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All bug bites can't just be shrugged off

Posted - Jul. 9, 2004 at 7:20 a.m.



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With most insect stings and some bites, the biggest concern is an allergic reaction soon afterward, say experts such as Texas A&M extension urban entomologist Mike Merchant and University of Texas Southwestern Medical School dermatology professor Karen Houpt.

If you have trouble breathing or develop a skin reaction - hives, for example - somewhere other than the immediate area of the wound, get medical attention right away. A drop in blood pressure right after the bite or sting is a bad sign, too.

Don't fool around - such allergic reactions, called anaphylaxis, can be fatal. Most such reactions come after stings, including those of fire ants. But bites can cause them, too, says Houpt, if they come from bedbugs, cone-nose beetles or deerflies.

People who know they're allergic should carry epinephrine injectors such as the EpiPen or Ana-Kit, available by prescription at drugstores. There's also an EpiPen Jr. for children up to about 60 pounds.

If you can't get to a doctor's office or hospital right away, and you don't have an epinephrine injector, as a last resort you can take some Benadryl orally while hurrying to the medics. An ounce of prevention is better still.

Houpt strongly urges people to get allergy shots if they have a history of allergic reactions to insects.

But if your only symptoms are the normal pain, itching or swelling around the bite or sting, you should apply calamine lotion or 1 percent hydrocortisone cream (such as Cort-Aid) for itching. You can also use an anti-itch cream such as Aveeno or Stiefel Sarna. Hydrocortisone can also help with swelling. If there's any concern about infection, apply antibiotic ointment. For pain, take acetaminophen, such as Tylenol, or other pain reliever.

Some people favor applying folk remedies, such as meat tenderizer (papain enzyme), to the bite or sting. The enzyme breaks down protein, so it's supposed to work against insect venoms, which are mostly protein-based.

Trouble is, says Merchant, the venom is in your bloodstream, beyond the reach of the tenderizer. Tenderizer is more useful against jellyfish stings, says Houpt.

Merchant and Houpt also have no opinion on the value of a new over-the-counter product, Mitigator, whose ingredients include papain and ground walnut shells.

Some bites require special attention. Here's what our experts advise:

Fire ant

A fire-ant sting produces a little white pustule. Try not to break it, which could lead to infection. If it does break, apply antibiotic cream. Otherwise, use hydrocortisone cream. One folk remedy is a dab of liquid bleach, but it has to be applied quickly, says Merchant. And Houpt notes that full-strength bleach can irritate the skin further.

Honeybee

Honeybees have a barbed stinger attached to a venom gland. When the bee stings, the stinger tears off, and the bee dies. But that stinger stays in your skin along with the gland, which continues to pump out venom. (You can see it throb.) Get the stinger and gland out as soon as possible - use a fingernail, a dull knife, tweezers, a nail file, anything handy. Don't worry; you won't make the venom go in any faster. Then as soon as you can, clean the sting and apply antibiotic ointment. If the sting itches, apply calamine, hydrocortisone cream or anti-itch lotion.

Stinging caterpillar

A stinging caterpillar's sting feels as if you've been burned by a match. Press some masking tape or duct tape against your skin and try to pull out any spines lodged there. Then apply hydrocortisone cream, and see a doctor if you get a larger rash.

Tick

Tick bites require a delicate touch. When you find one, use a pair of tweezers to grab the tick as close to the head as possible. Then use a gentle, steady motion to pull it straight out. Don't twist or bend it, because the head can break off and start an infection. (If the head does break off, apply antibiotic ointment.) And forget about the folk remedies of a dab of Vaseline or applying a just-extinguished match. Those just make the tick salivate more, which can speed up the transmission of any disease it carries.

Spider

Black-widow and brown-recluse spider bites require a doctor's prompt attention. An antitoxin is available for black-widow bites, which can produce fever, an increase in blood pressure, sweating, nausea or abdominal cramps. Symptoms usually become full-blown in one to three hours and last for a couple of days. Bites are rarely fatal, but can be in small children or older people.

A brown recluse bite is painless at first, but within 24 hours, a sore develops, along with stinging and a small blister. The pain's intensity may vary. The blister often turns into a raw ulcer that may take several weeks to months to heal. Plastic surgery may even be needed.

A recluse bite can be treated with an antibiotic called dapsone. The first thing to do, though, is apply the RICE technique after you've cleaned the wound: Rest, Ice Compresses on the bite area and Elevation of the affected limb.

With black widows and brown recluses, and ticks, which can transmit Rocky Mountain spotted fever and Lyme disease, it's a good idea to capture the insect after you're bitten (if you can do so safely).

Save it in an empty pill jar with some rubbing alcohol, and take it with you to the doctor if troublesome symptoms develop.

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DITCH THE ITCH: KEEPING THE BUGS AWAY

The best treatment for a bug bite is to prevent it in the first place.

UT-Southwestern dermatology professor Karen Houpt suggests that you avoid wearing white or bold colors if you'll be where insects are active. Dark or drab colors, such as khaki, are better. Houpt also warns against using perfume, after-shave, body lotion or any other scented stuff - the bugs like it just as much as you do. Same goes for food odors.

If you plan to be someplace where mosquitoes are active, then use repellent, especially in the evening, advises urban entomologist Mike Merchant. Ideally, you'll wear clothing that covers most of your skin and apply the repellent to your clothes.

In fact, some new lines of clothing even have built-in insect repellent, permethrin. You can also buy the repellent (the brand name is Permanone) separately in sporting-goods departments or stores, or online.

But if you can't avoid baring your skin, Merchant suggests that adults apply a repellent with a 12 percent to 25 percent concentration of DEET - no stronger. For children more than 2 months old, Houpt and the American Academy of Pediatrics (www.aap.org) recommend DEET concentrations of 10 percent or less. Never apply DEET products to children's faces and hands or let any spray get in their mouths. Also, consider new DEET-free repellents, which can be effective for 30 to 45 minutes.

If you need longer protection, just reapply. (If using a DEET product, it's better to use a lower concentration and apply more often.) Repellent washes off, so if you go swimming or you sweat heavily, reapply then, too.

If you see a mosquito land on you after you've applied repellent, that doesn't mean it's not working. Repellents don't keep mosquitoes off, says Merchant - they confuse the bugs by blocking chemical signals that tell the mosquitoes they've landed on their dinner. So they land and then fly away without biting.

Merchant doesn't place much faith in ultrasonic or light traps around the house, although he says that some carbon-dioxide traps may help.

And he says bug zappers do more harm than good. They kill beneficial insects more than harmful ones, and mostly males, which don't bite.

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(c) 2004, The Dallas Morning News. Distributed by Knight Ridder/Tribune News Service.

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