Insect bites and stings: symptoms, causes and treatment

Bug bites and stings are two different things, even though we often use the terms interchangeably. A bug bite is superficial. Insects that bite, such as mosquitoes, fleas, horseflies, ticks, and bed bugs, do this to feed on your blood. They use their mouthparts to pierce your skin and suck in blood. The skin reaction you experience is caused by the saliva that the insect leaves behind.

An insect sting, on the other hand, penetrates deeper into your skin and is usually painful right away. Bees, wasps, bumblebees and ants sting in self-defense, not to eat. They use their stinger to inject venom into your skin. This poison causes pain immediately and can lead to swelling and redness.

Generally, bug bites and stings are harmless. You have localized itching or pain for a few hours to days, but then it goes away on its own. The severity of your reaction depends on your individual sensitivity and the type of insect.

However, there are situations where insect bites and stings can indeed be dangerous. Some insects are carriers of diseases that they can transmit through their bite. Fortunately, this is rare in Belgium, but ticks can transmit the bacteria that causes Lyme disease, for example. People with allergies to bees, wasps or bumblebees can have a life-threatening reaction after a sting.

Insects bite and sting for a variety of reasons, and understanding these mechanisms helps to understand responses.

Blood-sucking insects such as mosquitoes need your blood as a source of nutrition. Only female mosquitoes bite because they need the proteins in your blood to develop eggs. When a mosquito bites you, it injects saliva that contains substances that keep your blood fluid. Your immune system recognizes this saliva as foreign and reacts to it, causing itching and swelling.

Ticks work in a similar way, but stay attached to your skin for much longer. They can feed on your blood for hours or even days. The longer a tick is stuck, the greater the risk of transmitting any pathogens. That is why it is important to remove ticks quickly.

Bed bugs hide in beds and furniture during the day and come out to bite at night. Fleas jump from the fur of pets or from the carpet on your legs. Both visit you during the night or when you sit still.

Stinging insects such as bees and wasps only use their stingers when they feel threatened. A bee can only sting once because its barbed sting stays in your skin. The bee tears free and then dies. A wasp or bumblebee can sting multiple times because their sting is smooth.

The venom that is injected via the sting contains various substances. Some of them cause pain and tissue damage directly. Others are allergens that can trigger an overreaction of the immune system in sensitive people. This can lead to local swelling, but in people with allergies, it can develop into a life-threatening reaction that can block the airways.

The individual response to insect bites and stings varies enormously between people. Some barely notice a mosquito bite, while others get big itchy bumps that last for days. These differences have to do with how your immune system responds and may even change over a lifetime.

The symptoms you experience depend a lot on which insect bit or stung you and how sensitive you are.

Bee mosquito bites first appears a small red spot that quickly swells into an itchy bump. For some people, this remains limited, while others get large swellings that can last for days. The itching can be quite intense and often gets worse when you scratch.

Flea bites you can recognize yourself by groups of small red dots, especially on your lower legs and feet. They are very itchy and can remain visible for weeks. Fleas often bite several times in a row, which explains the pattern of groups.

Bed bug bites are red, slightly swollen spots that are often in a row or group. They appear on parts of the body that were exposed while sleeping. The bites can be quite itchy and remain visible for several weeks.

Tick bites you often don't even feel like it happens because ticks inject a narcotic substance into your skin. You only notice that there is a tick when you feel or see it as a small black or brown ball. After removal, a small red spot may remain. It's crucial to be alert to a red ring that develops around the bite, often after about a week. This may indicate Lyme disease.

Horseflies are more painful than mosquito bites. A red, swollen area develops that can fester when you scratch it. Horseflies are more aggressive and their bites really hurt at the moment.

Bees, wasps and bumblebee stings are immediately very painful. The pain is sharp and intense. Immediately afterwards, the spot swells and turns red. The pain usually subsides after a few hours, but the swelling can last for days. In the event of a bee sting, the sting with the venom pouch stays in your skin and keeps pumping venom as long as it is there.

In people without allergies, the reaction is locally limited to the immediate vicinity of the bite or sting, usually no larger than a few centimeters in diameter. In sensitive people, the local response may be more extensive with larger swellings.

One allergic reaction you can recognize symptoms that go beyond just local swelling. You feel generally unwell, nauseous or dizzy. There may be red rashes or spots and itching all over your body. In severe cases, you feel your throat thicken, you have trouble breathing, and you panic. This is a life-threatening situation that requires immediate medical attention.

‍Mosquitoes bite mainly on uncovered skin areas that are easily accessible: your arms, legs, ankles, hands, face and neck. They are particularly active at dusk and at night, but some species also bite during the day. Mosquitoes are attracted to carbon dioxide from your breath, body heat, and certain body odors.

Bed bug bites appear on parts of the body that were bare while sleeping, such as your arms, legs, neck, and face. They often occur in a line or zigzag pattern, as the bed bug crawls over your skin and bites multiple times while feeding.

Flea bites mainly seen on the lower legs, ankles and feet. This is because fleas jump up from the floor or from pets and then bite the first piece of bare skin. However, they can bite anywhere they have access to your skin.

Sign can end up anywhere on your body, but prefer warm, humid areas. They often crawl up from your legs and look for areas such as your groin, armpits, behind your ears, on your neck, or in your scalp. In children, you often find ticks in and around the head.

Horseflies occur on exposed parts of the body, especially your arms and legs. Horseflies are active during the day and bite mainly outdoors. They can bite through thin clothing.

