How to Treat Bug Bites

1
You're (Probably) Not Going to Die

Aedes aegypti female mosquito sucking blood from a man's arm
Some bugs--like mosquitos--are easy to identify. Others, not so much. James Gathany, CDC, Atlanta, GA

In the United States, bug bites are horrible and can irritate you enough to leave the porch and take your glass of wine inside the house at sunset.

Unless they kill you.

Maybe I'm being a bit dramatic, but bug bites here in the US are sort of one extreme or the other. Either they are harmless other than a little discomfort, or they lead to devastating consequences. Luckily, it's overwhelmingly the former.

On other continents, by the way, live some very deadly critters. Since there's no way to cover the whole world in a single article, I'll focus on North America.

2
First, Identify the Culprit

Bark scorpion
Scorpion stings are truly nasty compared to other North American bugs. (c) Kevin Reilly, MD

The fact that North American bugs rarely kill you doesn't mean their bites and stings don't hurt. Insects, spiders, and scorpions are capable of causing very painful reactions. It's very helpful if you know what did the biting (or stinging):

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. So, let's start there.

3
Anaphylaxis

hives
Hives are a bad sign that anaphylaxis might be coming on. (c) Paul Cutler

If you don't know what type of bug got you, never fear. You can still treat it without too much trouble. Indeed, most bug bites go unidentified. First and foremost, look for signs and symptoms of anaphylaxis:

  • itching
  • swelling (other than the site of the sting)
  • shortness of breath
  • heart palpitations
  • chest pain
  • weakness
  • dizziness
  • hives or redness

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 name the person is carrying).

No anaphylaxis? Good. Let's talk about making it feel better and some other symptoms to look for.

4
Ease the Pain

boy with swollen eye from bee sting
Even after antihistamines, it can still take days for a local reaction to heal. Sam Bautista

Now that we know you're not going to die from anaphylaxis and you have no idea what bit you, here are some basic things you can do to ease the pain/itching/burning/swelling:

  1. Apply an ice pack to the site of the sting. Alternate on and off to prevent tissue damage - usually 20 minutes on and 20 minutes off.
  2. If the victim has any involuntary muscle movements, call 911 immediately. Black widows can cause muscle spasms.
  3. For pain relief, try topical treatments like sting swabs. Acetaminophen and ibuprofen are also good for pain.

Keep an eye out for signs of illness over the first few days following a bug bite. Fever, jaundice (skin or eyes turning yellow), sweating or pus oozing from the site of the bite all require a call to the doctor.

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