A qualified nurse, author and first aid trainer with over 30 years’ healthcare and teaching experience


The warmer summer months sees a swell in the insect population of the UK – as we can discover to our cost. Bites and stings can be painful as well as cause a reaction. In some cases a severe one, such as anaphylaxis, can be life threating.

Bugs that bite or sting include wasps, bees, horseflies, ticks, mosquitoes, fleas, spiders and midges.

We will look at the numerous precautions you can take to avoid being bitten, the common culprits who often bite and importantly, the first aid to make the bites and stings more bearable and as comfortable as possible.

Stop scratching

Importantly, please don’t scratch the bite.  This is for the very simple reason that once the skin has been broken, the bite is far more likely to become infected.

First signs of infection

The first signs your bite is becoming infected is that it gets redder, hot and itchier. If this is the case see a health professional as soon as possible.

Serious signs of infection

If the redness tracks away from the bite and spreads across the skin, this could be a sign of cellulitis, which is serious and you should get medical treatment quickly.

Reacting to the sting:

Anyone can react to a sting. Often, it is most commonly a local reaction, which just affects the bite or sting itself.  Some people suffer a mild allergic reaction. This is when a larger area of skin around the bite or sting becomes swollen, red and painful. Usually, this should pass within a week.

Treatment for a mild allergic reaction

If the person who has been stung experiences a local reaction, there is a three point treatment plan to help:

A wrapped ice pack applied to the affected area will help reduce the swelling and can reduce pain as well.

Antihistamines will help reduce the reaction and swelling, plus soothe the swelling.

Paracetamol or ibuprofen will reduce pain.

Severe allergic reaction – anaphylaxis or systemic reaction

Occasionally, a severe allergic reaction can occur. This causes symptoms such as breathing difficulties, dizziness and a swollen face or mouth. In these situations, immediate medical treatment is required.

If the casualty shows any signs of a systemic reaction or of anaphylactic shock,

Call an ambulance immediately

Use their Adrenaline Auto-injector if they have been prescribed one.

Remain calm, reassure them and position them appropriately whilst waiting for medical assistance:

Struggling to breathe

If they are struggling to breathe, they should be encouraged to sit in an upright position, putting something under their knees to help increase their circulation can be helpful – into the lazy W position.

Shock

If they are not having trouble breathing, but are feeling weak, dizzy, sick and thirsty – and showing signs of shock should lie down with their legs raised to help increase the circulation to their vital organs.

They should stay lying down even if they appear to recover, as sitting or standing them up could cause a further drop in their blood pressure.

Encourage them to turn their head to one side if they are likely to vomit. They should be covered to keep them warm and kept in this position until the paramedics arrive.

Read our article on acute anaphylaxis in the British Journal School Nursing here: https://firstaidforlife.org.uk/wp-content/uploads/2017/03/BJSN-Acute-Anaphylaxis-1.pdf

13 ways to avoid being bitten

Most insects are more active during the early mornings and late evenings. For example, this is when midges are most prevalent.

If you are outside, try to sit somewhere in the sun and with a breeze, as midges don’t like these conditions. Midges also prefer dark clothes, so light clothing may help.

Be wary of insect hotspots such as outdoor areas where food is served eg a pub garden.

Food and drink should stay covered when eating or drinking outside, especially sweet things such as a fizzy sugary drink. Remember wasps or bees can also get into open drink bottles or cans you’re drinking from and can be swallowed.

Never disturb insect nests – such as a wasp nest in a sheltered tree or in a roof space. If a nest is in, or near your house, arrange to have it removed professionally. See your local council for more details.

Doors and windows should remain closed or covered with thin protective netting to prevent insects getting inside the house. Keep car windows closed to stop insects getting inside.

Garden areas such as flowering plants, rubbish, and compost, can be insect gathering grounds.  Carefully remove any fallen fruit in your garden and keep dustbins sealed with a well-fitting lid.

Stagnant water can also be a magnet for insects. Therefore, avoid camping near water, such as ponds and swamps – mosquitoes and horseflies are commonly found near water.

Wear shoes when outdoors.

 To avoid tick bites it is advisable to cover up in long grassland. Always check yourself and pets following a grassy walk.

Cover exposed skin by wearing long sleeves and trousers.

Be aware that products such as soaps, shampoos and deodorants with strong scents can attract insects.

Insect repellent is worth using if you are spending a lot of time outdoors. Apply repellents that contain 50% DEET (diethyltoluamide) are most effective. Apply to exposed skin.

Ants

Although the common black ants often found in gardens do not bite, plenty of other ants do. Red ants, flying ants and wood ants will bite, when they feel threatened. However, ants have lower toxin levels than wasps or bees, you may feel a little nip, but only be able to see reddened skin.

Bee and wasp stings

Wasp stings cause of the most allergic reactions in the UK. However, you won’t be allergic on your first sting. In fact, allergy develops after one or more stings, as the wasp venom sensitises your system.

Bees and wasps are not generally aggressive and don’t look to sting people, however it is extremely common for people to accidentally step on them in bare feet, or for them to fly into us and then sting.

