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Coping With Bug Bites

Bug bites may seem like a rite of passage for enjoying the outdoors, but WebMD tells you how to protect yourself and when to take emergency action.
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Reality Bites

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)

This is the bad stuff. A small minority of people are at risk -- between 1 in 300 and 1 in 2000. Although rare, this reaction to common insect bites can be life-threatening. What is 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.

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