“What bit my daughter, doctor?” asks a father, showing a red lump on his daughter’s forehead.
“Where was she at the time of the bite?” asks the doctor, as he prepares to make the diagnosis: a local skin reaction due to an insect bite.
The father scratches his head, trying to remember where his daughter was, but finds nothing. He finally says, “I don’t know.”
This kind of dialogue is what often happens between doctors, parents, and caregivers as they try to solve the puzzle of insect bites.
Sting or bite: what’s the difference?
When in pain, insect sting victims don’t care if they got stung or bitten. However, technically speaking, when an insect bites, it injects toxins into the victim’s skin and blood system. This poison can trigger a local and widespread skin reaction or a general body reaction. Insects that tend to sting include bees, wasps, yellow jackets, hornets, and fire ants.
In contrast to the bite, which passes poison to the victim, the bite of an insect has the purpose of feeding, of taking food from the victim. To help them feed while biting, the insects inject saliva into the skin and tissues of the victim. The insect’s saliva is foreign to the victim, causing it to itch and scratch, causing local or widespread swelling.
Signs and symptoms of an insect bite
An insect bite skin bump refers to the local area of swelling that we feel when we slide our palms over someone’s bitten skin.
Other symptoms and signs of an insect bite include pain, itching, swelling, and redness at the site and the area around the bite. There may be more complaints and associated symptoms, such as a child refusing to put the right foot down due to pain associated with an insect bite on that leg.
Skin bumps due to insect bites can be single or multiple, and their sizes vary. They can be anywhere on the body. They can appear immediately or a few days after the bite, at which point the answers to the questions of “where” and “why” are buried under a pile of similarly lost memories.
Although insects transmit diseases, they do not always do so when they bite. Therefore, this article will not address life-threatening insect-borne diseases, such as malaria and West Nile fever, which are caused by mosquitoes, or trypanosomiasis, which is caused by tsetse flies.
The article is strictly limited to local reactions or swelling of the skin due to insect or ant bites.
How to Treat a Local Skin Lump Caused by an Insect Bite
Since some readers may be anxious to know how to treat local reactions to insect bites, I’ll reveal the protocol right away.
Minor insect bites do not need medical treatment. They will heal on their own.
Bug bites that are bothersome require some form of medical intervention: Benadryl is given orally to suppress itching: hydrocortisone cream, preferably 2.5%, is rubbed onto the swollen area and used to control redness , which is also called inflammation. Pain relievers such as Tylenol or ibuprofen are given by mouth to control pain.
Be aware that Benadryl, or any other antihistamine, can cause drowsiness. Do not give Benadryl if there is no itching.
Caregivers can try a milder concentration of steroid cream (1% hydrocortisone). Like Benadryl and pain relievers, hydrocortisone cream can be purchased at drug stores without a prescription.
From experience gained in private practice, I can assure you that, except in very severe cases, the local allergic reaction caused by insect bites improves within a couple of days. Therefore, stop the medicines when the child feels well.
There are no indications for the use of antibiotics for skin inflammation caused by insect bites, except in the rare case of bacterial superinfection. This is usually caused by children touching and scratching the bite areas.
Consult a doctor if the swelling caused by an insect bite does not go down, if fluid of any color comes from the lump, if there is an accompanying fever, and of course for any other specific concerns for the child.
Mosquitoes in Nigeria
Dividing insects into those that bite outside the house and those that bite inside the house is an essential way to see them.
Bed bugs are a good example of insects that bite a victim indoors and mosquitoes are a good example of insects that bite outdoors.
There are many bugs out there and many are native to the community where they reside. Quite a few can deliver a stinging bite.
However, there is a substantial overlap between indoor and outdoor bugs, depending on where you are in the world.
For example, mosquitoes in Nigeria are everywhere; under the sheets, perching on window panes, lounging in cupboard drawers and soup pots, enjoying eguisi [melon] soups—–seriously, no exaggeration.
How to know what bit you
Doctors can only give an informed opinion as to the specific cause of a sting, unless, of course, one has been able to capture and bring back the insect for identification, at which point a more confident examination can be made.
Knowing which bugs are dominant in a location helps clinicians determine who the perpetrator is.
For example, if someone in Onitsha, an urban ghetto, develops a local itchy swelling on the forearm or leg after standing on the porch, you can be sure that angry bloodsucking mosquitoes have attacked him.
Similarly, a six-year-old boy in Akokwa, a rural town in Nigeria, who was badly bitten on the buttock while sitting on a cement or sand floor to listen to his grandfather’s fairy tale, will almost certainly be a victim of a homegrown bad black ant, called agbusi.
To the west, a child who got red bumps on his arms, legs or face after playing at a community park in Connecticut was probably bitten by gnats, also called black flies, yellow flies or midges.
A bug can attack any part of the body, but especially exposed parts, with the legs and arms being the most vulnerable places, especially for those who wear short sleeves.
The whereabouts of a person at the time of the bite is helpful in finding out what bit them.
As the ice melts and spring arrives, the weather is good for outdoor activities. Children are eager to play in the backyard or in the park. Unfortunately, the bugs are waiting to bite; to lay their suckers on the exposed skins of defenseless children.
it’s a bug world, keep moving
The insects are opportunistic and target people who are motionless, stopping momentarily to put on socks or shoes, for example. They deliberately target children who are transient, between activities; stationery, sitting or resting.
If two children go to a park, one may be attacked by insects while the other is spared. Why did this happened? Well, the boy who is standing is like a sitting duck waiting for the bugs to attack. A child who is constantly busy is too quick a target for an insect attack. Another explanation is that some people have an intense reaction to an insect bite, while others are not as affected.
The exact moment of the sting is often forgotten. Swelling at the sting site may be immediate or it may take a day or two to manifest, by which time most people have forgotten about their exposure.
Insects that fly, ants that crawl, and scorpions and spiders that crawl are all related. They all descend from a common ancestor, called an Arthropod; an animal that has stiff arms and legs but no backbone.
Although this article is about local inflammation of the skin after insect bites, as mentioned above, the next paragraph deserves attention.
The need to carry an EpiPen for people experiencing a severe reaction
A life-threatening phenomenon known as anaphylaxis can occur in people who are allergic to the stings of certain poisonous insects. People experiencing an anaphylactic reaction may experience shortness of breath, facial swelling, and circulatory collapse. These people should carry the medication epinephrine, in a ready-to-use form, for example, EpiPen Auto-Injection, for intramuscular injection.
Hornets, wasps, and yellow jackets are examples of insects equipped to deliver a sting that could reverberate throughout the body, causing difficulty breathing, swelling around the face, fainting, wheezing, muscle breakdown, seizures, and potentially death.
Prevention of insect bites
Preventing insect bites is not too difficult. Wear long sleeves, pants, and socks when you anticipate any exposure to biting insects. Spray repellents or Bug Off around where there are infestations, and spray repellents on the fringes of clothing, hats, and shoes while on a bug-ridden trail. Eliminating standing water, the breeding ground for many insects, is also essential to controlling the insect threat.
Disclaimer: This article is not intended to diagnose or treat any individual bite or sting. Every bite or sting is different. Whenever there is concern about a specific bite, direct evaluation by a physician is essential.