Batting wasps away or swatting them will only make them cross and more likely to sting you.

Instead, avoid these aggressive insects calmly and slowly

When bees or wasps sting a person, they inject venom through their stinger into the skin of the victim. Wasps, hornets and other stinging insects have stingers without barbs that they retract when they sting, so these insects can sting people multiple times. Bees have a barbed stinger that they leave in the victim’s skin along with the venom sack.

Dealing with a bee sting

If someone is stung by a bee, and the sting remains in the skin, quickly flick it out using your thumb nail or a credit card. Try not to squeeze the sting or be tempted to remove with tweezers, as this can increase the amount of allergen entering the body and therefore increase any possible allergic reaction. The venom sac can take 2-3 minutes to release the venom and so removing the sac promptly can prevent further venom increasing the reaction.

Most people only experience a localised reaction to bee stings where the localised area around the skin is inflamed, red and painful.

Allergic reaction

About 3% of people stung by bees and wasps have an allergic reaction to the sting, and up to 0.8% of bee sting victims experience the severe and life-threatening allergic reaction known as anaphylaxis – this requires urgent medical intervention as detailed above.

Bee and wasp venoms are different. Don’t assume that you’re allergic to one if you are to the other.

Old Wives’ Tales

Old wives’ tales suggest neutralising stings with vinegar or bicarbonate of soda (depending on the source) is an effective remedy for wasp and bee stings.  Wasp sting venom is more alkaline and the remedy is neutralising the sting with vinegar to reduce the pain. Bee sting venom is predominantly formic acidic and so they advise this should be neutralised with bicarbonate of soda. Neither of these remedies have any scientific backing and it is more likely to be the power of suggestion than any real benefit that might make people feel better.

Caterpillars

The oak processionary moth is found in late spring and summer around oak trees – hence the name. Their bodies are covered in thousands of long white hairs and touching one causes a number of symptoms including extremely itchy skin rashes, breathing difficulties and eye problems. Be warned these hairs can be left all over the oak tree, so you can be affected, even if you don’t see or touch a caterpillar.

Link to our article here.

Chiggers

Chiggers are horrible little mites that are commonly found on meadows, golf courses, woodlands, parks and in grassland around lakes and rivers.

They are members if the Trombiculidae family and are tiny mite like spiders. They are often known as berry bugs, red bugs or harvest mites.

Symptoms of chigger bites include intense itching, and flat or raised red bumps on the skin that sometimes appear blistered.

Antihistamines and topical anti bite and sting relief creams. My children also love the click-it itch relief clickers and swear they work brilliantly.

Chiggers most commonly bite areas of thinned skin such as wrinkles and warm folds of skin such as the crotch and groin areas, armpits, and behind the knees. The ankles and calves are also common sites for chigger bites.

When the chigger bites, it inserts its feeding structures and mouth parts into the skin. They inject enzymes into the host skin that destroy the tissue around the bite and it is these that frequently provoke reactions. The area around the bite then hardens, and they insert a feeding tube, called a sylostome, further into the bite area. If chiggers are not disturbed, they can feed on the skin through this structure for a few days if they are not disturbed.

Link to our article here.

Fleas

Fleas are minute, irritating insects, that like to feed on our blood and that of our pets. They are a real nuisance and their bites are itchy and sometimes painful. Getting rid of fleas is hard and often requires professional pest control treatment for total eradication. Pet owners are most at risk of flea infestations, but it is possible to have fleas in your home without pets.

Fleas are tiny jumping bugs, that are extremely fast breeders.

Fleabites are distinctive small, red bumps with a red “halo” around the bite centre. Bites usually occur in groups of three or four, or in a straight line. Fleas are attracted to warm moist areas such as the waist, armpits, breasts, groin, or in the folds of the elbows and knees, but they also nibble the easy to reach areas such as ankles and calves.

The skin around each bite often becomes sore or painful and you might develop a rash or hives near the site of a bite.  Fleabites are incredibly itchy. Scratching the bites is very likely to lead to infection.

Flower bugs

Flower bugs are predatory insects that feast mainly on aphids and mites. They can be identified by their tiny oval body, orange-brown legs and reflective wings. However, they can also bite out of humans too.  The bite can be intensely itchy and slow to heal.

Horseflies

Horseflies are flying insects with a very painful bite. Some people develop serious allergies to horsefly bites.

Because of the way they inflict damage, horsefly bites can be more painful than bites from other bugs. This is because the horsefly uses its mouthparts in a scissor-like action to cuts the skin rather than punctures it. Once the skin is cut, the horsefly uses small hooks on its mouthparts to hold it to the skin whilst it feeds on blood.

This explains why a horsefly bite is surrounded by a red weal of skin.

It is also the reason why the bite of the horsefly is more likely to become infected than other insect bites.

Watch for redness of the skin that spreads or pus or discharge from the wound. A possible infection can also be shown by increased pain and swelling. This doesn’t happen immediately but usually at around a day or two later.

