Tips to take the sting out of insect bites

DIPESH NAVSARIA For children, summer brings the delight of endless hours outdoors, enjoying nature in full flourish. But that natural world includes insect life, some of which bite humans — including our children. While most are harmless, there are several issues that can cause concern. Let’s explore briefly the world of insect bites — when to worry, and when not to.

PREVENTION

Prevention is the best strategy. This does not mean that you should keep your child indoors (outdoor play and nature are good for children), but taking some straightforward measures to prevent bites will go a long way. Long ( but light) clothing will minimize the amount of skin exposed to potential biting insects, especially if you tuck the pants legs into socks to prevent insects from making their way up legs. Hats — and for babies, mosquito netting over a stroller or carrier — can also help.

Insect repellents are safe and effective for children over two months old. Although there is limited evidence that “natural” repellents (such as citronella and other essential oils) have some effectiveness, the best results have been found from those containing DEET or picaridin. DEET lasts about two to five hours (depending on the concentration used — you don’t need more than 30 per cent), and picaridin about three to eight hours.

REACTIONS TO BITES

Most issues involving insect bites have to do with reactions to the bites. They can vary from a little bit of redness all the way to severe allergic reactions. It may come as a surprise to learn that health-care providers often can’t tell what kind of insect bit your child based on the appearance of the bite. Even bites by two mosquitoes of the same species can result in two very different reactions. Often, knowing what caused the bite is not important.

Usually, reactions consist of small amounts of redness, swelling and itching. These are harmless and primarily annoying. Sometimes, in a phenomenon known as a large local reaction, the redness and swelling can be a few inches (several centimetres) in size. These often occur in the first few hours after a bite, and the concern is often that the bite has become infected. This is unlikely, especially if it itches.

These can be handled via a brief application of ice, topical steroids like one per cent hydrocortisone (available without a prescription) and oral antihistamines, which can help reduce the itching.

INFECTIONS

Still, infections do happen — either a local bacterial infection or an insect-carried infection. Local infections also present with redness and swelling, but usually develop a day or two after the bite. There is less itching, and there might be a pocket of pus (or draining pus) present, which is a sign that an infection is present.

Then there are infections that affect the whole body, and are often transmitted by biting insects. These include Lyme disease, Zika virus, Ehrlichiosis and others.

For the most part, the typical insect bite will not transmit these illnesses, so don’t panic. Most winged insects are unlikely to transmit disease, so unless you notice concerning symptoms — such as fever, fatigue, or an unusual rash — it’s best not to worry about the usual trivial insect bite.

WHEN TO CALL

YOUR PEDIATRICIAN

Call your pediatrician if your child seems to be ill and not merely uncomfortable due to the itching from a bite. Fever, fatigue, joint pain or an unusual rash are all good reasons to call. Evaluation may still determine that there is nothing serious at hand, but when unusual symptoms are present, reassurance can be very valuable to concerned parents.