Insect bites and stings occur when an insect feeds off a person's skin or tries to defend itself.
Different insects bite and sting in different ways. Common biting or stinging insects include mosquitoes, blackflies, bed bugs, fleas, ticks, fire ants, bees and wasps. Bees often leave stingers in the wound.
Insect bites usually cause mild swelling, redness and itchiness limited to the small area around the bite or sting.
Some children, however, can experience potentially life-threatening allergic reactions. This is called an anaphylactic reaction and requires immediate medical attention. In children who are at risk, anaphylaxis is most commonly caused by bees, wasps and hornets.
Other insects can transmit disease. For example, some mosquitoes can transmit malaria or West Nile virus, and some ticks can cause Lyme disease.
Signs and symptoms of an insect bite or sting
Signs and symptoms of insect bites and stings vary according to the type of insect and your child's reaction.
Normally, an insect bite or sting causes:
- a small, red, raised bump, pimple or blisters
- itchiness and irritation around the bump
The symptoms can last from a few hours up to a few days.
Some children develop a big firm, swollen, warm area around the bite. This is not an allergic reaction. It is known as a large local reaction and rarely leads to a skin infection.
If your child has an anaphylactic reaction, they may develop hives, facial or mouth swelling, or breathing problems or they may collapse. Use an epinephrine auto-injector, if your child has one, and call for emergency assistance.
How to treat insect bites and stings
- Cold, damp compresses or ice can relieve some of the swelling.
- Over-the-counter topical medications (medications you put on the skin) may also help to relieve the itch.
Some children may respond well to oral (taken by mouth) non-drowsy (non-sedating) antihistamine medication for itching. There are many over-the-counter non-sedating antihistamines available, such as cetirizine, loratadine, desloratadine and fexofenadine. Your child’s health-care provider or pharmacist can suggest a product.
Preventing insect bites and stings
Your child is more likely to be bitten in warm and damp weather and in the evening or at night. Here are some ways you can reduce your child's exposure to insects.
- Apply insecticide or insect repellent to clothing and exposed skin to avoid bites.
- Wear long pants and socks.
- Wear light-coloured clothing.
- Avoid areas where insects breed and live.
- Stay inside when insects are most active.
- Use mosquito nets, especially for infants aged less than six months.
Insect repellents
DEET
DEET is one of the most effective repellents for mosquitoes, ticks and biting flies, but it should be used with caution in children. Health Canada recommendations for DEET usage in children are summarized here:
- Babies less than six months old: Do not use any insect repellents with DEET. A mosquito net is recommended instead.
- Children aged six months to two years: Use a product with 10 per cent DEET or less and apply it no more than once a day.
- Children aged two to 12 years: Use a product with 10 per cent DEET or less and apply it no more than three times a day.
- Children aged over 12: Use a product with up to 30 per cent DEET.
Children under the age of 12 should not use DEET on a daily basis for more than one month.
Icaridin/picaridin
Icaridin/picaridin is a DEET-free chemical repellent that prevents tick, mosquito and insect bites and can be used in children over the age of six months.
Other natural repellents are not as effective as DEET and icaridin/picaridin and may not be effective against ticks.
How to apply DEET and icaridin/picaridin to your child's skin
- Apply it to exposed skin, following the manufacturer's instructions.
- Do not apply it to your child's face or hands or any areas where the skin is cut, grazed or irritated.
- Once the repellent is applied, wash hands and avoid touching the lips and eyes.
How to use insect repellent and sunscreen effectively
- Apply sunscreen about 20 to 30 minutes before you apply any insect repellent.
- Do not use a single product that combines insect repellent with sunscreen. The insect repellent can make the sunscreen less effective, and the sunscreen can increase how much insect repellent is absorbed by the body. In addition, you will normally need to apply sunscreen every two to three hours; it is not safe to apply insect repellent as frequently.
When to see a health-care provider after an insect bite or sting
If your child has been bitten or stung, see a health-care provider if:
- you are in an area where the insects are known to transmit diseases
- your child develops an unusual rash or fever
Seek emergency medical care if:
- your child develops hives, swelling, difficulty breathing or is known to be at risk of anaphylaxis from the insect bites or stings
References
Health Canada. (June 21, 2021). Personal insect repellents. Retrieved from https://www.canada.ca/en/health-canada/services/about-pesticides/insect-repellents.html#b1