Insect Bites…

Insect bites occur at all times of the year, but late summer, early fall is a particularly busy bite-time.  From mosquito’s, to ticks and even spiders, it’s sometimes hard to know if the bite requires medical intervention.

Most of the time, all a bite needs is cleaning and superficial care. It can become red, swollen, itchy and painful, but not necessarily a problem. If you receive a bite, clean it with soap and water.  Apply ice and if itchy, a topical anti-itch cream like Benadryl, Aspirin or an anti-inflammatory can help with pain and/or swelling if you are able to take them. A bite can remain red and swollen for several days.

The bites that require medical care are mostly those that have a secondary infection. This looks like an increased area of redness and swelling around the original bite area, usually occurs a day or two after the bite, and redness travels upwards from the bite.  These bites need evaluated to see if an antibiotic is necessary.

Spider bites can make people uneasy, but most will respond to the above-mentioned conservative care and do not need an antibiotic unless secondarily infected. The two biggest exceptions are the black widow and brown recluse bites. These bites are intensely painful, swollen, can cause systemic symptoms like nausea, cramping, lethargy and chills.  Black widow bites require anti venom, brown recluse bites require antibiotics and sometimes surgical removal of necrotic tissue.  There are many helpful photos on the internet to help you distinguish a ‘good’ from a ‘bad’ bite.

Tick bites cause the most anxiety for patients as everyone fears Lyme disease and it’s complications. If there is redness and swelling from a tick bite, see your doctor for discussion of what’s best to do.  Most of the time, the deer tick and not the dog tick, is the carrier for Lyme disease, but this is disputed. A rash that looks like a bulls-eye, red center surrounded by a cleared area and then a red ring is concerning and should be treated with an antibiotic for several weeks.  Many times we see Lyme disease in our office as a swollen joint, no history of rash or bite.  A recurrent, non-red but swollen joint that may or may not be painful, should be evaluated.

Insect bites can be a nuisance but are not necessarily a medical emergency. Treat supportively, but if any questions or concerns, check with your OIP caregivers!

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