Symptoms

It may be difficult to determine if you have been bitten or stung—and by what. The reaction to minor bites is usually confined to the area around the bite. It may be red or have slight swelling. It may itch. Pain and swelling usually improve in 24 hours.

Swelling can vary from a small dot to half an inch in size. A large swelled area doesn’t mean you are allergic to insect bites. The size of the swelling doesn’t necessarily mean the bite is serious.

Mosquito and gnat bites near the eye or ear can become very swollen. It also is not unusual for glands to become swollen as a reaction to insect bites.

Dangerous, life-threatening reactions to insect bites occur throughout the body usually within 20 minutes following the bite. The reaction appears on a part of the body separate from the sting site. Dangerous reactions include:

• Hives, intense itching, or swelling all over the body
• Shortness of breath
• Wheezing 
• Swelling of the throat that causes difficulty swallowing
• Nausea
• Stomach cramping
• Vomiting
• Loss of bowel and bladder control
• Weakness
• Dizziness or fainting
• Drop in blood pressure
• Shock or unconsciousness

Prevention

Don’t use perfumes, aftershave, scented hairsprays, or scented deodorants. Wear insect repellent, light-colored clothing, long-sleeved tops, long pants, socks, and shoes. Floral patterns attract bees, as do food, beverages, and garbage cans. If a bee comes near you, avoid sudden movements. Stay still or move away slowly.

Using Insect Repellents

DEET is the most effective insect repellent, offering protection for about 3 hours.

• Be careful when using DEET on children. Use low concentrations (no more than 10 percent) and apply lightly no more than twice a day. Follow manufacturer’s instructions.
• Don’t get insect repellent with DEET on your mouth or eyes, and wash it off your hands after applying.
• Other repellents, such as Skintastic and Skin-So-Soft, may be safer but less effective.
• Citronella comes in lotions, sprays, and candles and offers limited protection against some mosquitos.
• Repellents are less effective in higher temperatures because they evaporate.

Prevention for People with Serious Reactions to Bee Stings

People who have had a serious reaction to a bee sting can take the following steps to prevent a serious reaction in the future:

• Carry a bee-sting kit at all times. A doctor can prescribe one and show you how to use it. These kits contain injectable adrenaline, also called epinephrine, which can be lifesaving.
• Carry a card or wear a bracelet that alerts others to the condition.
• Ask your doctor if venom desensitization injections will help. (Desensitization is a process of making you less sensitive to venom.)

First Aid

• Remove the stinger when stung by a bee, wasp, hornet, or yellow jacket. Scrape over the stinger (which looks like a splinter) with a credit card, fingernail, knife blade, or other rigid object. Don’t try to pull it out with your fingers or a tweezers; you might end up squeezing more venom into the skin.
• Wash the site of the bite and the surrounding area thoroughly with soap and water.
• Apply cold quickly. Cool compresses or ice packs will help ease the pain and prevent swelling from most insect bites. The longer you wait to apply a cold treatment, the less benefit it will have. Apply cold packs for no more than 20 minutes at a time to avoid frostbite.
• Don’t scratch that itch. Apply calamine lotion, hydrocortisone cream, or baking soda and water. Take Benadryl (an antihistamine) if itching or more local swelling occurs. Benadryl will help reduce late-appearing symptoms but is not an effective emergency treatment. It can also cause sleepiness or hyperactivity in children.

Special Care for Children with Insect Bites

• Trim child’s nails to prevent trauma from scratching.
• Protect babies from insects, especially those under 1 year, because they can’t swat them away.
• Note that bites on young children and babies will be more swollen in general, and may form hard lumps that last for several months.