Itchy is normal—tender is not

USA Today (Society for the Advancement of Education), August, 2006

Itchy, red swollen bumps on the skin are an all-too-familiar summer sign that bugs--and bug bites-are flourishing. That annoying itch may be a good sign, however. "Itchy is normal. Tender is not," when it comes to bug bites, notes Robin Carder, assistant professor of dermatology and pediatrics at the University of Texas Southwestern Medical Center, Dallas. Tenderness, she cautions, may be a sign the bug bite is becoming infected and deserves medical attention.

"The main thing to watch for would be whether the bite is secondarily infected. It is normal for a bug bite to be a little red or swollen, and it may even blister," Carder explains. "But the lesion should be more itchy than sore. If it become tender, that may be a sign of infection."

Other signs of possible infection are redness extending beyond the immediate bite, drainage of pus, or worsening, rather than improvement, of the site over time. Mosquitoes and chiggers are the most common causes of insect bites in many regions, and the bites are relatively easy to treat with various over-the-counter remedies.

"Antihistamines--either the oral or the topical form--can be very effective in relieving the itch and decreasing the swelling or hive-like response," Carder advises. Topical steroids, such as hydrocortisone, also work well. Both can be found in touch sticks that make it easier to target the affected area.

Days spent outdoors also can mean ant, tick, wasp, and bee stings that could prove serious. Here are some of the most common bites and Carder's advice on what to watch for and various ways to treat them:

* Ant bites. Most are generally harmless, but fire ant bites can be similar to bee stings for some people and cause allergic reactions that quickly can become serious. Hives, swelling of the lips, breathing difficulty (wheezing), or fainting are signs that emergency care is needed.

* Tick bites. It is important to remove the embedded head of the tick from the bite. Try using a pair of tweezers and pulling back slowly or warming the tweezers to get the pesky bug to release its head from the skin. Another method is to apply petroleum jelly, which suffocates the tick by blocking its air passages. If you see an expanding circle of redness that radiates out from the bite, it could be a sign of Lyme disease, and the individual should be evaluated by a physician.

* Bee or wasp stings. Taking an antihistamine or ibuprofen immediately after being stung may help reduce the pain and swelling. People with known allergies to bee or wasp stings need to seek immediate medical care and carry an epinephrine pen (and know how to use it).

* Spider bites. Most can be handled the same as other insect bites. The bite from a brown recluse spider, however, means a trip to the doctor. You will know because the bite will develop a purple color within two to three days, often with a central crater or ulcer.

* Head lice. Lice live on humans, so you do not get them from a trip through the woods. However, day care centers and schools or camps where kids are in close contact with one another often are a source of transmission. Over-the-counter remedies work for the majority of cases, although the treatment should be applied two times (immediately, then repeating one week later) while carefully using a nit comb to remove all of the eggs from the hair.