Insect bite and insect sting: symptoms and treatment

Especially in the summer you can be struck by an insect bite or an insect sting. Insects such as bees, ants, fleas, gadflies, mosquitoes, wasps and arachnids can bite or sting. The bite or sting itself can be painful. It is often followed by an allergic reaction to the insect’s venom deposited in the skin, but non-venomous bites can also cause a skin reaction. Most insect bites and stings cause only mild discomfort, but some encounters with an insect can have serious consequences, especially if you have a severe allergy to the insect venom. Prevention is better than cure. So make sure you avoid biting and stinging insects.

  • Symptoms of an insect bite
  • Skin reaction
  • Infection
  • Allergic reaction
  • Insect bite or insect sting
  • Mosquito bite
  • Flea bites
  • Bedbug (bedbug)
  • Gadfly or horsefly
  • Lice
  • Tick bite
  • Scabies
  • Bees
  • Wasps
  • When to seek medical care for an insect bite?
  • Systemic symptoms
  • Infection of the bite or sting
  • Open wound or ulcers
  • Alarm symptoms
  • Examination and diagnosis
  • Interview and physical examination
  • Blood tests
  • Self-care for insect bites
  • Cooling and cleaning
  • Treating itching
  • Remove tick
  • Emergency treatment
  • Medical treatment of insect bites
  • Emergency treatment
  • Treating infectious disease
  • Desensitization
  • Prevention of an insect sting
  • Prognosis

 Swelling and redness due to an insect bite / Source: Martin Sulman

Symptoms of an insect bite

Skin reaction

Your reaction to a sting or bite from insects or ‘bugs’ varies and depends on several factors. Most insect bites and insect stings cause the following symptoms:

  • pain
  • swelling
  • redness or red spot
  • itch
  • blister(s)
  • (one or two) holes or dots at the stitch location



A wound may have developed that could become infected. If not treated properly, these local infections can become serious and cause a condition called cellulitis, an inflammation of the deeper parts of the subcutaneous connective tissue.

Allergic reaction

You may have a severe reaction outside the immediate area of the sting if you are allergic to the insect bite or insect sting. This is known as anaphylaxis. Symptoms of a severe reaction include:

  • itching all over the body
  • itchy mouth, itchy throat and itchy tongue

Stomachache / Source: Andrey Popov/

  • hives or red rash
  • watery or watery eyes, runny nose
  • swollen mouth, swollen throat and swollen tongue
  • shortness of breath, sometimes with wheezing
  • screeching sound when inhaling (stridor)
  • pressure or tightness in the chest
  • dizziness
  • nausea and vomiting
  • abdominal pain and sometimes diarrhea

In the worst case, this results in an anaphylactic shock, where you must be treated as quickly as possible with an adrenaline injection.Mosquito bite / Source: ProjectManhattan, Wikimedia Commons (CC BY-SA-3.0)

Insect bite or insect sting

Mosquito bite

A mosquito bite is a small, round swelling or small red bump that appears shortly after you are bitten. The bump becomes red, hard, swollen and itchy. You may have multiple bites in the same area.

Flea bites

Flea bites occur in both humans and animals. In humans they mainly occur in the legs and ankles, usually two or three bites in a row. It is an itchy, red bump surrounded by a red halo. You will feel it immediately as soon as you are bitten and the bites can hurt for up to a week.

Bedbug (bedbug)

The bedbug, formerly better known as bedbug, is a small insect that mainly lives in beds and mattresses in hotel rooms. The bed bug is a parasite that lives on the blood of others and at night the culprit crawls on the skin to suck blood. You will not feel the bite itself, but a small red bump will develop at the site of the bite. Often there are a few bumps in a row or close together, usually on parts of the body not covered by nightwear, such as the hands, neck or feet. The bumps itch and in the event of an allergic reaction, intensely itchy bumps may develop (hives).Bite of a horsefly / Source: BjornW, Wikimedia Commons (CC BY-1.0)

Gadfly or horsefly

The gadfly is notorious for its aggressive biting behavior. With their vicious blade-shaped teeth they drill into the skin and drink the blood that is released. The horsefly is the best-known horsefly in the Netherlands. A gadfly can cause a painful, itchy rash, which is caused by an inflammatory reaction at the site of the fly bite. Although usually harmless, a horsefly bite can lead to serious allergic reactions. Take precautions when traveling to endemic countries and areas by wearing thick, long-sleeved shirts and pants and using insect spray.


Head lice, pubic lice and body lice are different types of parasitic lice that affect humans. Body lice, unlike head lice, can transmit diseases such as typhus (a group of infectious diseases caused by the bacterium Rickettsia) or trench fever (an infectious disease transmitted by lice). However, infestation with body lice can be prevented through good hygiene, which is not the case with persistent head lice. Lice feed on blood and cause an itchy immune reaction at the site of their bites. For example, the allergic reaction to head lice can result in itchy red bumps or pimples on the scalp, neck and shoulders.Erythema migrans as a symptom of Lyme disease / Source: Hannah Garrison, Wikimedia Commons (CC BY-SA-2.5)

Tick bite

Ticks mainly live in shrubs, grasses and heathland, and it is a parasite that bites humans (and animals) to suck blood. These creatures bite into the skin and after a blood meal, which lasts several hours to days, they drop. A small red spot often appears at the site of the tick bite and this is a normal skin irritation. Ticks can be infected with bacteria and cause Lyme disease, among other things. In that case, a red ring-shaped spot may appear where the tick has bitten. This is called ‘erythema migrans’.


