Insect Bites and Stings and Spider Bites
Table of Contents
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Topic Overview
Health Tools
Check Your Symptoms
Home Treatment
Prevention
Preparing For Your Appointment
Related Information
Credits
Topic Overview
Insect and spider bites often cause minor swelling, redness, pain, and itching. These mild
reactions are common and may last from a few hours to a few days. Home treatment is
often all that is needed to relieve the symptoms of a mild reaction to common stinging or
biting insects and spiders.
Some people have more severe reactions to bites or stings. Babies and children may be
more affected by bites or stings than adults.
Examples of problems that are more serious include:
• A severe allergic reaction (anaphylaxis). Severe allergic reactions are not common
but can be life-threatening and require emergency care. Signs or symptoms may
include:
◦ Shock, which may occur if the circulatory system cannot get enough blood to
the vital organs.
◦ Coughing, wheezing, trouble breathing, or feeling of fullness in the mouth or
throat.
◦ Swelling of the lips, tongue, ears, eyelids, palms of the hands, soles of the
feet, and mucous membranes (angioedema).
◦ Lightheadedness and confusion.
◦ Nausea, diarrhea, and stomach cramps.
◦ Raised, red, itchy bumps called hives and reddening of the skin. These
symptoms often occur with other symptoms of a severe reaction.
• A toxic reaction to a single sting or bite. Spiders or insects that may cause this
include:
◦ Black widow spider.
◦ Brown recluse spider.
◦ Scorpion.
◦ Puss caterpillar (woolly slug).
• A toxic reaction to multiple stings or bites from a bee, wasp, or fire ant.
◦ A bee leaves its stinger behind and then dies after stinging. Africanized
honeybees, the so-called killer bees, are more aggressive than common
honeybees and often attack together in great numbers. Reaction to bee
stings can range from minor skin swelling and redness to a serious allergic
reaction.
◦ Wasps, including hornets and yellow jackets, can sting over and over.
◦ A fire ant attaches to a person by biting with its jaws. Then, pivoting its head,
it stings from its belly in a circular pattern at multiple sites.
• A large skin reaction with swelling and redness that spreads away from the site of
the bite or sting. It may be as large as swelling across two major joints, such as
from the elbow to the shoulder.
• A skin infection at the site of the bite or sting.
• Serum sickness, a reaction to the medicines (antiserum) used to treat a bite or
sting. Serum sickness may cause hives and flu-like symptoms about 3 to 21 days
after the use of antiserum.
• A virus infection. Infected mosquitoes can spread the West Nile virus to people,
causing an inflammation of the brain (encephalitis). For more information, see the
topic West Nile Virus.
• A parasite infection. Infected mosquitoes can spread malaria. For more information,
see the topic Malaria.
Check your symptoms to decide if and when you should see a doctor.
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
Decision Points focus on key medical care decisions that are important to many health
problems.
• Allergies: Should I Take Shots for Insect Sting Allergies?
Check Your Symptoms
Have you been bitten or stung by an insect or spider?
Yes
No
How old are you?
Less than 1 year old
1 to 11 years
12 years or older
Are you male or female?
Male
Female
Do you have a concern about a tick bite?
Yes
No
Did the bite or sting involve the eyeball?
Yes
No
Could you be having a severe allergic reaction?
This is more likely if you have had a bad reaction to something in the past.
Yes
No
Do you have symptoms of shock?
The symptoms in an adult or older child are different than the symptoms in a young
child.
Yes
No
Have you ever had a severe allergic reaction to a bite or sting?
A severe allergic reaction affects the whole body. Your doctor may have called it
anaphylaxis.
Yes
No
Are you having any symptoms of an allergic reaction now, even
mild ones?
If you've ever had a severe reaction to the same thing that's causing your symptoms
now, treat this as an emergency. Mild symptoms quickly may become severe.
Yes
No
Is there any serious swelling?
This could include swelling that is not near the bite or sting area, or swelling that
began at the bite or sting site but is expanding well beyond that area. (Some swelling
at the site of the bite or sting is normal.)
Yes
No
Are the lips, tongue, mouth, or throat swollen?
Yes
No
Did the lips, tongue, mouth, or throat swell quickly?
Yes
No
Does swelling involve the palms of the hands, the soles of the feet,
or the area from one large joint to another, such as from the ankle
to the knee?
Yes
No
Is the swelling getting worse (over hours or days)?
Yes
No
Did you get an epinephrine shot to treat the reaction?
Yes
No
Have you been bitten or stung by a poisonous spider (such as a
black widow or brown recluse spider), a scorpion, or a caterpillar?
Yes
No
Are there any hives?
Hives are raised, red, itchy patches of skin. They usually have red borders and pale
centers. They may seem to move from place to place on the skin.
Yes
No
Do the hives cover many places on your body?
