American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

What You're Itching to Know about Bug Bites

Girl roasting marshmallowsFrom bees and wasps to mosquitoes and ticks, there is no shortage of outdoor party invaders during the summer months. Before you head to your next barbeque, learn how you can protect you and your family from insect bites and stings, and keep enjoying those long summer nights.

"Insect bites and stings are extremely common,” says Alfredo Rabines, DO, an AOA board-certified emergency physician in Brooklyn, New York. “Stings from bees, wasps, hornets, yellow jackets and fire ants are typically the most troublesome. Bites from mosquitoes, ticks and biting flies also can cause reactions, but these are generally milder,” he adds.

Since bites and stings are an injection of venom or other substances into your skin, the injection can sometimes trigger an allergic reaction. “The severity of your reaction depends on your sensitivity to the insect venom or substance and whether you've been stung or bitten more than once,” says Dr. Rabines.  

According to Dr. Rabines, most bites and stings will only result in mild discomfort for a short period of time. “Typically the signs and symptoms of an insect bite are redness, swelling and itching that disappear within a day or so,” he says. 

Symptoms of a Severe Reaction

A small percentage of people experience a severe reaction. According to Dr. Rabines, symptoms of a severe reaction can include:

  • Wheezing or shortness of breath

  • Chest tightness or pain

  • Nausea

  • Difficulty swallowing

  • Faintness or weakness

  • Abdominal pain

  • Deterioration of blood pressure and circulation (shock)

"If you experience any of these symptoms, or have a history of severe reactions, you should seek medical attention immediately,” says Dr. Rabines.

A sting in the mouth is also serious. “Because stings in oral mucous membranes can quickly cause severe swelling that may block airways, it is important to monitor them very closely and see a doctor immediately if swelling begins,” explains Dr. Rabines.


To treat milder symptoms like redness and pain, you can apply ice to the affected area. Dr. Rabines recommends cleaning 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,” he says.

To treat itching, Dr. Rabines recommends applying an over-the-counter antihistamine such as diphenhydramine (Benadryl) in cream or pill form or Calamine lotion. “You should refrain from scratching because this may cause the skin to break and an infection to form,” he adds.

If symptoms do not improve after performing the measures above and the area appears more red, hot and tender, Dr. Rabines recommends consulting a physician for further evaluation of infection.

If you don't currently have a physician, consider Doctors of Osteopathic Medicine, or DOs. They look beyond symptoms to understand how lifestyle and environmental factors affect their patients' wellbeing. They listen and partner with them to help them get healthy and stay well.

Preventive Measures

To protect you and your family from insect bites and stings this summer, Dr. Rabines suggests the following:

  • Avoid outdoor activity during the most active time for mosquitoes, which is at dawn and dusk or in the evening.

  • Minimize areas of exposed skin by wearing long-sleeved shirts and pants.

  • Apply insect repellent to skin, clothing, shoes, tents, etc.

  • Keep an eye out for hives or nests and avoid them.

"It’s almost impossible to protect yourself completely from insect bites and stings,” concludes Dr. Rabines. “But, as long as you take measures to prevent them from happening in the first place, and know what symptoms to watch for, you can be quite effective in diminishing the chances of anything serious happening.” ​​​


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