Injuries Medical Encyclopedia Health Navigator Drug Interactions Drug Notes Health Capsules Smart Sites Back Pain Hip Pain Knee Pain Weight Loss Insect bites and stings Bee sting; Bites - insects, bees, and spiders; Black widow spider bite; Brown recluse bite; Flea bite; Honey bee or hornet sting; Lice bites; Mite bite; Scorpion bite; Spider bite; Wasp sting; Yellow jacket sting Definition Insect bites and stings can cause an immediate skin reaction. The bite from fire ants and the sting from bees, wasps, and hornets are usually painful. Bites caused by mosquitoes, fleas, and mites are more likely to cause itching than pain.Insect and spider bites cause more deaths from venom reactions than bites from snakes. Considerations In most cases, bites and stings can be easily treated at home. Some people have extreme reactions that require immediate medical treatment to prevent death. Certain spider bites, such as the black widow or brown recluse, can be serious and life-threatening. Most spider bites, however, are harmless. If bitten by an insect or spider, bring it for identification if this can be done quickly and safely. Symptoms Symptoms depend on the type of bite or sting. They may include:PainRednessSwellingItchingBurningNumbnessTingling Some people have severe, life-threatening reactions to bee stings or insect bites. This is called anaphylactic shock. This condition can occur very quickly and lead to rapid death if not treated quickly. Symptoms of anaphylaxis can occur quickly and affect the whole body. They include:Chest painFace or mouth swellingDifficulty swallowingDifficulty breathing First Aid For severe reactions:Check the person's airways and breathing. If necessary, call 911 and begin rescue breathing and CPR.Reassure the person. Try to keep him or her calm.Remove nearby rings and constricting items because the affected area may swell.Use the person's EpiPen or other emergency kit, if they have one. (Some people who have serious insect reactions carry it with them.)If appropriate, treat the person for signs of shock. Remain with the person until medical help arrives. General steps for most bites and stings:Remove the stinger by scraping the back of a credit card or other straight-edged object across the stinger. Do not use tweezers -- these may squeeze the venom sac and increase the amount of venom released. Wash the site thoroughly with soap and water.Place ice (wrapped in a washcloth) on the site of the sting for 10 minutes and then off for 10 minutes. Repeat this process.If necessary, take an antihistamine, or apply creams that reduce itching.Over the next several days, watch for signs of infection (such as increasing redness, swelling, or pain). Do Not Do NOT apply a tourniquet.Do NOT give the person stimulants, aspirin, or other pain medication unless prescribed by the doctor. When to Contact a Medical Professional Call 911 of your local emergency number if someone with a sting has the following symptoms:Trouble breathing, wheezing, shortness of breathSwelling anywhere on the face or in the mouthThroat tightness or difficulty swallowingFeeling weakTurning blueIf you had a severe, body-wide reactions to a bee sting, your doctor should send you to an allergist for skin testing and therapy. You should receive an emergency kit to carry with you wherever you go. Prevention Avoid rapid, jerky movements around insect hives or nests.Avoid perfumes and floral-patterned or dark clothing.Use appropriate insect repellants and protective clothing.Use caution when eating outdoors, especially with sweetened beverages or in areas around garbage cans, which often attract bees.If have severe allergies to insect bites or stings, you should have an emergency kit and EpiPen. Make sure your friends and family know how to use it if you have a reaction. Open References References Schlossberg D. Arthropods and leeches. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 380.Fradin MS. Protection from blood-feeding arthropods. In: Auerbach PS, ed. Wilderness Medicine. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 41.Otten EJ. Venomous animal injuries. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Mosby Elsevier; 2013:chap 62. Bedbug - close-up Illustration Bedbug - close-up Bed bugs bites can leave a colorless welt along with an itching or burning sensation. (Image courtesy of the Centers for Disease Control and Prevention.) Black widow spider Illustration Black widow spider This is a black widow spider. Note the red "hour glass" on the abdomen. The bite of the black widow can produce severe symptoms but is seldom fatal, except in young children and older adults. (Image courtesy of the Centers for Disease Control and Prevention.) Body louse Illustration Body louse This is a magnified view of a body louse. Lice produce itching and a characteristic skin rash, which looks like a scrape. Lice may also carry organisms that cause relapsing fever, typhus, and trench fever. (Image courtesy of the Centers for Disease Control and Prevention.) Flea Illustration Flea Different types of fleas prefer specific animals as hosts, but will infest humans if their specific hosts are unavailable. Fleas can carry plague and typhus. They are also thought to transmit several other diseases. (Image courtesy of the Centers for Disease Control and Prevention.) Fly Illustration Fly Flies carry disease by transporting infectious agents on their feet. They may spread salmonellosis, typhoid, and other diseases. (Image courtesy of the Centers for Disease Control and Prevention.) Kissing bug Illustration Kissing bug Triatomid, the kissing bug, can carry Chagas' disease (American trypanosomiasis). (Image courtesy of the Centers for Disease Control and Prevention.) Dust mite Illustration Dust mite This is a magnified photograph of a dust mite. Mites are carriers (vectors) of many important diseases including typhus (scrub and murine) and rickettsialpox. (Image courtesy of the Centers for Disease Control and Prevention.) Mosquito, adult feeding on the skin Illustration Mosquito, adult feeding on the skin There are many different species of mosquito, which can carry some of the world's most common and significant infectious diseases, including West Nile, Malaria, yellow fever, viral encephalitis, and dengue fever. (Image courtesy of the Centers for Disease Control and Prevention.) Wasp Illustration Wasp Wasps are not known to carry human diseases, but allergic reactions to their sting can be fatal. (Image courtesy of the Centers for Disease Control and Prevention.) Insect stings and allergy Illustration