By Sue Hubbard, M.D.
As kids head outside this spring and summer, insect bites and stings are sure to follow. Most are just an annoyance, but make sure you know which bites to be concerned about and which require just a hug and a kiss.
Knowing how to prevent and treat common insect bites and stings, and knowing when to not overreact, can help keep your kids safe and healthy.
Babies and children may be more affected, so let’s start with some common spring and summer insects:
1. Spider bites: Most spider bites don’t actually penetrate the skin, and the majority of spiders found in the U.S are mostly harmless, with the important exception of the black widow and brown recluse spider. Fortunately, spider bites are uncommon. In many cases, presumed spider bites are actually due to another skin condition or an insect sting.
A black widow bite is said to feel like a pin-prick, and some victims don’t even realize they’ve been bitten. The most common symptoms where the bite occurs are immediate pain, burning, swelling, and redness. Other symptoms may include chills, fever, nausea and vomiting, and severe abdominal pain.
While black widow spider bites are rarely fatal, deaths have occurred from brown recluse spider bites, and are more common in children than in adults. At first, the bite of a brown recluse leads to a mild stinging, followed by local redness and severe pain. Some reports describe a blue or purple area around the bite, surrounded by a whitish ring and large red outer ring in a bull’s eye pattern. A blister forms at the site, then sloughs off to reveal a deep ulcer that may turn black.
If bitten by a brown recluse or black widow: 1) Cleanse the wound and skin around the wound, 2) Slow the venom’s spread by tying a snug bandage above the bite and elevating the limb, 3) Apply a cloth dampened with cold water or filled with ice and seek immediate medical attention.
2. Bee stings: In most cases, these are just annoying and home treatment is all that’s necessary, but if you’re allergic to bee stings or you get stung numerous times, you may have a more serious reaction that requires emergency treatment.
Most symptoms from a bee sting are minor. Your child may experience a burning pain, a red welt and slight swelling. Some kids have a stronger reaction, with extreme redness and swelling. Anyone allergic to bee stings may have a severe reaction called anaphylaxis. Symptoms include: skin reactions like hives, itching and flushed or pale skin; difficulty breathing; swelling of the throat and tongue; a weak, rapid pulse; nausea, vomiting or diarrhea; dizziness or fainting; loss of consciousness; convulsions; shock.
For most bee stings, apply an ice pack or cool compress, or a meat tenderizer solution made by mixing one part meat tenderizer and 4 parts water. A baking soda paste works well or a topical anti-itch cream such as Calamine. Ask your pediatrician about ways to prevent bee stings and possible immunotherapy if your child is allergic.
If your child is allergic to bee stings, always have an EpiPen available. Wasp, hornet and yellow jacket stings are similar.
3. Fire ants: These insects are so named because their venom induces a painful, fiery sensation. When disturbed, fire ants are very aggressive.
To help kids avoid fire ants, regularly check your yard and play areas. If a child is stung, apply ice to the site and elevate the extremity. Check with your pediatrician for the correct dose of an oral antihistamine to ease itching and inflammation.
A small number of children experience a severe (anaphylactic) reaction within minutes of a sting and may experience hives, weakness, dizziness, wheezing, difficulty swallowing, shortness of breath, or confusion. Head to the nearest emergency room.
4. Ticks: These pests are common in grasses and wooded areas. If you have pets, make sure they’re tick free. Ticks are usually harmless but can carry Lyme disease. To remove a tick, use a cotton swab to apply rubbing alcohol or petroleum jelly on the site. Let this swab sit on the tick for 3 minutes. This suffocates the insect and it will back out for retrieval with tweezers.
5. Mosquito bites. Ivillage.com offers these tips for treating/preventing mosquito bites. The usual reaction is a local skin inflammation that’s red, raised and itchy. Apply anti-itch creams like calamine as needed to help prevent scratching. Use an anti-inflammatory like cortisone cream. For severe itching and multiple bites, use antihistamines like Benedryl. These make children drowsy, so work well at night. Antihistamines like Claritin, Allegra, and Zyrtec are less sedating. Check with you doctor on dosage.
An insect repellant with DEET is the most effectiveness against flies, gnats, chiggers, ticks and other insects.
6. Scorpions. These bites are painful but mostly harmless. The only dangerous scorpion in North America is the bark scorpion, found in all of Arizona and parts of California and New Mexico. Scorpions usually sting to protect themselves.
Scorpion stings without a serious reaction can be treated with ice and over-the-counter pain medication. Bark scorpion anti-venom is available only in Arizona.
Dr. Sue Hubbard is an award-winning pediatrician, medical editor and media host. “The Kid’s Doctor” TV feature can be seen on more than 90 stations across the U.S. Submit questions at http://www.kidsdr.com. The Kid’s Doctor e-book, “Tattoos to Texting: Parenting Today’s Teen,” is now available from Amazon and other e-book vendors.
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This column was printed in the June 14, 2015 – June 27, 2015 edition.