Midges

The midge is the tiny flying insect which can be found on damp cloudy summer days. For such a tiny insect they pack a powerful bite which is extremely itchy Midge bites can often they swell up too. Cover up as much as possible and wear insect repellent.

Mosquito bites

Most of us are familiar with the tell-tale buzz of the mosquito and well aware of the look of these pesky vampires.  We do get them in the UK and our increasingly warm summers are leading to a surge in numbers.

Mosquitos are flies that feed on human blood, they are also carriers of malaria, dengue fever, Japanese encephalitis and many more extremely serious diseases.

Mosquitos love stagnant water and breed prolifically when the conditions are right. Only female mosquitos bite humans as females need blood in their diet to reproduce. Male mosquitos have feathery antennae that help them sense the presence of female mosquitos – males only live for about a week. Females have less bushy antennae and can live for a few months.

Female mosquitos have long, tubular mouthparts that they use to pierce your skin and feed on your blood. When they bite you, they inject saliva into your body while suctioning your blood. Mosquito saliva contains proteins that most people react to causing an inflamed red and itchy bump. They sniff their victims out and choose them based on their scent. Many mosquito repellents try to change our smell to make us less appetising to the mosquitoes. You can get patches and sprays and people also say eating large amounts of Marmite can make you less appealing to the bugs.

Ideally use a high quality, insect repellent and cover up with loose fitting, long sleeved clothes and long trousers. Some mosquitos are around more in the daytime, some at dawn and dusk. Deet based insect repellents are widely seen as the most effective.

Mosquito bites, should be washed with soap and warm water. Antihistamine tablets and topical creams, anti-itch creams and applying an ice pack to the bites should provide relief from itching. Avoid scratching the bites.

It is rare for anyone to have a severe allergic or anaphylactic reaction to a mosquito bite. Therefore, if you develop aching, headaches, or fever after getting bitten, contact your doctor. These are more likely to be symptoms of a mosquito-borne disease.

Spiders

The false widow spider species isn’t the only eight legged creature in the UK who can bite, a number of spiders in the UK are capable of a bite. A spider bites as a means of defence. You can identify if it’s a spider bite by two tiny puncture marks on the skin. If you see this, try not to scratch and keep them as clean as possible to prevent them from getting worse. A bites from the false widow spider causes redness and swelling which is painful. Symptoms worsen if the bite becomes infected.

Tick bites (Ticks carry Lyme disease)

Ticks are tiny creatures that live in woodland and grassy areas, they are particularly prevalent if there are deer and other wildlife. They are blood sucking and bite into the skin to feed on blood. Initially they are extremely small, but swell as they eat, eventually becoming pea sized and therefore easier to spot and remove.

Ticks can carry Lyme disease (which is serious to humans) and they should ideally be removed by a health professional. If this is not possible, they should be very carefully removed with tweezers or ideally with a proper tick remover, gently pulling without twisting in any way. when using a tick remover, you should insert under the tick and rotate 360 degrees. It is possible for the tick to be only half removed, leaving its mouth parts in the skin and this can lead to infection, ultimately requiring medical treatment and possibly antibiotics.

Never burn the tick off or try and use chemicals to kill it. Keep the tick in a container to show to the medical professionals so they can ensure has been removed entirely.

Cover up with long trousers and socks when walking in woodland and long grass and always check yourself, your clothes and your dog for ticks on your return.

Lyme disease is a serious illness in humans, characterised by flu like symptoms, lethargy and aches and pains. 50% of people with Lyme disease develop a classic bulls eye type rash, which can appear on any part of the body and not necessarily where they were bitten. If you are worried you might have contracted Lyme disease, visit your doctor urgently. If Lyme Disease is diagnosed and treated quickly it is possible to make a full recovery, however it can cause paralysis, arthritis, meningitis and severe long-term problems.

Link to our article here.

This is not a 100% comprehensive guide to bites and stings. If you experience any unusual reactions or issues following a bite or sting, please seek medical advice.

Wishing you a safe and happy bite and sting free summer!

Written by Emma Hammett for First Aid for Life

It is strongly advised that you attend a fully regulated Practical or Online First Aid course to understand what to do in a medical emergency. Please visit https://firstaidforlife.org.uk or call 0208 675 4036 for more information about our courses.

First Aid for Life is a multi-award-winning, fully regulated first aid training provider. Our trainers are highly experienced medical, health and emergency services professionals who will tailor the training to your needs. Courses for groups or individuals at our venue or yours. First Aid for life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information.

  

Emma Hammett

Emma Hammett is a qualified nurse, author and first aid trainer with over 30 years’ healthcare and teaching experience. Emma is the Founder of three multi-award-winning businesses; First Aid for Life, Onlinefirstaid.com, First Aid for Pets and her social cause StaySafe.support. She has published multiple books and is an acknowledged first aid expert and authority on accident prevention, health and first aid. Emma writes for numerous online and print publications and regularly features in the press, on the radio and on TV. She is the first aid expert for the British Dental Journal, British Journal of School Nursing, the Mail online and Talk Radio with Eamonn Holmes. She is a member of the Guild of Health Writers and Guild of Nurses.

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