Deer lice flies occur mainly in forests in September and October. They crawl under your clothes and often bite covered parts of the body such as your torso, back, or upper thighs. Their bites are quite painful.

Bees, wasps and bumblebees sting anywhere you accidentally touch them or where they feel threatened. Many stings happen to the hands and arms when you hit the insect. Stitches in the face, mouth, or throat are more dangerous because of the risk of swelling that can obstruct your breathing. This especially happens if you accidentally swallow a wasp or bee. Feet are also a common spot, especially when walking barefoot through the grass where bees sit on clover flowers.

Treatment focuses on alleviating symptoms and preventing complications. In most cases, you can do this yourself.

Bee mosquito bites and other itchy bug bites is the most important advice: do not scratch. Scratching provides short relief but ultimately makes the itching worse and can lead to wounds and infections. Cooling with a cold compress or ice cube reduces itching and swelling. A cooling gel or anti-itch cream also brings relief. Anti-allergic tablets can help with frequent bites or severe itching.

Sign you should remove it as soon as possible. Use a tick tweezer or a drawing card and grab the tick as close to the skin as possible. Pull up gently and straight without turning. Then disinfect the area. Never try to sedate the tick with alcohol or oil, as it will release more pathogens. Mark the spot where the tick was and keep an eye on it for a few weeks. If a red ring appears or if you have a fever, contact your doctor.

At a bee sting you should remove the sting as quickly as possible because the poison bag keeps pumping. Scrape the nail out with something flat like a credit card or nail. Don't try to squeeze because you'll squeeze more venom into your skin. The sting of a wasp or bumblebee comes out by itself. Cooling with a cold compress helps relieve pain and swelling.

For stitches in the mouth or throat The following applies: lick an ice cube or drink cold water to prevent swelling. If you have severe swelling or trouble breathing, go straight to the emergency care center.

If you know that you allergic If you are against insect stings, you should always have an adrenaline injection with you. At the first signs of an allergic reaction, use it immediately and go to the hospital. People with a known allergy will receive instructions from their doctor about when and how to use the injection.

When signs of infection such as increasing redness, warmth, swelling, suppuration, or fever, contact your doctor. An infected bite or sting requires antibiotic treatment.

For people who are often stung and suffer from it a lot, a desensitization treatment may be considered. This is a long-term treatment where your immune system gradually gets used to the insect venom, making you react less violently.

Scratching insect bites definitely doesn't help, even if it provides some relief. You damage your skin, which actually makes the itching worse and makes it easier for bacteria to enter. This can lead to infections that are much more difficult than the original bite.

Squeezing open or pricking blisters that occur after a sting is also not a good idea. You create an open wound that can infect. Leave blisters intact, they heal faster if they stay closed.

Home remedies such as toothpaste, vinegar, lemon, or urine have no proven effect on insect bites. In fact, they can further irritate your skin. Stick to proven remedies such as cooling and possibly an anti-itch cream.

Common pain relievers help with bees, wasps and bumblebee stings, but they do not prevent an allergic reaction. If you're allergic, you really need adrenaline, not acetaminophen.

Burning out ticks with a cigarette or match is not only painful, it also increases the risk of disease transmission. The tick responds to the heat by releasing more saliva, including any pathogens. Always use a drawing tweezer. Waiting for a tick to release on its own is also not an option. The longer a tick is stuck, the greater the risk of infection.

Drip alcohol or disinfectants onto a tick before removing it is counterproductive. Just like when heated, the tick then releases more venom. Remove first, then disinfect.

In case of allergic reactions, anti-allergic tablets do not help quickly enough. A severe allergic reaction develops within minutes and only adrenaline can stop it. Anti-allergic drugs work too slowly to prevent a life-threatening situation.

‍How can I prevent bug bites and stings?

Wear protective clothing such as long sleeves and long pants when out in nature. Use insect repellents containing DEET on exposed skin. Avoid bright perfumes and scented body lotions that attract insects. Stay away from flowers, fruit and garbage cans that attract wasps and bees. Check yourself for ticks after a walk in the woods.

Why do some mosquito bites itch much worse than others?

This has to do with your individual sensitivity and which type of mosquito bit you. The time of the reaction also plays a role: the first bites of the season often itch worse because your immune system responds more alert. The more you get bitten, the reaction may decrease, although this does not apply to everyone.

Is it dangerous to let a tick sit for several hours?

Yes, the risk of disease transmission increases the longer the tick is attached. In the first 24 hours, the risk is relatively small, but then it increases significantly. That's why it's important to remove ticks as soon as you discover them.

Can I become allergic to insect stings?

Yes, an allergy can develop at any time in your life. You can get stung for years without any problems and suddenly have an allergic reaction. The seriousness of your response can also increase with each subsequent sting. If you have family with allergies, your risk is higher.

When should I go to the hospital after a bug sting?

Go to emergency care immediately if you have signs of an allergic reaction: a rash all over your body, swelling in the face or throat, trouble breathing, dizziness, or fainting. Rapid medical advice is also wise in the event of multiple stitches at the same time, a sting in the mouth or throat, or in children who have been stung.

How long do bug bites stay visible?

This varies enormously. Mosquito bites usually disappear within a few days. Fleas and bed bug bites can remain visible for weeks. The swelling after a wasp sting may last for a week or more. If you scratch a lot, the spots stay visible longer and can even form scars.

1. Skindr dermatologists
2. Health & Science, Insect Bites & Stings
3. eBPNet (Evidence-Based Practice Network)
4. Child and Family, Insect Dossier
5. Health & Science, Lyme Disease
6. Health & Science, Anaphylactic Response