Insect Bites

What may happen after an insect sting or bite?

Mostly you just treat the symptoms, antibiotics are rarely needed.

 A small local skin reaction – most cases

An insect sting – typically causes an intense, burning pain. This is quickly followed by a patch of redness and a small area of swelling (up to 1 cm) around the sting; this usually eases and goes within a few hours.

An insect bite – you may not notice the bite (although some can be quite painful, particularly from a horsefly). However, saliva from the insect can cause a skin reaction such as: Irritation and itch over the site of the bite. A small itchy lump (papule) which may develop up to 24 hours after a bite. This typically lasts for several days before fading away. Sometimes some redness (inflammation) surrounds each papule. A weal – a small fluid-filled lump and is very itchy. It may develop immediately after being bitten. A weal lasts about two hours, but is often followed by a small itchy solid lump which develops up to 24 hours later. This can last for several days before fading away.

A localised allergic skin reaction – occurs in some cases causing swelling at the site of the sting. This becomes larger over several hours, and then gradually goes away over a few days. The size of the swelling can vary, but can become many centimetres across. The swelling may even extend up an entire arm or leg. The swelling is not dangerous unless it affects your airway. However, if it is severe the skin may break out in blisters.

If stung by a bee and the stinger is still in place – scrape it out; the quicker you remove the sting the better, so use anything suitable to scrape out the sting quickly.

If any symptoms of a generalised allergic reaction develop (severe difficulty breathing only occurs in 3 in every 100 people bitten), you should:

  • Call an ambulance immediately
  • If you have been issued with an adrenaline pen, use it as straight away

If there is a localised allergic reaction (swelling around the site of the sting) then:

  • Take an antihistamine tablet as soon as possible. You can buy these at pharmacies. (Antihistamines block the action of histamine which is a chemical that is released by certain cells in the body during allergic reactions.)
  • Use a cold compress to ease pain and to help reduce swelling. For example, use a cold flannel or an ice pack.
  • Painkillers such as paracetamol or ibuprofen can help to ease the pain.
  • Continue with antihistamines until the swelling eases. This may be for a few days.

See a doctor if the swelling is severe.

Your doctor may prescribe a short course of steroid tablets to counter the inflammation

If it is itchy, you may not need any treatment as itching often soon fades, however, sometimes an itch persists for hours or days.

No treatment will take the itch away fully, but Crotamiton ointment (which you can buy at pharmacies) is soothing when rubbed onto itchy skin.