Treating Summer Bug Bites

Love the fresh foods of summer? So do bugs of all kinds—and for them, you are on the menu.

Bug bites are annoying at best and can potentially make you sick, but most won’t require a trip to the doctor’s office. Just clean the bite well with soap and water.

“Cleaning the bite area early protects it from dirt or debris that can cause further complications, such as a skin infection,” says UNC Health family medicine physician Modjulie Moore, MD.

Keep an antihistamine cream or ointment (such as Benadryl) handy to help soothe the itch. Hydrocortisone cream may be helpful for more serious itches. Ice or a cold compress and elevating the bite can relieve swelling, and acetaminophen (Tylenol) or ibuprofen (Advil) may help with pain.

Try not to scratch your bites. You may break the skin, exposing the wound to bacteria that live on our skin and increasing the risk of skin infection. Keep using soap and water to clean the bite, and apply an antibiotic ointment if you suspect infection.

When to Call Your Doctor for a Bug Bite

If anti-itch medicines don’t work, the pain or itching gets worse, or the bite site gets redder or looks infected, see your doctor. And if you have a lot of swelling—for example, if your bitten ankle doubles in size—get medical help.

If you scratch hard enough to break the skin, any bite can cause cellulitis, a common bacterial skin infection marked by redness, swelling, pain and increased warmth of the skin. If left untreated, cellulitis can cause other serious health problems, Dr. Moore says.

“If you have cellulitis, you will need a prescription antibiotic,” she says. “If your wound is red and swelling, go see your doctor.”

Summer Bugs That Bite

Here are some of the summer critters most likely to bite and what to do if one bites you.

“Ticks are the ones people are most concerned about,” Dr. Moore says. “Tick-borne illnesses are pretty significant, Lyme disease and Rocky Mountain spotted fever in particular.”

If you have been outside, make sure to thoroughly check yourself and others for ticks, especially kids and anyone who isn’t flexible enough to check their entire body.

“Ticks like to climb,” Dr. Moore says. “They might come in around the leg area and climb up to the top of your head. They like any place with hair, and they can be hard to get off.”

If you find a tick attached to skin, use tweezers to make sure you get the whole tick out. Save it in a plastic bag. If you become ill, seeing what kind of tick has bitten you may help your doctor know how to treat you. But know that most people who are bitten by ticks do not get sick and don’t need to see their doctor, Dr. Moore says.

“Watch the spot where the tick bit you for a day or two,” she says. If you see a rash or the bite is getting increasingly red, visit your doctor.

  • Mosquitoes: Mosquitoes are very bothersome in summer, but in the United States, very few carry diseases such as malaria or dengue. However, mosquitoes in the U.S. sometimes transmit West Nile Most people with West Nile virus will not get sick, but about 1 in 150 will experience serious and sometimes fatal illness.

Even if the bite is harmless, some people have more severe reactions to mosquito bites. If a topical or oral antihistamine doesn’t help, call your doctor.

“People can easily get 20 or more bites if they aren’t wearing an insect repellent,” Dr. Moore says. “Try not to scratch them and get them infected.”

  • Biting flies: Like mosquitoes, biting flies can be bothersome and occasionally may carry viruses. They range in size from tiny midges to big horseflies. Their bites are painful because they feed on blood and tear open skin with their sharp mouthparts.

If you have been bitten near your eye or in your mouth, pay special attention to any redness or swelling and get medical attention if the symptoms don’t improve.

  • Ants: Some ant bites or stings can be very painful, especially red ants and fire ants, Dr. Moore says. They are characterized by painful, swollen red welts that may itch after a few days.

“Ant bites are not a joke,” she says. “If you step on an anthill, you’re likely to get a lot of bites. The pain will go away in time, but you’re going to need a lot of antihistamine and maybe cortisone cream.”

  • Chiggers and other types of mites: These bites can be itchy and annoying, and if you scratch hard enough to break the skin, you can get an infection. Chiggers don’t burrow into your skin, and by the time you see a rash, they usually are gone.
  • Spider bites: Not all spiders are venomous, but the ones that are, such as the black widow and the brown recluse, can cause minor to severe symptoms, including rash, blisters, fever and high blood pressure.

Spider bites often cause more severe reactions than other insect bites, Dr. Moore says.

“You may see significant cellulitis—dead tissue or necrosis at the center of the bite,” she says. “You can get pus pockets or abscesses that need help in healing. If you suspect you’ve been bitten by a venomous spider, or a bite gets bad quickly, get medical help as soon as you can.”

  • Bees and wasps: Many people are allergic to bee or wasp stings and can have a serious allergic reaction. If you know you or your child is allergic, you should carry an EpiPen (epinephrine injection) to counteract the trouble breathing, dropping blood pressure, hives and swelling that may result. If you witness these symptoms, use an EpiPen if available and call 911.

It’s especially important to pay attention to the reactions children have to bee stings because parents may not know if their child is allergic.

“It’s not uncommon for a bee to fly onto a Popsicle or ice cream cone, and the child takes a bite and gets a sting in their mouth,” Dr. Moore says.

Wasp and hornet stings are often worse than bee stings because they are bigger, but any stinging insect can cause pain, especially if they sting sensitive places on the body.

“Ears, fingers, feet, facial areas like lips—these are places that don’t have a lot of room for swelling, and that adds to the pain,” Dr. Moore says. “Arms and legs accommodate swelling a little better.”

If you are stung, remove the stinger by scraping it with a fingernail or gauze.

You often won’t know what kind of bug bit you. Keep an eye on the bite to make sure it doesn’t get worse.

“If you’re worried, come in to see your doctor,” Dr. Moore says. “We’ll be happy to help you figure out what it was and find a way to deal with any reactions you’re having.”

Of course, your best bet is to avoid being bitten in the first place. Use an insect repellent regularly and make sure you apply it to all exposed areas, including the ankles, wrists, neck and ears.

If you are having a reaction to a bug bite, see your doctor or find one near you.