By Drs. Sally Robinson and Keith Bly

Spring is here, and with it comes warm weather, more daylight — and bugs. Many insects have bites or stings that can cause problems, but the key to treating the problems is in understanding the difference between a bite and a sting.

Venomous insects inject painful, toxic venom through their stingers. The stings are painful and red, and can cause swelling up to 12 inches from the site of the sting. This is called a local reaction. A person who is allergic to the venom of the insect may have a systemic, or “whole body,” reaction. Redness, hives and swelling may occur, and this type of reaction can affect airways as well as circulation. A systemic reaction may become life-threatening if not treated in time.

Non-venomous insects bite in order to feed on your blood. Allergic reactions do occur from non-venomous insect bites, but severe allergic reactions are rare.

The two greatest risks from most insect stings and bites are allergic reaction, which can be fatal, and infection.

Here are a few tips to remember if your child is stung or bitten:

  • A bee leaves behind a stinger attached to a venom sac. Don’t try to pull it out because doing so may release more venom. Gently scrape the sac out of the skin with a blunt-edged object, such as a credit card.
  • Wash the area carefully with soap and water. Repeat two to three times a day until the skin is healed.
  • Apply a cold pack, an ice pack wrapped in a cloth, or a cold, wet washcloth for a few minutes.
  • Apply a paste of baking soda and water and leave it on for 15 to 20 minutes.
  • Give acetaminophen for pain.
  • To relieve pain and itching, dab a tiny bit of household ammonia on the area or use an over-the-counter product that contains ammonia. If you doctor says it’s OK, give an over-the-counter antihistamine.
  • Insect bites around the face, especially near the eyes, will normally cause swelling. Use cool compresses and give your child an antihistamine to reduce the swelling. If the area turns red, hard and warm, and causes pain, call your pediatrician.
  • If your child is stung in the mouth or nose, seek immediate medical attention because swelling may block airways.

Insect repellents can keep biting insects away. Check the label on the repellent and choose a product containing between 10 and 30 percent DEET, which is the most effective insect repellent. DEET can be used on children over 2 months of age.

Important things to remember when using insect repellent include:

  • Apply repellents to exposed skin and clothing. Do not use under clothing.
  • Do not use repellent on wounded or irritated skin.
  • Spray on hands first and apply to the face, avoiding the eyes and mouth. Never spray directly on the face.
  • Do not allow children to handle insect repellent. Do not apply it to a child’s hands or spray directly on a child. Apply the product to your hands first, and then put it on the child.
  • Do not spray in enclosed areas, and avoid breathing the repellent.
  • Do not use near food.
  • After returning indoors, wash the treated area with soap and water, or bathe.

If your child experiences a large area of swelling, abnormal breathing, tightness in the throat or chest, dizziness, hives or rash, fainting, nausea or vomiting, or pain and swelling that lasts longer than 72 hours, she may be having an allergic reaction to the sting or bite and you should seek immediate medical attention.

Dr. Sally Robinson is a pediatrician in the division of children’s special services at the University of Texas Medical Branch at Galveston. She teaches medical students about caring for children with chronic medical conditions. Dr. Keith Bly is a hospitalist and assistant professor of pediatrics at UTMB.

The Your Health column is written by health and medical experts at the University of Texas Medical Branch at Galveston. The column focuses on topical health issues that we believe are of interest to your readers. It is e-mailed every Tuesday. If you have any questions about the column, or would like to suggest topics, please contact John Koloen, media relations specialist, at (409) 772-8790 or email