FAQ's on Insect Bites

FAQ’s on insect bites!


Today we are talking about insect bites! Kids are very curious and interested by insects and love playing outside. Most bites are self-limited and benign, but there are occasions that warrant a trip or call to the pediatrician. Read below for information on some common questions we hear.


General Questions


What can I do at home to treat insect bites?

The first thing to do is to clean the bite well with soap and water. Using a cold compress and elevating the bite can help with pain and swelling. For young children with bites on the hands, playing in a bowl of cool water can have a similar effect as using a cold compress. Putting a topical antihistamine (ex. Hydrocortisone cream) on a bite can help decrease the itching. Talk to your pediatrician before putting anything on the bite if you have a very young child. It is important to monitor insect bites especially in children because they often itch, which can break the skin and lead to infection. Tylenol or ibuprofen can also be beneficial if your child is in pain.


Why do my child’s hands and feet get so swollen after they get a bite?

Hands and feet are often held below the heart. Children also have small hands and feet, so due to gravity and their size, swelling can be significant. Using cold compresses and elevating can help with swelling. If this does not help and the swelling is severe, please bring your child to see their provider.


What are signs of a bite becoming infected or other complications?

An insect bite that becomes infected is usually red, warm and tender to touch, and may have purulent (pus) drainage. It can be helpful to mark redness around a bite so it is easier to monitor if it is getting bigger. If you have any concern about infection after a bite, please give your child’s provider a call. To help prevent infection, clean the bite well with soap and water and remind your child not to scratch.

Some children may have more than a localized reaction to an insect bite. This most commonly is characterized itchy rash (hives) on the whole body. If this happens, it is important to call your child’s provider. Some children may have an anaphylactic reaction, in which they could have swelling around their mouth, lips, or tongue, difficulty breathing, coughing, turning blue around the lips, wheezing, dizziness, nausea/vomiting or are not acting themselves. If you see any of these signs, call 911 immediately, as these are signs that your child needs immediate medical care.


When should I bring my child to the doctor?

We never want you to worry  about your child at home; if at any point you are concerned about what is going on with your child, please let us know. With that being said, we recommend bringing your child in if the insect bite has redness around it that is spreading, it is very hard, warm, and very tender to the touch, or if there is purulent (pus) drainage from it. This could indicate there is an infection.

We also would like to see your child if there is significant swelling that is not improving, especially on the face, near the mouth, or in the genital area. Insect bites can cause significant swelling, especially in hands and feet.


Spider Bites


What are the characteristics of a spider bite?

Most spider bites do not cause as significant reaction. Usually there is a small localized reaction, and usually the only care needed is  to clean the wound and use e a cold compress. If it is on the arm or leg then elevating the extremity can help as well (if your child will cooperate). If you have a young child, talk with your pediatrician before giving medication for the bite. An antihistamine for older children can help with itching. Monitor the site closely as children tend to itch bites and this can cause a secondary infection.


What types of spider bites can cause significant problems?

There are two types of spiders that can be harmful to your child are  the black widow and brown recluse, both of which are found in central Texas. Black widows have a red hourglass marking on its body. Signs of black widow bite start with slight swelling at the site with red marks. Then there can be intense pain, stiffening, abdominal pain and cramping. Children may also have a fever, chills or nausea.

Brown recluse spiders have a violin-shaped marking on its body (but this is often hard to see). Signs of this bite start with mild pain, which then progress to redness and intense pain. There may be black, dark blue, or purple coloration around the bite. If you know your child was bitten by either of these spiders, or has any of these signs and symptoms, it is important to seek medical care immediately.


Chiggers


What are chiggers?

Chiggers are tiny red mites that do not cause painful bites, but do cause very itchy skin.  Chiggers are so small that you need a magnifying glass to see them. Chiggers pierce the skin with small claws, then they inject saliva which dissolves skin cells for the chiggers to consume. They then fall off the skin a few days later, leaving  red itchy bumps. They are usually in groups on the wrists, ankles or in skin folds.

Most of the time these bites do not cause significant problems (other than being very uncomfortable and itchy). It is important to wash this area with soap and water (this can help remove any chiggers still on the skin). Using cool compresses and anti-itch cream can help with the itchiness. Monitor the sites closely for any signs of infection and encourage your children not to scratch.

If your child has bites in their genital area, often causing swelling, it is important to bring your child in to see their provider, as this can cause pain or difficulty with urinating.


Wasps and Bees

What can I do to care for my child who was stung by a bee or wasp?

The first thing to do after a sting is to attempt to remove the stinger if it is still in the body. This should be done by a scraping motion as opposed to grabbing the stinger to remove it. Grabbing it can cause the venom to be released into the body. After removing the stinger, clean the site with soap and water to help prevent infection. Like other bites, a cool compress can be helpful as can anti-itch lotion.  

If the bite was near or in the mouth, it is important to seek medical care, as these places can cause swelling.  Many people are allergic to bees, so if you notice any of the above signs of an allergic reaction, seek medical care immediately. If your child has a known allergy and is exhibiting signs of an allergic reaction, you can also use the child’s epi-pen as instructed by their provider.


Prevention


What can I do to prevent insect bites for my kids?

If possible, dress kids in lightweight, long sleeve shirts and pants that are tucked in when playing outside (especially when hiking or playing in fields). Using insect repellant can also help.  For children be sure the amount of DEET in the insect repellant is no more than 30%. The percentage of DEET actually shows how long the insect repellant will be effective, and does not increase the effectiveness. No insect repellant should be used on infants less than 2 months old. Products with DEET may also be applied to clothes, strollers and shoes.



References:

https://kidshealth.org/en/parents/chiggers.html

https://kidshealth.org/en/parents/insect-bite.html



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