Spiders and Bees and Bugs, Oh My! Treating insect bites and stings

Spiders and Bees and Bugs, Oh My! Treating insect bites and stings

By Benjamin M. Starnes, MD, FAAP
Pediatric Physician

Another beautiful Seattle summer is just around the corner.  As we stare out windows and wait for our long days of sunshine to begin, know this – the bugs are doing the same thing!  Any day now all our biting, stinging, and pinching friends will begin to appear.  Make sure you prevent bites with insect repellants.  The American Academy of Pediatrics recommends using repellants containing 30% or less of DEET for all children older than 2 months of age.  But if a bite happens, arm yourself (and your medicine cabinet) with a treatment plan to get your kids back outside ASAP.
 
Treatment for all bites:
  • Wash with soap and water first.
 
Treatment for itchy bites:

  • Apply over the counter 1% hydrocortisone cream to the individual bites four times a day until the itching stops.
  • Teach a child to ‘push’ on the bite rather than itch it.  This sometimes helps reduce the itchy feeling without damaging the skin by scratching.
  • For severe itching, give an oral antihistamine such as diphenhydramine.  Do not use topical antihistamines.
 
For painful bites:
  • Apply a cold compress for 20 minutes.
  • Give acetaminophen or ibuprofen as needed.
  • Apply a mixture of water and baking soda to the bite for 20 minutes.  Dab on with a cotton ball.
 
For bee stings:

Follow instructions for painful bites.  Know that bee stings often will swell around the bite site over the first 24 hours before they begin to improve.  This local reaction is common and is not an allergic reaction.  If the swelling is very large or painful, call your doctor.  An allergic reaction to a bee sting will cause full body symptoms, such as swelling to the face, breathing problems, full body hives, vomiting, diarrhea and a very ill appearance.  Call 911 if this happens.
 
For spider bites:

Most spider bites are painful but harmless and can be treated according to the painful bite section above.  According to the Washington Department of Health, the only medically important venomous spiders in our state are the Black Widow and the Yellow Sac Spider.  Black Widow bites are dangerous and can cause severe abdominal pain and muscle cramping.  Yellow Sac Spider bites can cause an ulcer at the bite site that will heal slowly.  Fortunately, both of these spiders are not aggressive and tend to bite only in self-defense or when pressed against the skin.  Because of this, these bites are very rare.  To be on the safe side, if you think your child was bitten by a venomous spider, call your doctor.
 
If any bite becomes an open sore or blister, it is a good idea to schedule an appointment to see your doctor within 24 hours.
 
Call your doctor immediately for any of the following:
  • Excessive pain not improved by above treatments.
  • If you think your child was bitten by a venomous spider.
  • If your child develops full body symptoms following an insect bite such as hives, abdominal cramps, muscle cramps, or if your child begins to act very sick.
 
Medicine cabinet shopping list:  1% hydrocortisone cream, oral diphenhydramine children’s liquid (12.5mg/5mL), acetaminophen and/or ibuprofen, insect repellant containing DEET (30% or less.)
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