Insect stings and allergy Allergic reaction to bee stings occurs when a person becomes sensitized to the venom from a previous sting. This reaction is different from the reaction to the poison in the bite of a black widow spider, which injects a potent toxin into the blood. Ordinarily, bee venom is not toxic and will only cause local pain and swelling. The allergic reaction comes when the immune system is oversensitized to the venom and produces antibodies to it. Histamines and other substances are released into the bloodstream, causing blood vessels to dilate and tissues to swell. Severe reactions can lead to anaphylactic shock, a life-threatening series of symptoms including swelling of the throat and difficulty breathing. Persons who develop an allergy to bee stings should carry prescription bee sting kits to counteract the reaction to bee venom. Brown recluse spider Illustration Brown recluse spider The brown recluse is a venomous spider most commonly found in midwestern and southern states of the United States. It is about one-half inch overall and has long skinny legs. The brown recluse is brown with a characteristic dark violin-shaped marking on its head. It is most commonly found outside in wood, leaves, or in piles of rocks. If a brown recluse wanders indoors they will go to dark closets, shoes, or attics. The brown recluse is a non-aggressive spider and will only bite when it is disturbed. Black widow spider Illustration Black widow spider The female black widow is easily recognized by her shiny black body and red hourglass marking underneath her round abdomen. Although black widows can be found in nearly every state they are most common in the southern areas of the United States. The black widow makes her home in wood piles, under eaves, and other undisturbed places. The bite of a black widow can be serious and require medical attention. Symptoms include pain radiating from the site of the bite, nausea, overall aching of the body, profuse sweating, and labored breathing. Stinger removal Illustration Stinger removal To remove a stinger, scrape the back of a knife or other straight-edged object across the stinger. Do not use tweezers since it may squeeze the venom sac and increase the amount of venom released into the wound. Next wash the site thoroughly with soap and water. Place ice wrapped in a washcloth or other suitable covering on the site of the sting for 10 minutes and then off for 10 minutes. If needed an antihistamine can be applied to help reduce the itching. Over the next several days the stinger site should be watched for signs of infection, such as increased redness, swelling, or pain. Flea bite - close-up Illustration Flea bite - close-up Fleas are blood-feeding insects. Pain and itching results from an allergic reaction to the materials that the fleas inject into the skin at the time of the bite. Insect bite reaction - close-up Illustration Insect bite reaction - close-up This is a 2 to 3 centimeter wide blood-filled (hemorrhagic) blister (bullae) that has resulted from an insect bite. It is located on the wrist. Bullae formation and tissue necrosis (death) are more common with spider bites, but may also be caused by insect bites. Insect bites on the legs Illustration Insect bites on the legs Insect bites may be grouped, raised (papular), hive-like (urticarial) and have a surrounding halo. Occasionally a central depression, or punctum, can be seen. Head louse, male Illustration Head louse, male This is a photograph of a male Pediculus humanus var. capitis, a head louse. Head lice have become an increasing problem in schools and day care centers. Some grade schools have started programs to examine children for head lice. Head louse - female Illustration Head louse - female This is a photograph of a female Pediculus humanus var. capitis, a head louse. Head lice have become an increasing problem in schools and day care centers. Some grade schools have started programs to examine children for head lice. Head louse infestation - scalp Illustration Head louse infestation - scalp This is a close-up picture of lice egg sacks (nits) on the hair. They cling to individual hair shafts. (Image courtesy of the Centers for Disease Control and Prevention.) Lice, body with stool (Pediculus humanus) Illustration Lice, body with stool (Pediculus humanus) These are Pediculus humanus, or body lice. Other types of lice infest the scalp, head (Pediculus humanus capitis), or the pubic area (Phthirus pubis). Some body lice may carry diseases such as epidemic typhus, relapsing fever, or trench fever. (Image courtesy of the Centers for Disease Control and Prevention.) Body louse, female and larvae Illustration Body louse, female and larvae This is a magnified view of a female body louse with larvae. Lice cause itching and a characteristic excoriated skin rash (looks like a scrape). They may also transmit diseases, including relapsing fever, typhus, and trench fever. (Image courtesy of the Centers for Disease Control and Prevention.) Crab louse, female Illustration Crab louse, female This is a photomicrograph of a female pubic louse. The condition known as "crabs" is so named because of the resemblance of a pubic louse to a crab. The bodies of pubic lice are shorter and rounder than those of head lice. (Image courtesy of the Centers for Disease Control and Prevention.) Pubic louse-male Illustration Pubic louse-male This is a photomicrograph of a male pubic louse. The condition known as "crabs" is so named because of the resemblance of a pubic louse to a crab. The bodies of pubic lice are shorter and rounder than those of head lice. Head louse and pubic louse Illustration Head louse and pubic louse This picture compares the relative size and shape of the head louse and the pubic louse. Brown recluse spider bite on the hand Illustration Brown recluse spider bite on the hand This lesion was produced by the bite of a brown recluse spider. The brown recluse is one of two common spiders in the United States considered venomous. (The other is the black widow.) However, the hobo spider, wolf spider, and jumping spider can also produce bites that require medical attention. Insect bites and stings Illustration Insect bites and stings Even though some insect bites or stings can be extremely painful they usually do not require emergency medical care. Although the stung or bitten area should be carefully observed for signs of infection or reaction to venom. Related Information Anaphylaxis Shock Black widow spider Review Date: 01/13/2014 Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.