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INSECT BITES
You are giving your child a bath and notice several bumps that
weren’t there earlier that day. They are scattered throughout
the legs, but nothing is present on the upper body. She seems
to have been scratching them. What could they be? The most
common cause of such spots is insect bites.
Here is Dr. Sears guide to taking care of insect bites.
Almost everyone has experienced insect bites, so it is no mystery
what they look like. The main issue with insect bites is to treat
the itching and to prevent infection.
THREE MAIN TYPES OF INSECT BITES
Spider bites – these are the largest type of bite,
often creating a large, raised, circular area with a visible
pinpoint bite mark in the middle. They can grow in size and
redness for several days, and tend to be quite painful. They
can number from just one to 5 or 10, often in a straight line or
confined to one body area. Spiders often travel across a body
part at night, snacking along the way. The initial bite is often
painful, but not always.
Flea bites – these usually occur in greater numbers
than spider bites, and mostly occur on the legs (and the diaper
area for crawling and sitting infants). They often are not
painful at the time of the bite, and usually become increasingly
itchy. Different people will react to flea bites to varying
degrees. Some people are very sensitive to flea bites. Common
places to get flea bites include houses with pets, beaches (sand
fleas) and parks.
Mosquito bites – these usually occur in exposed areas
such as hands and forearms, ankles, and neck. They are usually
quite obvious, and you often will know that you and your child
were outside in a mosquito environment.
TREATING INSECT BITES
Itching – this can be treated with benadryl by mouth
(click on it for dosing), or a variety of over-the-counter
itch-stopping products applied directly to the bite. Be careful,
these can sting if the bite has been scratched open. Pink
Calamine lotion or Aveeno anti-itch cream with calamine can be
very effective for itching, but be aware that if placed on a
bite that has been scratched open, it may increase the chance of
scarring. Benadryl cream is also available, but should only be
used sparingly if you are also giving Benadryl by mouth to avoid
overdose.
Cut the fingernails – this will decrease the risk of
infection being introduced into the bites, and will lessen the
chance of scarring.
Stinging or burning – apply a cold washcloth to any
particularly large, burning, stinging or itching bites.
Prevent infection – flea bites and mosquito bites
usually don’t require any special measures to prevent infection
of the surrounding skin. Insect bites will normally have some
amount of redness and swelling, as well as a bit of clear drainage.
Spider bites, however, tend to create a much larger area of
redness and swelling. While this is normal, it does increase the
risk of infection developing in the bite.
Before a bite becomes infected - here are some measures
you can take to prevent a large spider bite from becoming infected.
Follow these steps two or three times a day:
Wash the bite with warm soapy water
Apply some diluted hydrogen peroxide (mix ½ water with ½
peroxide)
Wash off the peroxide after two minutes
Apply an over-the-counter antibiotic ointment
Ice applied to a large spider bite can decrease the pain and
burning
Following these steps will usually prevent an infection from
setting in.
Infected bites - if the red area around the bite
continues to enlarge, becomes more swollen and painful, and
starts to drain pus, then it has become infected. Here are
some steps you should follow three times a day if this occurs:
Wash with warm soapy water
Apply a hot washcloth to the area for 10 minutes
Apply diluted hydrogen peroxide, then wash off after two
minutes
Apply diluted Betadine solution (mix ¼ of this over-the-counter
brownish red antiseptic with ¾ water) and let it dry for two minutes
Thoroughly wash off all Betadine
Apply over-the-counter antibiotic ointment. If your doctor
will call in a prescription strength ointment called Bactroban,
then this may work better.
It may take one or two days for this treatment to start to
improve the infection, but it should not keep getting worse
during this treatment.
More serious infection – if the redness and drainage
continue to worsen, or your child develops fevers or red streaks
extending out from the bite, then you should see your doctor right
away. If it is after hours, you should page your doctor. Your
child will probably need antibiotics to treat the infection.
WHEN TO SEE OR CALL THE DOCTOR
Besides as stated above under infection, there are three other
situations that may require the doctor’s attention.
Bites on the ear – the cartilage in the ear is more
susceptible to becoming infected from an insect bite. Follow
the precautions as above to prevent infection, but also be sure
to use warm soaks from the start (instead of only if an infection
sets in). If it does become infected, see your doctor. You may
need antibiotics sooner than normal bites.
Brown Recluse spider bites – this particular spider
bite can form a large purple irregularly shaped blister surrounded
by a red ring. Over the next few days, the blister opens and an
ulcerated area forms. This looks like an infected crater forming
at the bite. If you suspect this bite, see your doctor. This
ulcerated area can continue to enlarge if not treated promptly by
a physician. This brown spider has a dark-orange violin-shaped
mark on it’s head and tends to live in dark, dry places such as
vacation homes or abandoned houses. If you can, bring the spider
to your doctor or ER.
Black widow – this spider has a red hourglass on the
body. Bites from this spider have a 5 % fatality rate. The bite
seems normal, but within less than an hour generalized symptoms
occur, including muscle cramps, painful muscle spasms, loss of
sensation or tingling, headache, dizziness, vomiting, or trouble
swallowing. Go to an ER or call 911 if you are bitten by a
known black widow spider or you experience theses symptoms.
Bring the spider with you.
AskDrSears.com is intended to help parents become better informed consumers
of health care. The information presented in this site gives general advice
on parenting and health care. Always consult your doctor for your individual
needs.
