Treatment depends on the type of reaction. If there is only redness and pain at the site of the bite, application of ice is adequate treatment. Clean the area with soap and water to remove contaminated particles left behind by some insects (such as mosquitoes). These particles may further contaminate the wound if not removed. Refrain from scratching because this may cause the skin to break down and an infection to form.
You may treat itching at the site of the bite with an over the counter antihistamine such as diphenhydramine (Benadryl) in cream or pill form. Calamine lotion also helps relieve the itching.
People who have a history of severe reactions to bites or stings may have been prescribed an anaphylaxis kit. The kit contains an epinephrine injector (you give yourself an injection), tourniquet, and an antihistamine. The kit should be used according to the doctor's instructions.
Medications
Severe reactions are treated with injections of epinephrine and an antihistamine such as diphenhydramine (Benadryl). Steroids (drugs in the cortisone family) are also usually given. Oral antibiotics may be given for infected bite wounds. For seriously ill people, an IV will be started, oxygen given, and a heart monitor used until the symptoms have improved.
Next Steps
After emergency treatment, antihistamines are taken for a short period of 3-5 days. Steroids (cortisone type drugs) may also be prescribed.
Follow-up
In the emergency department, you may be instructed how to use an emergency kit in case of future stings to prevent a severe reaction. The anaphylaxis kit contains an epinephrine injector, tourniquet, and an antihistamine.
You may be referred to an allergist for desensitization therapy. After testing to determine which venom you are sensitive to, the doctor will gradually increase the doses of venom injected over time. Desensitization is usually effective in preventing a severe reaction to future stings.
Prevention
You can minimize your exposure to insect bites by changing your patterns of activity or behavior.
- Some vector mosquitoes are most active in twilight periods at dawn and dusk or in the evening, so avoid outdoor activity during these periods.
- Wear long sleeved shirts, long pants, and hats to minimize the areas of exposed skin. Shirts should be tucked in.
- Use insect repellants. Repellents applied to clothing, shoes, tents, mosquito nets, and other gear will enhance protection.
- Permethrin-containing repellents (Permanone) are recommended for use on clothing, shoes, bed nets, and camping gear. Permethrin is highly effective as an insecticide/acaricide (against ticks and mites) and as a repellent. Permethrin-treated clothing repels and kills ticks, mosquitoes, and other arthropods and retains this effect after repeated laundering. Such treated clothing is thought to pose little danger for poisoning to humans wearing it.
- Repellents containing DEET (N,N-diethylmetatoluamide) as an active ingredient are recommended by most authorities. A common commercial repellant that contains this chemical is the brand name OFF. DEET repels mosquitoes, ticks, and other arthropods when applied to skin or clothing. Formulations containing less than 35% DEET are recommended because the additional gain in repellent effect with higher concentrations is not significant when weighed against the potential for toxicity, which include rare cases of encephalopathy (brain infection) in children.
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