Insect stings and bites 101

It’s that time of year when yardwork and beach trips become standard weekend plans in Columbia, SC! Being a primary care physician, I receive a few calls about stings and bites every year, so I wanted to write a Stings and Bites 101 article for your reference. As always, if you have any concerns after getting bit or stung, please call your doctor (if that is not me!).

Bee/Wasp/Hornet stings – Bees usually only sting once, but wasps and hornets can sting multiple times. Step 1 is to remove the stinger with a fingernail or tweezers as soon as you can. The longer the stinger stays in, the more venom is released and the more painful it will become. Wash the area with soap and water. Put an ice pack on the area for 10-20 minutes.
• If someone starts to develop hives and/or has trouble breathing after being stung, they need to go to the ER asap. This type of reaction is what Epi-pens are for, and here is a 90 second video on how to use an Epi-pen.

Jellyfish stings – To pee or not to pee, that is the question! You may be surprised to learn that urine has NOT been shown to be an effective treatment for jellyfish stings! Similar to a bee sting, jellyfish also inject venom into your skin when you are stung and you want to remove any jellyfish parts that are attached to the skin as soon as possible. UNLIKE a bee sting though, you want to use very warm water (110 degrees or so) to soak the affected area for about 30 minutes. Vinegar can help, but research so far has shown that hot water appears to be the most effective treatment.
Mosquito bites – Did you know that baking soda will reduce itching? In fact, baking soda is the active ingredient in “After Bite,” the popular medicine you can buy at the pharmacy. If you’d like to save some money, you can make your own “After bite” at home. Mix 1 Tbsp baking soda with just enough water to make a paste. Apply to the bite and wash off after 10 minutes.
-You can use baking soda to treat itching from more than just mosquito bites — try mixing it in a bath for things like poison ivy.

Basic principles
• Try not to scratch bug bites and stings. The skin is already inflamed and the bacteria under your nails may have an easier time starting an infection if you scratch the area.
• I don’t recommend Benadryl cream. Ironically, it can cause skin irritation.
• You can take Advil or Aleve to treat pain from stings if it is safe for you to take these medicines.

Melissa Boylan MD, FAAFP
Family Physician and Owner of Noreta Family Medicine