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Dealing with bites and stings 

Most insect bites and stings cause small reactions that are confined to the area of the bite (localised reactions). They can usually be treated at home.

However, if your symptoms are severe, see your GP as soon as possible.

Removing a sting

As soon as you have been stung by a bee, remove the sting and the venomous sac if it has been left in the skin. Do this by scraping it out, either with your fingernails or using something with a hard edge, such as a bank card.

When removing the sting, be careful not to spread the venom further under your skin and do not puncture the venomous sac.

Do not pinch the sting out with your fingers or a pair of tweezers because you may spread the venom. If a child has been stung, an adult should remove the sting.

Wasps and hornets do not usually leave the sting behind, so could sting you again. If you have been stung and the wasp or hornet is still in the area, walk away calmly to avoid being stung again.

Basic treatment

Most insect bites and stings cause itching and swelling that usually clears up within several hours.

Minor bites and stings can be treated by washing the affected area with soap and water, placing a cold compress (a flannel or cloth cooled with cold water) over the affected area to reduce swelling and not scratching the area because it can become infected (keep children’s fingernails short and clean)

See your GP if the redness and itching gets worse or does not clear up after a few days.

Additional treatment

If the bite or sting is painful or swollen, you can also wrap an ice pack (such as a bag of frozen peas) in a towel and place it on the swelling, take painkillers, such as paracetamol or ibuprofen (children under 16 years old should not be given aspirin),use a spray or cream that contains local anaesthetic, antihistamine or mild hydrocortisone (1%) on the affected area to prevent itching and swelling or take an antihistamine tablet to help reduce swelling (antihistamine tablets are available on prescription or from pharmacies).

If local swelling is severe, your GP may prescribe a short course of oral corticosteroids, such as prednisolone, to take for three to five days.

If you have an allergic reaction after a bite or sting, even if it is just a skin rash (hives), you may be prescribed an adrenaline pen (called an auto-injector) by your GP and shown how to use it. You will also be referred to an allergy clinic to see an immunologist for further tests and treatment.

Blisters

If you develop blisters after being bitten by an insect, do not burst them because they may become infected. Blisters do not often cause pain unless they rupture (burst), exposing the new skin underneath. If possible, use an adhesive bandage (plaster) to protect the blistered area.

Infected bites

See your GP if the bite or sting fills with pus and feels tender to touch, your glands swell up and you feel unwell with flu-like symptoms.

Your GP may prescribe oral antibiotics (medicines to treat infections caused by bacteria). You will need to take these as instructed, usually two or four times a day for seven days.

Allergic reaction

If you have swelling or itching anywhere else on your body after being bitten or stung, or if you are wheezing or have difficulty swallowing, you will need emergency medical treatment. Call the emergency services immediately and ask for an ambulance.

If you have the symptoms of a systemic reaction (SR), it could lead to anaphylactic shock. If you experience anaphylaxis, you may need to have an adrenaline injection, antihistamines, oxygen or an intravenous drip (a drip directly into a vein).

Allergy clinics

If previous insect bites or stings have caused a large skin reaction, such as redness and swelling of over 10cm (4 inches) in diameter, your GP may refer you to an allergy clinic. The criteria for referring someone to an allergy clinic may vary depending on what is available in your local area.

Immunotherapy (desensitisation or hyposensitisation) is a possible treatment option if you are allergic to insect bites or stings, although it is more commonly used for wasp or bee stings. It involves being injected with small doses of venom every week and being observed to check for an allergic reaction.

Your body soon becomes used to the venom (desensitised) and will start to make antibodies to prevent further reactions.

When a high enough dose has been reached, the injections will be given monthly and could last for a further two or three years.

Your immunologist will decide how much venom is injected and how long the injections need to continue for.

Ticks

If you have been bitten by a tick (a small arachnid), remove it as soon as possible to reduce the risk of getting a tick-borne infection, such as Lyme disease (a bacterial infection that causes a rash).