Bites-insect - Treating insect 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, see your GP as soon as possible if your symptoms are severe.

Removing a sting

As soon as you've been stung by a bee, remove the sting and venom sac if it's been left in your skin. Do this by scraping it out, either with your fingernails or 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 don't puncture the venom sac.

Don't 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 don't usually leave the sting behind, so they could sting you again. If you've 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
• not scratching the area as it can become infected (keep children's fingernails short and clean)

See your GP if the redness and itching gets worse or doesn't 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 of age shouldn't 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
• 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 being bitten or stung, even if it's just a skin rash (hives), your GP may prescribe an adrenaline pen (an auto-injector) and show you how to use it. You'll also be referred to an allergy clinic for further tests and treatment.

Blisters

If you develop blisters after being bitten by an insect, don't burst them because they may become infected.

Blisters don't usually cause pain unless they rupture (burst) and expose 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'll need to take these as instructed, usually two to four times a day for seven days.

Allergic reaction

Dial 999 to request an ambulance if you have swelling or itching anywhere else on your body after being bitten or stung, or if you're wheezing or have difficulty swallowing. You'll need emergency medical treatment.

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

Allergy clinics

If previous insect bites or stings have caused a large skin reaction, such as redness and swelling more than 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's available in your local area.

Immunotherapy (desensitisation or hyposensitisation) is a possible treatment option if you're allergic to wasp or bee stings.

It involves being injected with small doses of venom every week to alter your body's immune response to venom.

You need to be observed after each injection to make sure you don't have an allergic reaction to the treatment.

Over time, your body becomes used to the venom (desensitised) and you're no longer at risk of anaphylaxis.

When a high enough dose has been reached, the injections are given at four to six-week intervals for a further two to three years.

Your allergist (allergy specialist) will decide how much venom is injected and how long the injections need to continue for. This will depend on your initial allergic reaction and your response to the treatment.

For more information about immunotherapy, see treating allergies.

Ticks

If you've been bitten by a tick, 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 pink or red circular rash to develop around the area of the bite). 

It's important that you remove the tick quickly and correctly by:

• using a pair of fine-tipped tweezers or a tick removal tool (available from pet shops or veterinary surgeries)
• wearing gloves or using tissue over your fingers to avoid touching the tick
• grabbing the tick as close to the skin as possible
• gently but firmly pulling straight up until all of the tick's mouthparts have been removed
• not twisting or jerking the tick while removing it to avoid the mouthparts breaking off and remaining in the skin
• washing your hands with soap and water afterwards

Don't use petroleum jelly, alcohol, a lit match or any other method to try to remove a tick. It won't work and could cause infection.

After removing the tick, clean the bite with soap and water or an antiseptic, such as an iodine scrub.

Avoid scratching the bite because it will cause further swelling and increase the risk of infection. Most tick bites will heal within three weeks.

Seek medical attention if you've been unable to remove all of the tick. You should also see your GP if you develop:

• a pink or red rash
• a temperature of 38°C (100.4°F) or above
• other flu-like symptoms, such as a headache or joint pain
• swollen lymph nodes

You may need antibiotics to prevent Lyme disease.

Read more about how Lyme disease is treated.