Insect Bites and Stings

Insect bites can cause an allergic reaction. More people have allergic reactions to stinging insects than to biting insects.

Signs and Symptoms

• Red swollen warm lump or hives
• Itching tenderness pain
• Sores from scratching; can be infected
• Serious allergic reactions when symptoms spread (This is called anaphylaxis). These can include difficulty breathing dizziness nausea diarrhea fever muscle spasms or loss of consciousness. Call for emergency medical help right away.

What Causes It?

Stinging insects include bumblebees yellow jackets hornets wasps and fire and harvester ants. Biting insects include conenose bugs mosquitoes horseflies deerflies spiders bedbugs and black flies.

What to Expect at Your Provider's Office

Your health care provider will determine if you are having or are at risk of having a serious allergic reaction. If you are having an allergic reaction your provider will give you drugs to stop it. When you feel better you may have a series of shots to prevent a strong reaction if you are bitten again.

Treatment Options

Treatment Plan

Large local reactions usually go away in three to seven days with no treatment. For symptom relief try the following.

• Ice pack or wet compresses
• Apply paste of 1 tsp. meat tenderizer mixed with 1 tsp. water

For a serious allergic reaction your health care provider will give you medication. It is helpful to rest elevating your legs.

Drug Therapies

Prescription

• Epinephrine—the dosage is repeated every 15 to 20 minutes until you are better
• Intravenous (IV) epinephrine—for shock
• Breathing in epinephrine—helps relieve swelling in your upper airway
• Oxygen—if you are not breathing well on your own
• Injections of antihistamine (e.g. Benadryl) to decrease itching
• Topical steroids and systemic glucocorticoids—commonly used to decrease symptoms but scientific evidence of effectiveness is poor

Over the Counter

• Antihistamines—for example Benadryl help to decrease itching
• Acetaminophen ibuprofen aspirin—for pain relief; do not give aspirin to children under 18 years because of the risk of a life-threatening disease called Reye's syndrome

Complementary and Alternative Therapies

Anaphylaxis requires immediate medical attention.

High doses of bioflavonoids and vitamins may reduce severity and duration of reaction.

Nutrition

• B complex (50 to 100 mg a day) especially B₁ (50 to 100 mg one to two times a day) and B₁₂ (1 000 mcg a day) can be used in prevention as a mosquito repellent.
• Vitamin C helps reduce histamine release resulting in a milder reaction. For severe reactions take 1 000 mg every two hours to the limit of your bowel tolerance (i.e. loose stools) which may be more than 10 000 mg a day. After acute episode take 1 000 mg three to four times a day.
• Bromelain (250 to 500 mg four times a day between meals) is a proteolytic enzyme that has anti-inflammatory effects.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

• Licorice root (Glycyrrhiza glabra) reduces inflammation. Take 500 to 1 000 mg every three to four hours during acute reaction. Do not use licorice root if you have high blood pressure.
• Quercetin is a bioflavonoid that has powerful anti-inflammatory effects. Take 500 to 800 mg every two hours for severe reactions.
• Turmeric (Curcuma longa) strengthens the effects of bromelain. Take 250 to 500 mg four times a day with bromelain.
• Combine equal parts of coneflower (Echinacea purpura) cleavers (Galium aparine) oat straw (Avena sativa) red clover (Trifolium pratense) elder (Sambucus canadensis) and marigold (Calendula officinalis). This is best used as a tea 4 to 6 cups per day to increase hydration. Tincture may be used as well (30 to 60 drops four times a day).
• Poultice of bentonite clay and goldenseal powder (Hydrastis canadensis) with enough water to make a paste. Add several drops of essential oil (4 to 6 drops per tbsp. of paste) such as lavender peppermint chamomile or tea tree. Use this topically with severe inflammation and swelling as it has soothing properties.
• Poultice of raw grated potato or plantain leaves (Plantago major).
• Make a strong tea from peppermint (Mentha piperita) using 1 heaping tsp. per cup. Place in spray bottle and chill. Spray on stings and bites to relieve itching.
• Witch hazel mixed with a few drops of lavender oil can be used as a cooling compress.
• Bug repellent herbs include lavender citronella eucalyptus and pennyroyal. Mix 15 drops of each essential oil with one ounce of food-grade oil (for example almond or olive). May need frequent application three to four times per day.

Homeopathy

Some of the most common remedies used for insect bites are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms get better.

• Aconite for acute swelling with anxiety and fear
• Apis mellifica for stinging pains with rapid swelling
• Belladonna for rapid intense swelling with redness and heat
• Ledum for puncture wounds
• Topical homeopathic preparations containing Ledum Arnica Calendula Hypericum or Urtica may provide symptomatic relief. Do not apply over broken skin.

Acupuncture

May be helpful in reducing inflammation.

Following Up

Sometimes serious reactions happen again soon after the first reaction stops. Your provider may want to observe you for 8 to 12 hours.

Special Considerations

• If you have had a serious reaction to an insect bite keep an emergency insect sting kit and wear a medical alert bracelet.
• Keep bites clean and to prevent infection don't scratch.
• When outdoors avoid perfumes and floral-patterned or dark clothing.

Supporting Research

Habif TP. Clinical Dermatology. 3rd ed. St. Louis Mo: Mosby-Year Book; 1996.

Kruzel T. The Homeopathic Emergency Guide. Berkeley Calif: North Atlantic Books; 1992:198–200.

Middleton E ed. Allergy: Principles and Practice. 5th ed. St. Louis Mo: Mosby-Year Book; 1998.

Rakel RE ed. Conn's Current Therapy. 50th ed. Philadelphia Pa: WB Saunders; 1998.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.