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Insect Bites and Stings

Part 3: Treatment of Insect Bites and Stings

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Updated May 20, 2014

Most children with insect bites or stings only need symptomatic treatment for the symptoms of pain and itching.

Anaphylaxis

Some children who are allergic to the venom in the insect sting can develop more serious anaphylactic reactions.

Since this type of reaction is life-threatening, treatment should be started as soon as possible and you should activate your local emergency medical services. An injection of epinephrine is the main treatment for anaphlactic reactions. Children with a history of anaphlactic reactions should have an auto-injector of epinephrine available for immediate administration, but you should still call 911.

Since children do not always outgrow these types of reactions, an evaluation by a Pediatric Allergist can be helpful to confirm the allergy (skin and/or RAST testing) and consider venom immunotherapy (allergy shots). These shots can protect your child from having furture reactions to an insect bite or sting. Children usually begin with weekly shots of a gradually increasing strength of insect venom. This is followed by monthly maintenance shots so that the protection lasts.

Children with anaphylactic reactions should be given an emergency kit with an epinephrine autoinjector and they should wear an identification tag, such as a MedicAlert bracelet.

Bee Stings

Unlike other insects that sting, the honey bee leaves its stinger behind. Proper removal of this stinger following a honey bee sting can help prevent worsening symptoms. What you should not do includes pulling the stinger out with tweezers or pinching it out with your fingers, since this can inject more venom and cause a worsening reaction. Instead, use a credit card or dull blade to scrape it out.

Symptomatic Treatment

Most insect bites and stings only cause local reactions, including redness, swelling, pain and itching.

After you thoroughly wash the area with soap and water, other symptomatic treatments that may help your child feel better include applying:

  • an ice pack or cool compress
  • a meat tenderizer solution, which can be made by mixing one part meat tenderizer and 4 parts of water. This is especially helpful for painful stings from bee, wasp or ant. For best effect, soak a cotton ball in the meat tenderizer solution and use it to rub the area of the bite for 15-20 minutes.
  • a baking soda paste
  • a topical steroid or other topical anti-itch cream, such as Calamine lotion, to the area
Other medications, including an oral antihistamine for itching, such as diphenhydramine (Benadryl), and/or pain medications, such as ibuprofen or acetaminophen, may also help. More extensive local reactions may sometimes require a short course of an oral steroid.

Antibiotics may be needed if the bite becomes infected.

Is it infected?

Insect bites and stings are commonly misdiagnosed as an infection. Or if the initial bite or sting is identified, the resulting redness and swelling is confused as a secondary cellulitis. While both conditions can cause similar symptoms, the local reaction of a bite or sting usually begins quickly and generally within 6 to 24 hours of the bite. A secondary infection usually occurs after the first 24 hours and can cause spreading redness, especially red streaks, and fever.

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