Insect bites are a common problem 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

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Signs
The type of reaction which occurs after an insect bite depends on the species of insect, the age of the person and whether or not the person 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. With prolonged, repeated exposure to the insect, a wheal develops immediately after the bite and an itchy bump forms 24 hours later.

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, for example bee stings, can cause a serious allergic reaction called anaphylactic shock.

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.

Get help immediately if:

• You have difficulty breathing, are pale, sweaty, cold and drowsy. You may be suffering from an anaphylactic reaction.
• You develop flu-like symptoms or headaches, or experience nausea.
• You have had an allergic reaction to the insect’s bite before.

Home treatment
If you have been stung by a bee, remove the sting by gently scraping the skin with a clean knife blade. Tics can be removed by covering the tic with vaseline and clutching the tic with tweezers as close to the skin as possible.

Treatment for insect bites 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 but should only be used for a short time.

Call your doctor if:

• you have an obviously infected bite
• there is marked redness and swelling around the bite which is becoming increasingly painful
• there are multiple bites which are causing swelling around the eyes

Prevention
When you are 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. Also sleep under a mosquito net and wear protective clothing.

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.

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