Bug Bites and Stings

Bug bites and stings are injuries that can range in severity from mild annoyances to life-threatening emergencies. How a bite or sting affects you depends on the bug in question and your immune system’s response. Most bites and stings are minor and treatable at home. But some can cause your immune system to overreact, leading to symptoms like hives, trouble breathing or muscle spasms.

It’s not always easy to tell which type of bug has bitten or stung you. But when possible, identifying the type can help you and your healthcare provider plan treatment and watch for complications.

What are the different types of bug bites and stings?

Common types of bug bites and stings in the U.S. include:

• Ant bites, including those from potentially dangerous fire ants
• Bed bugs bites
• Bee stings
• Chigger bites
• Flea bites
• Fly bites, including those from black flies, deer flies, horse flies and sand flies
• Mosquito bites
• Scorpion stings
• Spider bites, including those from potentially dangerous brown recluse spiders and black widow spiders
• Tick bites
• Wasp stings, including those from yellow jackets and hornets

Most of the bugs listed above are insects. That’s why people often use “insect bites” and “bug bites” to mean the same thing. But there are a few exceptions. Chiggers, scorpions, spiders and ticks aren’t insects. They’re arachnids. So, “bug bites” is a more general term that people casually use to cover everything.

What are the signs and symptoms of bug bites?

Signs and symptoms depend on the type of bite or sting. In general, you might experience these issues at the site of the bite or sting:

• A raised bump or welt on your skin. The bump may be red or discolored. You may have multiple bumps that form a line or cluster.
• Itchy or irritated skin. Bites and stings can be very itchy. You may also notice a mild tingling or burning sensation.
• Minor swelling. This means the area around the bite or sting looks a little puffy.
• Pain or discomfort. The pain may be sharp when the bite or sting first happens.

Severe symptoms

Black widow spider bites, brown recluse spider bites and scorpion stings may cause more severe symptoms. If you have any of the symptoms below after a suspected bite or sting, call 911 or your local emergency number immediately:

• Abdominal pain or cramping
• Excessive saliva and drooling
• Excessive sweating
• Fast pulse
• Headache
• Nausea and vomiting
• Muscle pain, stiffness or spasms throughout your body
• Numbness all over your body
• Sensitivity to light
• Slurred speech
• Trouble breathing or swallowing

Allergic reaction to bug bites

An allergic reaction to a bug bite is when your immune system overreacts to the bug’s saliva or venom. Many allergic reactions are mild and only cause symptoms at the site of the bite or sting (providers call these localized symptoms).

But bug bites and stings can sometimes lead to anaphylaxis. This is a severe, life-threatening allergic reaction. Bees, wasps and fire ants are common culprits. Symptoms might start off mild but quickly progress to anaphylaxis.

Signs and symptoms of a bug bite allergy include:

• Dizziness or fainting
• Fast pulse
• Hives
• Muscle spasms
• Nausea, vomiting or diarrhea
• Seizures
• Swelling of the area where the bite/sting occurred
• Swelling of your tongue or throat
• Trouble breathing or swallowing
• Wheezing

With an allergic reaction, the swelling around the bite or sting will be much larger than expected. It may expand to cover more than 4 inches (10 centimeters) from end to end.

Allergic reactions typically start within 15 minutes of a bite or sting. But they may occur up to six hours later (and, rarely, even after that). The most severe reactions often start right away. It’s possible (but uncommon) to have delayed allergic reaction symptoms. Providers call this serum sickness, and it can begin several days after a bite or sting.

If you’ve had a milder allergic reaction to a bug bite or sting in the past (for example, large swelling limited to the bite/sting area), you’re more likely to have a severe reaction in the future. Tell your provider about any reactions you’ve had so they can give you the best advice on prevention and first aid.

Why do bug bites itch?

Bug bites itch because of a chemical your body makes called histamine. When a bug bites you, its saliva enters your skin. Your immune system recognizes the saliva as a substance that doesn’t belong in your body. So, it sends histamine to the site to get rid of this invader.

Bug bites that itch include those from mosquitos, horseflies, bed bugs, fleas and chiggers.

How do bug bites and stings happen?

Bug bites and stings can happen any time you encounter an insect or arachnid. Working or playing outdoors makes run-ins with bugs much more likely. But bugs can also live in your home, especially in attics, basements and wood piles.

Ways people commonly get stung or bitten include:

• Stepping on a bug while walking barefoot
• Being in a forest, garden or overgrown field, especially when there’s high humidity
• Disturbing a nest underground or in a tree, shrub or wall

What raises my risk?

You’re more likely to encounter bugs if you:

• Live close to a lake, river, pond or marsh
• Spend a lot of time in forests or grassy areas
• Work on a farm or have regular contact with animals, especially dogs, cats or horses
• Work as a gardener or beekeeper

What are the complications of bug bites and stings?

