Emergency and Urgent Care - Insect Bites and Stings

Insect Bites

Biting insects that are common in the UK include midges, gnats, mosquitoes, flies, fleas, mites, ticks and bedbugs. They can all cause swelling or bumps on the skin. Antibiotics are NOT always required.

• A small itchy lump (papule) may develop up to 24 hours after a bite and can typically last for several days before fading away, there can also be quite severe inflammation surrounding the bite
• A wheal is a red, slightly raised, localised mark on the skin, which is often itchy but is temporary. It may develop immediately after being bitten and often develops into a solid lump up to 24 hours afterwards. It can last several days before fading away
• Some reactions can be more severe and can include blistering, bruising, hot skin, swelling and pain, however, the treatment is the same

Treatment:

• The sting/tick will be removed if still present
• Advice will be given on how to care for the reaction and what to look out for

Do:

• Take oral antihistamines (such as chlorphenamine)
• Topical corticosteroids (hydrocortisone cream 1%) may help to reduced inflammation and itching
• Take oral analgesics such as paracetamol, which can help with the pain, and ibuprofen can help reduce pain and inflammation
• Apply wrapped ice/icepack for 20mins at a time, every 2 hours. This helps to soothe and cool the area
• Cover any ruptured blisters/wounds with a breathable dressing (not waterproof plasters as this will make the skin sweat)

Don't:

• Scratch the area
• Pick at any scabs or blister formations

Occasionally a skin infection develops following a bite, particularly if you scratch it a lot, which can damage the skin and allow germs (bacteria) to get in.

Signs of Infection:

• Inflammation (redness) spreads and looks shiny
• You may see a red line coming from the area tracking upwards as if following the line of a vein
• You may develop a green/yellow discharge from puncture site
• You may develop a fever or feel unwell “flu-like” symptoms.  If you develop any of these symptoms seek medical attention by contacting NHS 111, your GP or attending an Urgent Treatment Centre or Emergency Department
• If you or your child develop signs of sepsis – mottled, bluish, pale skin; lethargy or difficult to wake; abnormally cold to touch; fast breathing; rash to the skin that does not fade when you press it; fit/seizure or convulsion. Call 999 immediately for an ambulance

Insect Stings

Most insect stings (of which most common are bee and wasp stings) result in a mild local skin reaction. Treatment is the same as for insect bites.

If the sting is still in place, scrape it our using your fingernail or a blank card (avoid tweezers).

There is an uncommon reaction but more serious reaction to an insect sting that happens most often with wasp stings, this is called ANAPHYLAXIS. This will usually develop within minutes of the sting and without quick treatment can be life threatening. If any of the following occur call 999 immediately for an ambulance.

Symptoms of Anaphylaxis:

• Itchy blotchy skin
• Swelling to face, lips, tongue and throat
• Stomach cramps and feeling sick
• Redness of your skin
• A fast heart rate, feeling of palpitations
• Feeling faint or you collapse
• Wheezing or difficulty in breathing

Prevention of insect bites and stings:

Bites and stings most commonly occur when outside, in hot humid conditions, near ponds and rivers etc.

The following measures are recommended to reduce the risk of stings and bites:

• Apply insect repellent before going out (purchase from a chemist or supermarket)
• Wear light-coloured clothing
• Avoid perfumes and picking fruit from the ground or trees
• Avoid drinking out of an opened drinks can or bottle to prevent being stung inside the mouth
• Be vigilant when eating outdoors as this attracts insects
• Wash hands after eating or handling sticky or sweet foods outdoors (especially children’s hands)

Useful links:

https://patient.info.skin-conditions/insect-bites-and-stings-leaflet

If you require further information or advice, please contact NHS 11 via telephone or their website, or you can contact Rochdale Urgent Treatment Centre – 01706 517023.