- Yellow jackets
Sometimes, it may be hard to tell which type of insect has caused the skin lesions, as many insect reactions are similar. Flying insects tend to hit exposed skin areas, while bugs such as fleas tend to hit the lower legs and around the waist, and often have several bites grouped together. Some individuals are far more sensitive to insects and have more severe reactions, so the fact that no one else in the family has lesions does not rule out an insect bite.
There is no proven effect of race or sex in terms of bite reactions. However, some individuals clearly appear more attractive to insects, perhaps related to body heat, odor, or carbon dioxide excretion.
Severe allergic reactions to stings occur in .5–5% of the US population.
Flying insects tend to choose exposed areas not covered by clothing, while some bugs (such as fleas) focus on the lower legs. Bedbugs prefer the head and neck area, often biting several times in the same area and leaving a group of lesions.
Common reactions to arthropod stings include:
- Redness, pain, and swelling
- Severe reactions such as facial swelling, difficulty breathing, and shock (anaphylaxis)
- Fever, hives, and painful joints (though these reactions are not as common)
- Bees may leave a stinger behind.
- Try to gently scrape off the stinger with a blunt object, such as a credit card.
- Wash the wound with soap and water.
- Apply an ice pack or cold water for a few minutes.
- Take acetaminophen for pain and an antihistamine (diphenhydramine or chlorpheniramine) for itching, as needed.
- Wash with soap and water.
- Apply cool compresses.
- Use antihistamines to relieve itching and take acetaminophen for pain.
- 1% hydrocortisone cream may help reduce the itching but is usually not as effective as a prescription-strength topical corticosteroid such as triamcinolone acetonide.
- Using tweezers, grasp the tick as near the skin as possible and pull firmly until it releases.
- Swab the area with alcohol or soap and water.
- Save the tick for identification, if needed.
- Wash the area with soap and water, then apply 1% hydrocortisone in anticipation of any reaction.
- A deep blue or purple area around the bite, often with a surrounding white area and a red outer ring
- Abdominal pain
- Muscle stiffness
When dealing with stings, be sure to watch out for symptoms such as:
- Hives, itching, or swelling in areas beyond the sting site
- Swelling of the lips or throat
- Tightness in the chest or difficulty breathing
- Hoarse voice or tongue swelling
- Dizziness or loss of consciousness
For insect bites:
- Prescription topical corticosteroids
- Muscle relaxants, pain medicines, antivenom, antibiotics, and sometimes local surgery to relieve venomous insect bites
- Antihistamines or corticosteroids
- Epinephrine, antihistamines, corticosteroids, intravenous fluids, and oxygen (for anaphylaxis)
- Injectable epinephrine, for those with known severe allergic reactions
- Immunotherapy to reduce the chance of repeated severe reactions