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In a defensive attack, venomous insects inject painful and toxic venom through their stings. Non-venomous insects pierce the skin to feed on human blood.

There are a lot of insects whose bites or stings can cause problems, and they can be categorized into venomous and non-venomous. Venomous insects include wasps, hornets, yellow jackets, bees, and fire ants among others. Non-venomous insects include mosquitoes, sand flies, chiggers, fleas, lice, bed bugs, scabies, and ticks among others.

Localized allergic reactions to the saliva and anti-coagulants are known to occur from non-venomous bites, and severe reactions such as anaphylactic shock are the outcome of venomous stings.

Venomous stings result in localized reaction presenting as redness, pain and swelling around the sting site. Occasionally, these reactions can cause other symptoms, such as fever, joint pain, vomiting and headaches. In sensitive individuals, a systemic or generalized reaction occurs, with redness, hives, swelling in the face, shortness of breath or wheezing, difficulty swallowing, and light-headedness or fainting.

These usually occur within minutes to an hour after the sting. These systemic reactions can be life threatening. Biting insects may not only produce these reactions but they may also spread diseases like malaria, yellow fever, lyme disease, typhus, and encephalitis.

Protection against insect bites

Wear long-sleeved shirts, long pants, and hats to reduce exposed skin which helps to minimize mosquito and other insect bites. Repellents rubbed to clothing, shoes, tents, mosquito nets, and other stuff assist in protection against insect bites. Bed nets are convenient and protective in situations where adequate shielding or air-conditioning is not available in the accommodations.

Apple cider vinegar (ACV) is a natural repellent against bugs. Repellents containing DEET (N, N-diethylmeta-toluamide) and permethrin are commonly available, and are effective against mosquitos, ticks, and other arthropods when applied to skin or clothing. Repellents with DEET concentrations of about 30% are quite effective and last for about four hours. They are available in aerosol and pump sprays, creams, lotions and dry formulations.

Treatment of bites

The main symptom to manage after insect bites is itching. Crotamiton ointment has soothing effects when rubbed onto itchy skin. Jewelweed is a natural remedy used to reduce itching and soothe the skin. Equal parts of baking soda and vinegar are known to soothen the itch. Calamine lotion also helps relieve the itching. Topical antihistamines and anesthetics are for quick temporary relief; Hydrocortisone cream has slower onset, but longer effect. In particular, a sedative antihistamine can prove helpful if the itch is interfering with night sleep.

Applying a cold compress (a cloth soaked in iced water) or toothpaste relieves pain. A home remedy suggests the application of juice from crushed plantain leaves for pain relief. An insect bite lotion made with lavender essential oil and vegetable oil may be applied to relieve itching and pain. A dab of manuka tea tree oil or a small amount of East Cape manuka tea tree cream sterilizes the area of the sting or bite, and reduces swelling and pain from the sting or bite due to the anti-inflammatory properties of the oil.

Ibuprofen gel also seems to be an excellent anti-inflammatory with quick onset for management of pain and swelling associated with insect stings. Xylocaine gel 2% provides immediate relief from surface itching and pain. Hydrocortisone cream 1% is known to improve both itching and swelling/redness. It actually has anti-inflammatory effects, not just symptomatic temporary relief that comes with the topical anesthetics. However, it does take longer to produce full effects as compared to topical anesthetics.

Local reactions generally don't require professional care. But if the redness/swelling is severe enough to distract you from your daily activities or is worsening after 24 hours, then you should see your doctor. Any systemic reaction should immediately be reported to a doctor. Your doctor may recommend carrying an adrenaline injection device around with you to use in case you have an anaphylactic reaction, if you have had several of these allergic reactions in the past.

Desensitization may be done by administering injections of tiny amounts of venom from the type of insect that caused the allergic reaction. Repeated doses of venom over several weeks can desensitize the immune system, therefore a milder reaction would be produced on the event of the next bite. This treatment is given in specialized centers due to the associated risk of developing a severe reaction.

Treatment of tick bites

If you locate a tick attached to your skin, it is imperative to remove it as soon as possible with tweezers by grasping as close as possible to the skin so that the head or mouthparts are not left behind. Clean the site of the bite with a disinfectant. Conventional methods of tick removal using a burnt match, petroleum jelly, or nail polish do not work well and are therefore not recommended.

In some areas, ticks may carry a bacterial infection (caused by Borrelia burgdorferi) that can result in Lyme disease. It is important to see a doctor if you develop flu-like symptoms or a rash within a few weeks of a tick bite. Lyme disease can be treated with antibiotics. If untreated, it can cause more serious symptoms affecting the nervous system, joints and heart.

Treatment of Stings

The initial step is to remove the stinger. The complaints associated with stings include pain, swelling, and itching. Home remedies for management of stings include baking soda or meat tenderizer compresses to remove or destroy the protein-based venom. The scientific data available to support these techniques is insufficient, but they do make logical sense and can be considered as a rational approach. 

Anti-inflammatory drugs are used to treat pain and swelling associated with stings. Topical antihistamines, anesthetics/analgesics and topical Hydrocortisone may be used to provide relief against itching. Topical anti-bacterial drugs are advised for prevention of infections.

Sting Removal

Place the edge of a dull table knife (or the edge of a credit card, a fingernail, or anything similar) firmly against your skin next to the embedded stinger. Applying constant firm pressure, rub the knife across your skin surface and the stinger. This removes the stinger without injecting more venom into the skin, which is said to happen when you try to remove the stinger with tweezers or fingers.