Some bugs, like mosquitos and ticks, carry diseases and can infect you through a bite or sting. These are called bug-borne diseases or vector-borne diseases. Examples include:

• Babesiosis
• Chikungunya
• Dengue fever
• Ehrlichiosis
• Encephalitis
• Lyme disease
• Malaria
• Rocky Mountain spotted fever
• Typhus
• West Nile virus
• Yellow fever
• Zika virus

Each disease typically spreads in certain areas of the U.S. or around the world (they’re not everywhere). Your healthcare provider can tell you which diseases are local to your area. Before traveling, it’s a good idea to check which diseases are common there.

How are bug bites and stings diagnosed?

You might not need to see a provider for a diagnosis. But if you do, your provider may ask you questions like:

• When did the bite or sting happen?
• How many bites or stings did you get?
• How soon did symptoms start?
• What first aid or treatments have you done so far?
• What bites or stings have you gotten in the past, and how did your body react to them?

If you have a serious reaction to a bug bite or sting, your provider may recommend allergy testing. They may also prescribe you an epinephrine auto-injector (Epi-Pen®) and tell you how to use it.

What should I know about bug bite treatment?

You can treat most bug bites and stings on your own. Exactly what you do depends on the bug in question and your symptoms. If your provider has prescribed you an EpiPen® to manage an allergy, use it as directed and then seek emergency care. You should also seek emergency care if you suspect a scorpion sting, brown recluse spider or black widow spider bite.

General first aid tips include:

• Get the stinger out right away, if there is one.
• Remove the bug. This might be as simple as shaking off your shirt. Or you might need to use tweezers to remove a tick.
• Wash the area with soap and water. Any break in your skin can allow bacteria to get in. Cleansing the area lowers your risk of infection.
• Apply a cold compress to the area to relieve swelling and pain.
• Take over-the-counter medicines, like NSAIDs, to manage pain or discomfort. But ask your provider first to make sure they’re safe for you.

Treatments your provider may give you in certain situations include:

• Antibiotics or antiparasitic medications to treat infections
• Antivenom injection for a black widow spider bite or scorpion sting
• IV fluids and medications to treat anaphylaxis
• Venom immunotherapy (a long-term treatment) to lower your risk of anaphylaxis

How to stop bug bites from itching

Creams and lotions you apply to your skin can help ease itching. Options include:

• Antihistamines.
• Hydrocortisone.
• Pure aloe vera.

The most important thing to know is that you should not scratch that itch. It’s tempting. But scratching your skin only makes it more likely that your skin will break open. And that raises your risk for infection.

What to do for a swollen bug bite

Applying a cold compress can help reduce mild swelling from a bug bite or sting. Wrap ice or an ice pack in a thin towel before putting it on your skin.

See a healthcare provider if the swelling:

• Is severe or occurs with other symptoms like trouble breathing or swallowing.
• Gradually expands to cover more of your skin.
• Affects other areas of your body besides the bite/sting site.

How long do bug bites last?

Itching and mild swelling usually clear up within a few days. But some bites and stings need a week or two to fully heal. You might need longer to recover from a severe allergic reaction or insect-borne disease.

How can I prevent bug bites and stings?

It’s not always possible to prevent all bites and stings. But here are some things you can do to lower your risk:

• Wear bug spray in areas where you might encounter bugs — whether it’s on the job or while camping or hiking. Spray containing DEET helps fend off mosquitos, ticks, chiggers, flies and fleas.
• Wear long-sleeved tops, pants and boots when in the woods or other areas with lots of bugs. Tuck your pants into your boots for added protection.
• When traveling, check the bed for signs of bed bugs.
• Don’t wear floral-scented products when spending time outdoors.
• Cover foods at picnics or outdoor gatherings so bees aren’t attracted to the area.
• Don’t swat at bees, which may make them defensive. Stay calm if one is near and it’ll likely leave you alone.
• Check firewood for spiders before bringing it into your home.
• Avoid walking barefoot outside.

When should I see my healthcare provider?

Contact a provider if you have any of the following:

• Multiple bee or wasp stings
• A bite or sting close to your eye
• Severe itching or swelling
• Open wounds due to itching
• Symptoms that get worse or don’t start to go away after a few days
• Signs of a skin infection (cellulitis), which include a reddish streak that extends from the affected area, blisters and pus drainage

You should also see a provider if you have any symptoms of an insect-borne illness. These can develop within two weeks of a bite and include:

• Body aches
• Chills
• Fever
• Joint pain
• Nausea and vomiting
• Pain behind your eyes
• Round rash around a bite that looks like a bull’s eye (a sign of Lyme disease)
• Swollen lymph nodes