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Bug Bites – General Information

Of course, bugs can bite you at any time of the year, but summer is the worst time. Among the most common offenders are mosquitoes, mayflies, fleas, and (especially in Northern New England) black flies. We have special concerns about tick bites and spider bites (see below).

"The insects love me!!" Some people do seem to be bitten more or react more to bites than others. Why? Probably due to a combination of factors. Perfumes and foods attract insects. When a mosquito bites someone, it actually injects a little of its saliva (yuck!). What we call a "bite" is actually a reaction to this saliva, and some people are more allergic to it than others.

Can you tell what bit you? Usually not, unless you see the insects. But when the bites are in a cluster, it suggests flea bites. However, certain ant bites (fire ants) have a very distinctive appearance, and are quite painful when you are bitten.

Contact us or your primary care physician if you have any questions or concerns about bug bites.

Prevention

Insect repellents containing DEET (Diethyl-meta-toluamide) are still considered the best, despite reports about the alleged effectiveness of other products including catnip. If used correctly, DEET is safe. (The reports of toxicity have all been from cases in which it was used excessively or abused). For young children, a lower strength (10 to 15%) is preferred. I prefer drops rather than sprays.  Apply the repellents on shoes, hats and seams of clothing.
Also, avoid the use of fragrances when exposed to biting insects and be sure to clean any food off the skin.

Appearance

A bug bite has a central point (or puncta) within the bump and sometimes may become very large or even blister.

Treatment

For mild reactions to bug bites, all that you need to use are soothing products such as calamine lotion or anti-itch products. We have such products at our office, and many others are available at pharmacies. We do not recommend topical Benadryl (diphenhydramine) products because of their risk of sensitization reactions.
For more severe reactions, we may prescribe steroid creams.

Types of Bug Bites

There are many varieties of bug bites – more than we could discuss here. We therefore emphasize those that can have serious medical consequences and that are most likely to occur in New England.

Tick Bites

Unfortunately, Rhode Island and neighboring states have a very high incidence of Lyme disease. This disease is caused by bacteria called Borrelia, transmitted by the bite of a deer tick, a very small tick. The deer tick is carried not only by deer but also by the very common white-footed mouse.

When to Suspect Lyme Disease

If you are sure or even suspect that you have had a tick bite, and an expanding rash develops at the site (sometimes as large as 8 cm, which is more than 3 inches), you should see us. If we suspect Lyme, we'll order a blood test and may do other evaluation.

You can get Lyme Disease without a rash. If you've had a tick bite and develop muscle or joint aches, you’ve probably had the disease for a while and should be evaluated by an expert in Lyme, such as an infectious disease specialist. Lyme Disease is treated with antibiotics.
Ticks may also transmit other diseases.

How to Remove a Tick

Grasp the tick with forceps near the head and lift it gently away from the skin. If the mouth parts break off, they should also be removed.

Bee Stings

There are two important things to remember about bee stings:

  • If you know you are allergic to bee stings, consult your primary care doctor or an allergist before you are exposed to bees again. You should probably be equipped with an emergency source of epinephrine, such as an Epipen® auto-injector, because delays in treatment may be life-threatening. Allergists also sometimes offer desensitization protocols. If you were unaware that you were allergic and start to develop severe symptoms, such as wheezing, trouble breathing, feeling faint, or massive swelling, get emergency treatment as soon as possible.
  • Always remove the stinger of a bee. When a bee stings, it leaves its stinger, full of venom, embedded in you. To avoid injecting more venom into your body, grasp the tip of the stinger firmly with a forceps or tweezers (or two wooden sticks, if no forceps or tweezers is available), and pull it out gently. Icepacks may help until you receive medical care (if symptoms warrant it).

Epipen samples