First Aid for Insect Bites and Stings

We all long for the return of warm weather, when we move outdoors to exercise, work, and relax. This journey into nature puts us right in the middle of the insect universe. Although inevitable, there are ways to mitigate insect bites and stings, as well as treat those we can’t seem to avoid. 

First, a word about prevention.

• Wear insect repellent, especially when outside around dawn and dusk, or anytime when in shady wooded areas.  Repellents that contain DEET are effective for 8 – 12 hours. If you are looking for a more natural alternative, repellants containing oil of lemon eucalyptus repel mosquitoes and ticks for 4 – 5 hours.
• Do not disturb insect nests.
• If you accidentally disturb a nest, move to a safe area to avoid additional bites or stings.
• Limit areas of standing water around your yard.
• Consider replacing outdoor lightbulbs with “bug” bulbs.
• Be sure window and door screens are in place and in good repair.

Even with these preventive steps, we might be stung or bitten once in a while. Luckily, most reactions to insect bites and stings are mild, but they can cause pain and itching. For minor insect bites and stings, here are some steps to provide relief.

• If stung, check to see if the stinger is protruding. You can remove the stinger with tweezers. If you do not have tweezers handy, a credit card or key tag scraped over the area will do.  The important factor is to remove the stinger promptly, to limit more venom leaking into the skin.
• Wash the stung or bitten area with soap and water.
• Apply a cool compress to the stung or bitten area, like a wash cloth dampened with cold water. An ice pack wrapped in a towel would also work. Additionally, to help reduce pain and swelling, apply ice for 20 minutes or less.
• For any associated discomfort or pain, take over the counter ibuprofen or acetaminophen as directed on package.
• Apply hydrocortisone cream or calamine lotion a few times a day to the stung or bitten area until symptoms subside. If you have neither, a paste of baking soda and water will also work.
• If needed, take a dose of antihistamine, like Benadryl, to reduce itching to the stung or bitten area.  Other non- drowsy antihistamines to minimize the itch, are cetirizine (Zyrtec), fexofenadine (Allegra) or loratidine (Claritin.)
• Avoid scratching, as the breaks in the skin that result can become infected. If you cannot help scratching, rub the area gently with your finger pads, instead of using your fingernails.

There are still a small number of insect bites that become infected. If the redness and swelling is not improving by 72 hours following the bite or sting, or if there is development of red streaking from the site, warmth, or you feel unwell, please seek medical attention.

Did you know that ticks are not insects? They are actually in the spider family. For additional information about tick bites, see this article.

If someone has been stung by an insect of the bee family and has never been stung before, monitor for signs and symptoms listed below, and have a phone readily available, in the event an allergic reaction develops.

If you or someone you’re with experiences severe signs and symptoms as a result of an insect bite or sting, call 911. Symptoms include:

• Difficulty breathing
• Swelling of the lips, eyelids, or throat
• Dizziness, faintness, or confusion
• Rapid heart beat
• Hives
• Nausea, cramps, or vomiting

Some people who know they are allergic to insect stings carry an epinephrine auto-injector, more commonly known as an EpiPen, to treat an allergic attack. If one is available, you can help the person administer it.

With an ounce of prevention combined with prompt action, a pesky insect sting or bite should be only a mild disruption in an otherwise healthy and happy summer.

Crystal Labbe-Hasty, PA, is a physician assistant at SVMC’s Respiratory Evaluation Center/ExpressCare in Bennington. The practice has recently moved from the Medical Office Building to 120 Hospital Drive. Both locations are on SVMC’s Bennington Campus.