By Janice Harvey, RPh, CDE
The hot summer weather is a wonderful invitation to spend time outdoors, enjoying family BBQs, taking a dip at local swimming holes and beaches, tackling hiking trails, and getting in a last camping trip during the Labour Day long weekend. It’s also the time when we’re most likely to get bitten or stung by insects.
Bites vs. stings
Some of the most common biting insects are mosquitoes, flies, fleas and ticks. Insect bites don’t usually cause much skin damage, but they do leave a puncture mark. The saliva can include substances that numb the area, prevent clotting, and cause inflammation. Bites from spiders (arachnids, not insects) will usually sting a bit initially, which then leads to itching and inflammation.
Wasps, bees and fire ants are common stinging insects. They have a stinger through which they inject venom. When a honey bee stings, the stinger is left behind and the bee dies soon after, but that’s not the case for bumble bees and wasps, which can sting more than once.
What are the symptoms?
Most people will experience only mild, localized reactions to bites and stings: minimal pain, itching, redness, and swelling. However, some individuals will have a more significant reaction that may last longer than 7 days and can include a large area of swelling that extends beyond the bite or sting site, hives, joint pain and/or fever. “Skeeter syndrome” is the term used for an intense reaction that results in dramatic swelling, heat, redness, itching and pain, as well as a low-grade fever that occurs within hours of a (usually mosquito) bite. Severe reactions are more likely to the stings of bees, wasps, hornets, and yellow jackets. Having a severe or extensive local reaction increases the risk of a systemic (anaphylactic) reaction in the future.
Is treatment really necessary?
In the case of bug bites, your pharmacist can recommend over-the-counter products, such as antihistamines, pain relievers, and products to relieve itch. There are many options, with different active ingredients:
- Aveeno Anti-Itch, Cerave Itch, Gold Bond Medicated Cream, Pramox HC, and generics of these include pramoxine, a topical anaesthetic that is not related to benzocaine or lidocaine.
- Cortate and its generic equivalents include hydrocortisone, a corticosteroid to help with itch and inflammation.
- Products containing menthol or camphor provide a cooling sensation, which may provide some mild pain relief and an anti-itch effect.
- Calamine lotion is soothing for itchy, irritated skin.
- Afterbite, which contains ammonia and baking soda, may also have a mild cooling effect and offers some relief of itching.
Please chat with us so we can help you make the best choice. There are also a few prescription medications that pharmacists can now prescribe, if necessary.
Aside from reducing the symptoms of itching and swelling, it’s also important to take steps to prevent infection. If you need to remove a stinger, place a firm edge (such as a credit card) next to the stinger, then scrape firmly across the skin surface to remove the stinger — this is better than using tweezers, which could squeeze the stinger and cause more venom to be injected. Applying ice or cold compresses will also help to slow the spread of the venom. In all cases, wash the bite or sting site with soap and water.
We recommend meeting with our pharmacists for a minor ailment assessment. While pharmacists have always provided counselling on treatment of bug bites and stings, it was often limited by time constraints in the pharmacy. We usually have two pharmacists working, so we can ensure that you have our full attention during your appointment. We can take the time to confirm which medication is best for you, considering your specific needs, health conditions, and possible drug interactions. We can also provide a treatment plan that includes additional information and advice. Even if you need to be referred due to a more severe reaction, this will still have been time well spent. Please visit our website for more information about pharmacist prescribing for minor ailments and contraception.