Wearing long sleeves and pants, never going barefoot, and avoiding insect-infested areas and nests will prevent most bites and stings. Spend enough time outdoors, though, and one day you'll likely feel that telltale pinch. How can you tell if a bite or sting is serious?
According to Pramod Kelkar, MD, an allergist and immunologist in Maple Grove, Minn., reactions to insect bites fall into three categories:
1. Normal Reaction
When insects bite or sting, they commonly inject a small amount of venom or chemicals under the skin. This irritating beetle juice causes the reaction most of us are familiar with:
- A small area (less than half an inch) of redness, swelling, and itching
- Pain, especially when stinging insects are involved.
The worst of these symptoms should resolve within a few hours, and simple remedies can help ease the discomfort:
- Over-the-counter pain medicines like ibuprofen (Advil or Motrin) or acetaminophen (Tylenol)
- Cold compresses or ice
- Calamine lotion for itching.
2. Large, Local Reactions
Rarely, the reaction gets worse instead of going away. A revved-up immune response to a bite or sting may lead to significant swelling and pain over a larger area of the body.
Large local reactions:
- Can spread to involve an entire arm or leg
- Can be severely painful and disabling
- Often require treatment with a prescription medication, such as prednisone (an oral steroid), to fight inflammation.
Large local reactions develop slowly and usually require a trip to the family doctor, not the ER.
How do you know when it's time to get help?
- After a few hours, the swelling is getting worse, not better
- The swelling involves more than one-third of your arm or leg
- Pain and swelling stop you from using that part of your body.
You can't predict if you'll get a large local reaction, but, "If you've had this reaction before, you are more likely to have it again," says Kelkar.
3. Life-Threatening Reactions (anaphylaxis)
- An allergic reaction that spreads through the whole body
- Itching and swelling that commonly occur far away from the bite or sting
- Swelling that can squeeze the lung's airway closed -- a medical emergency.