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Updated 13 February 2013

Insect bites - children

Insect bites are a common problem in children and may be difficult to diagnose.

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Insect bites as a problem in children

Description

  • Insect bites are commonly caused by mites, spiders, fleas, mosquitoes, ants, lice and bedbugs
  • The usual reaction is an itchy lump in the area of the bite
  • Treatment is aimed at relieving the itching
  • Call your doctor if your child is having difficulty breathing or swallowing after being bitten, has an obviously infected bite, or there are multiple bites around the eyes causing marked swelling

Insect bites are a common problem in children and may be difficult to diagnose. The main classes of insects which cause bites are:

  • Mites, spiders and ticks
  • Centipedes
  • Millipedes
  • Mosquitoes and flies
  • Fleas
  • Ants, bees and wasps
  • Lice
  • Bedbugs, kissing bugs

What are the symptoms and signs of insect bites?

 

The type of reaction which occurs after an insect bite depends on the species of insect, the age of the child and whether or not the child has been exposed to the insect before.

Insects not only bite, but also cause contact dermatitis or irritation to the skin.

Most reactions to insect bites depend on a reaction to the saliva or venom. When someone is bitten for the first time, no reaction develops. But after repeated bites, sensitivity develops. This produces an itchy bump around 24 hours after the bite and is the most common reaction seen in young children.

With prolonged, repeated exposure to the insect, a wheal develops immediately after the bite and an itchy bump forms 24 hours later. This combination of reactions is seen most often in older children.

By adulthood or the teenage years, only a wheal may form with the subsequent itchy bump.

Insect bites can be single or multiple, depending on the feeding habits of the insect concerned. For example, fleas may produce multiple bites, while a mosquito may bite only once.

Spiders may produce a reddened wheal and an ulcer.

In some cases an insect bite can cause a serious allergic reaction called anaphylactic shock, for example, bee stings.

It is worth noting that a condition called papular urticaria can often be confused with insect bites, since it can resemble a number of insect bites in a small area. However, this is actually an allergy to insect bites and can be treated with calamine lotion or antihistamine creams.

How are insect bites treated?

 

The treatment is aimed at relieving the itch. This can be achieved by oral antihistamines, cool compresses and soothing lotions such as calamine.

In cases of multiple bites which are causing a lot of swelling and itching, particularly around the eyes, oral steroids may be useful - used for a short time.

How can you prevent insect bites?

 

When your child is playing in the garden it is very difficult to prevent bites from the common insects which are present.

However, insect repellents are effective against mosquitoes, fleas, flies and ticks and should be used where these insects are common. The child should also sleep under a mosquito net.

Make sure that the household pets are free of fleas by regular use of the currently available anti-flea preparations. If fleas are obviously infesting the house then fumigation may be needed.

When to call your doctor

  • If your child is having difficulty breathing, is pale, sweaty, cold and drowsy then they may be suffering from an anaphylactic reaction and must see a doctor as an emergency
  • If your child has an obviously infected bite
  • If there is marked redness and swelling around the bite which is becoming increasingly painful
  • If there are multiple bites which are causing swelling around the eyes

(Reviewed by Prof Don du Toit)

 
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