the Difference Between a Bite and a Sting?
Although many people use these terms interchangeably, insect bites and stings are completely different and can cause different reactions.
Biting insects use their mouthparts that resemble tiny saws or needles to tear or pierce the skin. Insect bites are commonly caused by mosquitoes, certain types of flies, fleas, and bed bugs. Bites frequently cause itching, redness, and small swollen bumps.
Stinging insects inject venom through a stinger. Bees, wasps, hornets, and yellow jackets are common examples. Stings are more likely to cause immediate pain, burning, redness, and swelling.
For most people, these reactions are uncomfortable or painful, but not dangerous. However, some people are at risk of a severe allergic reaction known as anaphylaxis.
First Aid for a Minor Insect Bite or Sting
If the person is breathing normally and has only a localized reaction around the bite or sting, basic first aid is usually all that is needed.
1. Move Away From the Insects
Before treating the injury, move to a safe location. This is especially important after encounters with bees, wasps, hornets, yellow jackets, or fire ants, where additional bites or stings may occur.
2. Remove The Stinger if Present
Honeybees can leave a barbed stinger in the skin. If you can see one, remove it promptly. The preferred way to remove it is to scrape the stinger. Start at the point where it enters the skin and scrape away from it. A hard and flat item, such as a credit card, works well. If you use tweezers, be sure to grab the stinger as close to the skin as possible to avoid releasing more venom.
Wasps, hornets, and yellow jackets generally do not leave their stingers behind. But they may sting more than once.
3. Wash the Area
Wash the bite or sting with soap and water. This helps remove dirt and contaminants and may reduce the risk of infection, especially if the area is bleeding.
4. Apply a Cold Pack
Place a cold pack or ice wrapped in a cloth over the affected area for about 10 to 20 minutes at a time. Cold can help reduce pain and swelling. Do not place ice directly against bare skin.
5. Treat Itching and Discomfort
For a mild reaction, an over-the-counter hydrocortisone cream or calamine lotion may help relieve itching quickly. An oral antihistamine may also help with itching and swelling when appropriate for the person taking it.
Over-the-counter pain relievers can be used for discomfort according to their labels.
How Much Swelling Is Normal?
Most bites can cause minor redness, pain, itching, and swelling. A sting can cause significantly more swelling and still be a localized reaction. Seek medical attention if the swelling is causing severe pain or is in a sensitive area.
When an Insect Sting Becomes an Emergency
A severe allergic reaction can quickly become a life-threatening emergency. This reaction, called anaphylaxis, requires immediate action. It’s essential to recognize the signs and symptoms.
Signs of Anaphylaxis
Warning signs may include:
- Swelling of the face, lips, tongue, or throat
- Difficulty breathing or shortness of breath
- Wheezing
- Tightness in the throat or chest
- Difficulty swallowing
- Widespread hives or itching away from the sting
- Dizziness, weakness, or fainting
- Confusion or decreased responsiveness
- Vomiting, diarrhea, or severe abdominal symptoms
- Signs of shock
Call 911 immediately if you suspect anaphylaxis.
Using Epinephrine for a Severe Allergic Reaction
People with known severe allergies may carry an epinephrine auto-injector (EpiPen).
If a person is having an anaphylactic reaction and has a prescribed epinephrine injector, it should be used immediately or as per the instructions of a physician.
Note: It’s best to allow the person to inject themselves. If you administer the injection, Good Samaritan Laws may not protect you.
How to inject yourself with an EpiPen:
- Prepare the device: Remove the injector from its case, then remove the cover (usually blue)
- Hold the orange end of the injector against your thigh at a 90-degree angle.
- Swing your arm away, then swing back and push the injector into your thigh. You will hear a click. Hold the injector in place for 10 seconds.
- Remove the injector and massage the area for 10 seconds.
Call 911: Even if symptoms initially improve, it is essential to seek advanced emergency medical care.
How to inject someone else with an EpiPen:
The procedure is the same. However, you may not be protected by Good Samaritan Laws. A 911 dispatcher may instruct you to provide the injection.
