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Bug Bites and Stings

Angela Oswalt Morelli , MSW, edited by Mark Dombeck, Ph.D.

Skin irritations due to bug bites or plants such as Poison Ivy are the potential negative consequences of playing outside in the summer and fall. However, steps can be taken to help prevent bites and toxic plant exposures from occurring. As well, various remedies are available (both store bought and home-made) to help soothe discomfort when children do develop reactions to bites or irritating plant oils.

Insect Bites and Stings

teen in painThere are many different sorts of biting and stinging insects. Some of these insects, including mosquitoes, biting flies, gnats and, no-see-ums, can be repelled from biting with the application of commercially available insect repellents, generally available at drug and grocery stores. Parents can spray repellents on to children's skin before they play outside. Because such repellents contain potentially dangerous chemicals, they need to be used with care, and as directed on product instructions.

Chemical insect repellents are applied directly to the skin and clothing, and are thus extremely portable. They are maximally useful when children are going to be roaming through an unconfined or wooded area. If children and other family members will be spending time in the backyard, however (e.g., near a source of electricity and within a defined area), there are other, less potentially toxic options available for handling biting insects.

"The best defense is a good offense", as the saying goes. Removal of all standing water sources near home or sites where children play will help to reduce the total local mosquito population. Mosquitoes lay their eggs in such standing water pools, so disrupting the pools results in fewer mosquitoes surviving to maturity.

Once mosquitoes have matured, however, they must be handled via different means. The use of screened porches or portable shelters helps to limit biting insects from getting near enough to bite kids. Citronella candles offer some repellent protection. As well, products like the Mosquito Magnet®, various "bug zappers", and wasp traps placed near the house will help to further reduce the local biting and stinging insect population.

Bites associated with mosquitoes and gnats typically result in itching and raised marks but are not generally painful. In contrast, stinging insects such as bees and wasps can result in quite painful injuries. In some cases, children may have a severe allergic reaction to insect venom which can result in death if not promptly treated. Parents should teach their children to identify stinging insects - what they look like individually, and what their homes look like - so that they can avoid playing in areas near where these insects are active.

In some cases, children have an intense allergic reaction to the bite or sting. Parents should call the doctor in the event a child receives multiple stings at once or develop hives in places on the body other than the sting site. If a child has difficulty breathing or show symptoms of shock (e.g., rapid breathing, dizziness, and cool, clammy skin) after a sting, adults should immediately call for emergency medical help, as a serious allergic reaction can quickly become life-threatening.

Children who have a known allergy to stings may be prescribed an EpiPen® or similar pre-filled syringe of adrenaline (otherwise known as epinephrine). Adrenaline is a hormone that increases the body's ability to mobilize resources during a crisis situation by opening up blood vessels, airways, and speeding up the heart to increase blood flow and oxygen diffusion around the body. Adrenaline can help a person continue to breathe even after having an allergic reaction. This medication can be administered through clothing to the fleshy part of the upper thigh by any nearby adult when the bite/sting occurs.

Some bees and wasps leave behind a stinger and sacs of venom at the sting site which must be removed. Caregivers should remove the stinger and venom sac with a flat edge or tweezers as soon as possible.

Assuming that a bite or sting has not resulted in a medical crisis, the goal of treatment for the bite or sting is then to decrease discomfort. The site of a bug bite or sting can be expected to become raised, red, and itchy. Parents can offer children a cold compress or ice cube to put on the affected site to reduce and minimize swelling, itching, and pain. Stings can also be covered with a paste made from water and baking soda, or with calamine lotion to reduce discomfort. Children should be discouraged from scratching the bites or stings, as this can cause scarring and damage to the skin, or open the sites up to potential infection. If the itch is unbearable, over-the-counter antihistamines (e.g., Benadryl) can also bring relief.