How to Treat Insect Bites and Spider Stings

Most bug bites and stings are a minor irritation, and you may simply want to relieve the pain, itch, and swelling. But you might be worried it they have the potential for more serious consequences. The good news is that most of bites and stings you get from North American critters are harmless in themselves, but some people can have a moderate to severe reaction, even anaphylaxis. On other continents, you face a greater risk of deadly infections that are spread by bug bites, and there are some poisonous insects. Here is what you should do when you get bitten or stung in North America.


Identify the Insect That Bit or Stung You

Bark scorpion
Scorpion stings are truly nasty compared to other North American bugs. (c) Kevin Reilly, MD

Insects, spiders, and scorpions are capable of causing very painful reactions. It's very helpful if you know what did the biting or stinging:

  • Mosquito bites can expose you to serious diseases like West Nile virus or Zika. Mosquitoes are usually found near standing water.
  • Tick bites can expose you to Rocky Mountain spotted fever or Lyme disease. They are usually found in wooded areas.
  • Biting flies can be found around garbage or waste.
  • Fire ant bites give burning sensations and pain.
  • Flea bites often occur in clusters and you can often pick them up when around pets.
  • Bedbugs give itchy red bumps that are usually in a pattern of two to three in a row and occur at night. (Learn more about diagnosis and treatment.)
  • Spider bites and, especially, scorpion stings can be more worrisome, even potentially deadly.

The reality, however, is that most bites are from unidentified bugs. In the worst case scenario, they can be immediately dangerous because of the possibility of anaphylaxis.



Hives are a bad sign that anaphylaxis might be coming on. (c) Paul Cutler

The most serious concern is a bite that triggers an extreme reaction in a sensitive person, known as anaphylaxis. While the bite or sting is uncomfortable for most people, it can set off an overreaction of the immune system in a small number of people. Without immediate treatment, there is a risk of death.

Look for signs and symptoms of anaphylaxis:

  • Itching
  • Swelling (other than the site of the sting)
  • Shortness of breath
  • Heart palpitations
  • Chest pain
  • Weakness
  • Dizziness
  • Hives or redness

If you see or feel any of those symptoms, call 911 immediately. If the person who was bitten has a history of severe allergy and carries epinephrine, those signs and symptoms tell you that it's time to use the epinephrine. Call 911 first, then use the EpiPen (or whichever brand the person is carrying).


Ease the Pain of Insect Bites and Stings

boy with swollen eye from bee sting
Even after antihistamines, it can still take days for a local reaction to heal. Sam Bautista

If you've been bitten or stung, move to place away from further exposure to the bugs to prevent getting more bites or stings.

Here are some basic things you can do to ease the pain, itching, burning, or swelling from a bug bite or sting:

1. If you've been stung, remove the stinger if it is still in your skin.

2. Apply an ice pack or cold compress to the site of the sting. Alternate on and off to prevent tissue damage and don't place the ice directly on the skin. Usually 20 minutes on and 20 minutes off.

3. If the person with the bite or sting has any involuntary muscle movements, call 911 immediately. Black widow spider bites can cause muscle spasms.

4. For pain relief, try topical treatments like sting swabs, hydrocortisone lotion, or lidocaine preparations. Acetaminophen and ibuprofen are good for pain. You may want to use an antihistamine such as Benadryl if you have swelling.

Keep an eye out for signs of illness over the first few days following a bug bite. Fever, jaundice (skin or eyes turning yellow), sweating, or pus oozing from the site of the bite all require a call to the doctor.

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