If the person becomes unresponsive and is not breathing normally, check for signs of circulation and provide CPR or Rescue Breaths as necessary.
Other Situations That May Require Emergency Care
Anaphylaxis isn’t the only reason an insect bite or sting can become serious.
Multiple Stings
A large number of bee, wasp, hornet, or yellow jacket stings can provide a significant amount of venom. This can be life-threatening, even in someone who is not allergic. Especially in children, older adults, or anyone with underlying health conditions.
Seek emergency medical care after a large number of stings, especially if the person develops vomiting, weakness, dizziness, breathing problems, confusion, or other significant symptoms.
Stings Inside the Mouth or Throat
A sting inside the mouth or throat can cause swelling that may interfere with breathing.
This is a common injury that happens when someone accidentally drinks from a can or bottle containing a bee or wasp.
Call 911 if a sting in or around the mouth or throat causes difficulty breathing, swallowing, speaking, or significant swelling.
Eye Injuries
Bites or stings on or very close to the eye should be evaluated by a medical professional.
Watch for Infection
Most insect bites and stings heal without complications. However, an infection caused by a bite or sting warrants professional medical treatment.
Possible signs of infection include:
- Increasing redness or warmth
- Increasing pain or tenderness
- Swelling that continues to worsen
- Pus or drainage
- Red streaks extending from the affected area
- Fever
Please note: Redness and swelling immediately following an insect bite or sting is not a sign of infection.
If the area becomes increasingly painful, warm, swollen, or begins draining, contact a healthcare professional.
What About Mosquito and Tick Bites?
Mosquitoes and ticks are known to carry some serious illnesses. These illnesses can easily be transmitted through Mosquito and tick bites.
Common diseases:
Mosquitoes can spread diseases such as
- West Nile virus
- Dengue
- Zika
Ticks can transmit:
- Lyme disease
- Rocky Mountain spotted fever
- Ehrlichiosis
Seek medical advice if you develop symptoms such as fever, severe headache, unusual fatigue, muscle or joint pain, or a new or expanding rash after a recent mosquito or tick bite.
Ticks also require a specific removal technique: use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible and pull upward with steady, even pressure. Clean the bite area afterward.
The US Department of Health and Human Services has developed new protocols for combating Lyme disease and other tick-borne illnesses. It’s important to seek medical attention after any tick bite.
When Should You See a Doctor?
Consider contacting a healthcare professional if:
- Redness, swelling, or pain continues to worsen
- You develop signs of infection
- A large local reaction is severe, persistent, or grows
- The bite or sting is near the eye
- You develop fever, a rash, or other unexplained symptoms after a bite
- Symptoms continue instead of gradually improving
- You have concerns about a tick bite or possible insect-borne illness
- You have had a significant allergic reaction to an insect sting
People who have experienced a serious allergic reaction to an insect sting should also discuss prevention and emergency treatment such as an epinephrine injector with their healthcare provider.
Preventing Insect Bites and Stings
By following a few common sense precautions, you can reduce your risk to.
Use an appropriate insect repellent when spending time outdoors. Wear long sleeves, pants, socks, and closed-toe shoes in areas with heavy insect activity. Avoid walking barefoot through grass where ticks, bees, or fire ants may be present.
Be careful when drinking sweet beverages outdoors, especially from cans or bottles where an insect can go unnoticed. Keep food and garbage covered.
Avoid disturbing insect nests or hives. If bees or wasps begin flying around you, remain calm and move away. Swatting at them can cause them to become aggressive and attract others.
Final Thoughts
Most insect bites and stings are minor and can be treated at home. Simply wash the bite area, apply a cold pack, and treat itching or discomfort as needed.
It is essential to recognize when the reaction is no longer minor. Difficulty breathing, swelling of the tongue or throat, widespread hives, dizziness, fainting, or other signs of anaphylaxis require immediate emergency treatment. Use epinephrine if available and call 911.
Multiple stings and stings involving the mouth or throat can also become emergencies. Taking a First Aid and CPR course can help you recognize these warning signs and respond appropriately when an everyday insect encounter turns into a medical emergency.