Insect Bites

Scratch... Scratch... Scratch! Insect bites can be one of the worst parts of summer. What can be done to help our itchy children?

The first step is prevention... When enjoying the outdoors in the spring, summer, and fall, we recommend using insect repellent, electronic, and other chemical means (i.e. Citronella candles or torches) to keep the mosquitoes and other biting insects at bay. Long pants and long sleeves can be very helpful especially in the evenings if the temperature is not too hot.

"My child is scratching. Now what can I do?" There are several ways to deal with "itchy" insect bites. It is recommended to start with antihistamines such as diphenhydramine (Benadryl). These come in both topical and "by mouth" preparations. If the itching seems to be very local, sometimes the topical agent will be enough. For more widespread areas, the oral ("by mouth") agent is preferred. Also, topical corticosteroid creams can be helpful. These creams are helpful in decreasing inflammation and itching. An example of this would be 1/2 - 1 % hydorcortisone (Cortaid), applied up to 2 times a day for not more than several days in a row.

"When should we call or see the doctor?" The complications of insect bites primarily include infection and severe allergic reaction. Infection does not occur immediately. It generally occurs a day or two later, after the broken skin has had time to become infected. If the area where the bite took place is tender, or appears to have a pus filled collection, it may be infected. Severe allergic reactions can occur immediately or shortly after the bite. They are characterized by swelling and redness that is generally not painful, but does itch.

If there are any breathing problems, the doctor or 911 should be called immediately. If you feel that the bite has become infected, the allergic reaction is severe, or over-the-counter medications are not helping, your child should be seen in the office.

JDMD 7/2/02