Advanced Dermatology, PC News FIRST AID FOR BUG BITES


Leading dermatologist discusses symptoms and treatments

New Hyde Park, New York, September 2008 – Along with the change of any season and as we move indoors, in come some of those pesky annoyances such as the little bugs and their bites that irritate more than our nerves. Most insect bites cause a stinging sensation along with itching and mild swelling that disappears within a day or two.  But experiencing soreness, redness, swelling and warmth beyond the immediate bug bite, or pus are warning signs that a bug bite may be infected and you should see a doctor.

“If you scratch these bites, you could break the skin, which can lead to an infection and possibly scarring.”, notes Dr. Joshua Fox, founder of Advanced Dermatology and a spokesman for the American Academy of Dermatology. To reduce itching, prior to seeing the doctor, Dr Fox advises to

1.  Apply a hydrocortisone cream(0.5 percent or 1 percent), calamine lotion, Aveeno powder, or a baking soda paste (3 teaspoons baking soda to 1 teaspoon water) to the bite several times a day until symptoms subside.

2. A cold pack or baggie filled with ice can help reduce swelling and itching too.

3.  For stronger bug bite reactions, Dr. Fox recommends taking an antihistamine containing diphenhydramine (Benadryl, Tylenol Severe Allergy), chlorpheniramine maleate (Chlor-Trimeton, Actifed) or loratadine (Claritin) to reduce the body’s response and itch.

4.  Also, products with camphor and menthol often alleviate the severe itching.

“If a bite site develops a rash, or if you experience a fever, headache, joint pain, dizziness, fatigue, nausea or vomiting following a bug bite, it is important to consult a physician immediately,” says Dr. Fox. “Although rare, you can get a serious reaction to bug bites, which can result in swelling in your throat, significant hives and wheezing to arthritis and heart problems – all of which require immediate medical attention.”

Learn more about West Nile Virus

West Nile Virus is spread by the bite of an infected mosquito.  Mosquitoes become infected with the virus from biting infected birds, natural hosts of West Nile. About 80 percent of the people who are infected with West Nile Virus show no symptoms.  Up to 20 percent of the people who become infected have symptoms such as fever, headache, fatigue, body aches, nausea, vomiting, and sometimes swollen lymph glands or a skin rash on the chest, stomach and back. Symptoms can last for as short as a few days, though even otherwise healthy people have become sick for several weeks. People with West Nile fever recover on their own, though symptoms can be relieved through various treatments (such as medication for headache and body aches) — seeing a doctor is recommended.

What to do if you get a deer tick bite

If you get a deer tick bite, remove the entire tick from the bite and avoid squeezing the tick.  Use fine point tweezers to grasp the tick near its head or mouth and then pull gently to remove the whole tick without crushing it or leaving a piece of the tick in the skin.  It is often helpful to save the tick in a plastic bag (noting the date it was removed) in case you need to visit a doctor. After the tick is removed, wash the bite site with soap and water, or an antiseptic. The person who removed the tick should wash their hands thoroughly. Dr. Fox points out that ticks often hide in warm, moist places, such as the groin, armpits, the back of the neck, navel, ears and scalp.  He has pulled out multiple ticks which have even masqueraded as skin growths – including one on his own daughter.

If you see an expanding circle or circles of redness about two inches in diameter that radiates out from the bug bite, it could be a sign of Lyme disease and the bite needs to be evaluated by a doctor.  Lyme disease is an infection caused when a person is bitten by a deer tick that is infected with B. burgdorferi bacteria. About 80 percent of individuals with Lyme disease will develop a rash that looks like a bull’s–eye near the bite. The rash is often accompanied by flu-like symptoms such as fever or headache, nausea and vomiting. “Some people may only develop flu-like symptoms and not a rash but still have Lyme disease,” Dr. Fox advises.  “Treatment with antibiotics is necessary to fight the infection and prevent more serious, heart or arthritic symptoms.”

Dr. Fox recommends using insect repellents on the intact skin and clothing to be more completely protected against bug bites. Repellents containing permethrin should be applied only to clothing, where the agent has a residual effect through several wash cycles, providing lasting protection against bugs. Insect repellent containing 10% percent DEET should be applied directly onto the skin to ward off mosquitoes, ticks and other insects.

First aid for spider bites

If you are bitten by a jumping spider (the most common biting spider in the United States) or a brown recluse spider it is important to immediately see a doctor.  You can identify a brown recluse spider by violin shaped marking on its top. The brown recluse spider bite has cytotoxic venom which causes severe pain or burning accompanied by local redness and itching. The wound may take on a bull’s-eye appearance, with a center blister surrounded by a red ring and then a blanched (white) ring.  A fluid-filled blister forms at the site and then sloughs off to leave a deep, enlarging ulcer that scabs over. Other symptoms from a brown recluse spider bite are: fever, chills, nausea, vomiting, listlessness and muscle aches.

The bite from a jumping spider is painful and itchy — the site becomes red and there is significant swelling. Symptoms can include painful muscles and joints, headaches, fever, chills, nausea and vomiting which may last from one to four days.  “It’s important to stay as motionless as possible to prevent the venom from spreading and if the spider bite site is at an arm or leg, it should be elevated to reduce swelling,” says

Dr. Fox. “Wash the wound with cool water and mild soap and then apply ice to decrease the pain and swelling.  Use acetaminophen for pain relief and antihistamines such as Benadryl can be taken for itching and swelling.”

How to treat bedbug bites

A bedbug is a small (about the size of a pencil eraser), flat, reddish-brown bug that feeds on human and animal blood.  Bedbugs are active at night and bite any areas of exposed skin.  The bite feels itchy and looks like little red bumps (similar to mosquito bites) which often occur in a line on the body. “Wash the bites with soap and water and use calamine lotion or a topical corticosteroid cream to help with the itching,” says Dr. Fox.  “Bedbugs pose very little health risk for infection and minimal risk for other diseases.”  They often present with three adjacent red bumps on an exposed extremity after getting a “new mattress”.

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