Yes
No
Did the hives appear within 3 hours after the bite or sting?
Yes
No
Are there any symptoms of infection?
Yes
No
Do you think you may have a fever?
Yes
No
Are there red streaks leading away from the area or pus draining
from it?
Yes
No
Do you have diabetes, a weakened immune system, peripheral
arterial disease, or any surgical hardware in the area?
"Hardware" includes things like artificial joints, plates or screws, catheters, and
medicine pumps.
Yes
No
Have you developed any flu-like symptoms after the bite or sting,
such as fever, shaking chills, muscle or joint pain, headache, or a
general feeling of illness?
This could happen within minutes of the bite or sting or up to 3 weeks later.
Yes
No
Did these symptoms begin within minutes after the bite or sting?
Yes
No
Do you have other symptoms, such as belly pain, vomiting, or
diarrhea?
Yes
No
Did these symptoms begin within minutes after the bite or sting?
Yes
No
Have tiny red or purple spots or bruises appeared suddenly?
Yes
No
Is there a blister, a painful sore, or a purple discoloration at the
site of a bite or sting?
Yes
No
Are you having new muscle spasms or stiffness?
Yes
No
Do you have pain at the site of the bite or sting?
The pain may feel like a burning pain. It may be very bad for several minutes right
after the bite. You may still have some pain hours later.
Yes
No
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is
the worst pain you can imagine?
Signs of pain in an adult or child are different than signs of pain in a baby or toddler.
8 to 10: Severe pain
5 to 7: Moderate pain
1 to 4: Mild pain
Has the pain lasted for more than 8 hours?
Yes
No
Is the pain getting worse?
Yes
No
Have you tried home treatment for more than 2 days?
Home treatment includes things like using ice on the area, taking an antihistamine,
and taking pain medicine such as acetaminophen (Tylenol) or ibuprofen (Advil,
Motrin).
Yes
No
Did you get more than one bite or sting?
This does not include mosquito bites.
Yes
No
Was there more than one bite or sting from bees, wasps, hornets,
yellow jackets, or fire ants?
Yes
No
Did you get at least 5 bites or stings from bees, wasps, hornets,
yellow jackets, or fire ants?
Yes
No
Did you get at least 10 bites or stings from bees, wasps, hornets,
yellow jackets, or fire ants?
Yes
No
Do you think you may need a tetanus shot?
Yes
No
Have symptoms lasted for more than a week after the bite or
sting?
Yes
No
Home Treatment
Common bites and stings
Most bites and stings will heal on their own without a visit to a doctor. There are several
things you can do to relieve pain and itching and prevent infection from a bite or sting.
Insect or spider bites or stings or contact with caterpillars
• Move away from the stinging or biting insect. Bees will alert other bees, making
them more likely to sting.
• Remain as calm and quiet as possible. Movement increases the spread of venom
in the bloodstream.
• If you have been stung by a bee and the stinger is still in the skin, remove the
stinger as quickly as possible.
• If you have been stung on the arm or leg, lower the limb at the time of the sting to
slow the spread of venom. Hours later, if swelling is present, you can elevate the
limb to help reduce swelling.
• After contact with a puss caterpillar, remove broken-off spines by placing
cellophane tape or commercial facial peel over the area of the contact and pulling it
off.
• If you have been stung by a scorpion, see a doctor right away. There is now a
medicine (antidote) for scorpion stings.
Relieve pain, itching, and swelling
• Apply an ice pack to a bite or sting for 15 to 20 minutes once an hour for the first 6
hours. When not using ice, keep a cool, wet cloth on the bite or sting for up to 6
hours. Always keep a cloth between your skin and the ice pack. Do not apply ice for
longer than 15 to 20 minutes at a time. Do not fall asleep with the ice on your skin.
• Elevate the area of the bite or sting to decrease swelling.
• Try a nonprescription medicine for the relief of itching, redness, and swelling. Be
sure to follow the nonprescription medicine precautions.
◦ An antihistamine taken by mouth, such as a nondrowsy one like loratadine
(Claritin) or one that might make you sleepy like diphenhydramine (Benadryl),
may help relieve itching, redness, and swelling. Don't give antihistamines to
your child unless you've checked with the doctor first.
◦ A spray of local anesthetic containing benzocaine, such as Solarcaine, may
help relieve pain. If your skin reacts to the spray, stop using it.
◦ Hydrocortisone 1% cream or calamine lotion applied to the skin may help
relieve itching and redness. Note: Do not use the cream on children younger
than age 2 unless your doctor tells you to. Do not use in the rectal or vaginal
area in children younger than age 12 unless your doctor tells you to.
• After the first 6 hours, if swelling is not present, try applying warmth to the site for
comfort.
Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your fever or pain:
• Acetaminophen, such as Tylenol
• Nonsteroidal anti-inflammatory drugs (NSAIDs):
◦ Ibuprofen, such as Advil or Motrin
◦ Naproxen, such as Aleve or Naprosyn
• Aspirin (also a nonsteroidal anti-inflammatory drug), such as Bayer or
Bufferin
Talk to your child's doctor before switching back and forth between doses of
acetaminophen and ibuprofen. When you switch between two medicines, there
is a chance your child will get too much medicine.
Safety tips
Be sure to follow these safety tips when you use a nonprescription
medicine:
• Carefully read and follow all directions on the medicine bottle and box.
• Do not take more than the recommended dose.
• Do not take a medicine if you have had an allergic reaction to it in the
past.
• If you have been told to avoid a medicine, call your doctor before you take
it.
• If you are or could be pregnant, do not take any medicine other than
acetaminophen unless your doctor has told you to.
• Do not give aspirin to anyone younger than age 20 unless your doctor tells
you to.
Some people try a home remedy, such as putting witch hazel or underarm deodorant on
the bite. Home remedies haven't been proven scientifically, but usually they won't hurt
you if you want to try them.
Prevent a skin infection
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Wash the area with clean water 2 times a day.
After washing, wipe the area with rubbing alcohol or first-aid antiseptic.
Trim fingernails to prevent scratching, which can lead to infection.
Do not break any blisters that develop.
You may cover the wound with a thin layer of petroleum jelly, such as Vaseline, and
a nonstick bandage. Apply more petroleum jelly and replace the bandage as
needed.
For home treatment of lice, scabies, tick bites, bedbugs, or kissing bugs, see the topics
Body Lice, Head Lice, Pubic Lice, Scabies, Tick Bites, Bedbugs, and Kissing Bugs.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
• New symptoms develop.
• Symptoms of a skin infection develop.
• Flu-like symptoms develop.
• Symptoms become more severe or more frequent.
Prevention
Take the following measures to help prevent bites and stings.
• Apply insect repellent before going into the woods or other areas where you may
come in contact with insects. Use insect repellents according to directions,
particularly when applying repellent to children.
◦ Apply repellents safely.
◦ Use a lower-concentration repellent on children.
◦ Do not put repellent on small children's hands, since they often put their
hands in their mouths.
◦ Wash the insect repellent off with soap and water after returning indoors.
• Wear light-colored, smooth-finished clothes that cover your body, such as longsleeved shirts and long pants. Button long sleeves and tuck long pants inside
boots. Avoid loose clothes that might entangle a biting or stinging insect. Avoid
bright colors. Avoid going barefooted or wearing sandals outdoors. Some outdoor
stores may sell clothing treated with a repellent.
• Avoid wearing perfumed lotions, aftershave, or scented hair products during the
warm months.
• Take positive steps to manage your surroundings.
◦ Always close car windows.
◦ Do not put your picnic out until you are ready to eat. Repack picnic food as
soon as you are finished serving.
◦ Avoid flowering plants.
◦ If you have a severe allergic reaction (anaphylaxis) to insect bites or stings,
have someone else mow lawns or clip hedges.
• Avoid swatting at insects or flailing your arms around them. Instead, retreat slowly
and calmly when insects act threatening.
Additional measures include those to:
• Prevent bee stings (also hornet, wasp, and yellow jacket stings).
• Prevent spider bites.
• Prevent flea bites.
• Prevent bedbug bites.
• Prevent kissing bug bites.
If you have had a severe allergic reaction (anaphylaxis) to bites or stings in the past:
• Talk to your doctor about getting a prescription for epinephrine. Learn how and
when to give yourself an epinephrine shot, and have it near you at all times.
• Wear a medical identification tag to let others know you have an insect allergy.
• Discuss allergy shots (immunotherapy) with your doctor. Shots may be appropriate
to control and prevent your symptoms.
Allergies: Should I Have Allergy Shots for Insect Sting Allergies?
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your
Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer
the following questions:
• What type of insect or spider bit or stung you? Be prepared to describe it.
• When were you bitten or stung? How many times were you bitten or stung? Where
on your body were you bitten or stung?
• Have you ever had a severe allergic reaction (anaphylaxis) to a similar bite or
sting?
• What are your main symptoms?
• When did your symptoms begin? How have your symptoms developed,
progressed, or changed since the bite or sting?
• What home treatment have you tried for the bite or sting? Did it help?
• What prescription or nonprescription medicines have your tried on the bite? Did
they help?
• Have you traveled recently?
• Do you have any health risks?
Related Information
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Rash, Age 11 and Younger
Rash, Age 12 and Older
Skin Changes
Credits
By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Adam Husney, MD - Family Medicine
E. Gregory Thompson, MD - Internal Medicine
Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
Current as of April 13, 2017
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