Scabies is a highly contagious skin condition caused by the scabies mite. It may take four to six weeks for symptoms to appear. This is because the female scabies mite digs tunnels in the skin to lay eggs. This causes an extremely itchy rash that may be pustular, consisting of small blisters or flaking. Raised, white or flesh-colored lines appear in the skin.


A bee sting is a sting from a bee. A small white circle with a diameter of 1 cm may develop, after which an irregularly shaped red spot and swelling ranging in size from a few centimeters to an entire limb may develop. A bee can only sting once. After a bee stings, the sting remains stuck in the skin. This forces the bee to break away and as a result the stinger and venom bladder are torn from its body and it will die. A bee only stings when it feels threatened.


A wasp sting usually only causes harmless, local symptoms, such as sharp pain, redness, swelling and itching or burning sensation at the sting site. A raised edge often also appears around the puncture site. Wasps can be aggressive and are capable of stinging you multiple times

When to seek medical care for an insect bite?

Systemic symptoms

Hives are the most common systemic symptom of an insect bite. They appear as irregular, raised, red blotchy areas on the skin, accompanied by a lot of itching. If hives are the only systemic symptom present, it can be treated with an antihistamine, but if other symptoms occur such as shortness of breath and/or other symptoms listed below, seek immediate medical attention. If you begin to experience symptoms that extend beyond the site of the bite or sting (or if you have had severe reactions in the past), see a doctor immediately. These symptoms (systemic symptoms affect the entire body) can progress into a life-threatening anaphylactic shock, an acute, very serious allergic reaction to a foreign substance.

Infection of the bite or sting

If the bite appears infected (redness with or without pus, warmth, fever, or a red streak that spreads to the body), see a doctor immediately.

Open wound or ulcers

If you don’t know which insect stung you, it’s important to monitor the area closely to make sure it doesn’t become infected. Call your doctor if an open or ulcerated wound develops.

Alarm symptoms

People with a history of severe reactions after an insect bite or sting should go to the nearest hospital emergency department if they experience symptoms. Those who have no history of severe reactions should also go to the emergency department immediately or call 911 if they have any of the following symptoms:

  • wheezing (wheezing)
  • shortness of breath
  • chest pain or shortness of breath
  • feeling of closing in the throat or difficulty speaking or swallowing
  • feeling of weakness and general malaise
  • if you have been stung in your mouth, tongue or throat, or on your eyelids or lips


Examination and diagnosis

Interview and physical examination

The diagnosis of a reaction to an insect bite or insect sting can usually be clearly deduced from what happened. The doctor will perform a physical examination to look at the effects of the bite on different parts of the body. If you can identify what bit or stung you, this can provide important information for both diagnosis and treatment. Examination of the skin, respiratory system, cardiovascular system, and oral cavity are particularly important to determine both diagnosis and treatment.

Blood tests

To identify the disease transmitted by biting or stinging insects, a blood test is usually required; As soon as the definitive diagnosis has been made (for example Lyme disease), specific treatment can be started.

Self-care for insect bites

Cooling and cleaning

Treatment depends on the type of reaction to the insect bite or insect sting. If there is only redness and pain at the bite site, the application of an ice pack or wet cloth is an adequate treatment. This prevents swelling and pain. Clean the area with soap and water to remove contaminated particles left behind by some insects (such as mosquitoes). These particles can further contaminate the wound if not removed. So make sure that the sting or other parts of an insect have been removed, after which you can rinse the wound and dab it with iodopovidone or alcohol (70%).

Treating itching

You can treat the itching at the bite site with an over-the-counter antihistamine in cream or pill form. Calamine lotion also helps relieve itching. Calamine dries and cools the skin and relieves itching. Menthol sprinkle powder or a cream can also help.

Remove tick

A stuck tick should be removed immediately, preferably with tick removers. Then wash the wound thoroughly and disinfect with iodopovidone or alcohol (70%).

Emergency treatment

People with a history of severe reactions to insect bites or insect stings may have been prescribed an ’emergency kit’ containing ampoules and/or tablets and/or aerosol beta mimetic.

Medical treatment of insect bites

Emergency treatment

Treatment of severe reactions to insect stings or insect bites should be done in the emergency department. Treatment can start with epinephrine (subcutaneous); diphenhydramine and steroids (drugs in the cortisone family) are also commonly administered. Oral antibiotics can be given for infected bite wounds. Severely ill people are given intravenous or subcutaneous fluids, given oxygen and placed on a cardiac monitor until symptoms improve with medication.

Treating infectious disease

For those insect bites and insect stings that result in transmission of pathogenic or disease-causing organisms, the physician’s next step is to make a definitive diagnosis so that appropriate treatment can be initiated. Consider, for example, Lyme disease.


You may be referred to an allergist for desensitization, a treatment aimed at getting the immune system used to the substance to which you are allergic.

Prevention of an insect sting

You can minimize your exposure to insect bites and insect stings by taking a number of measures:

  • Some vector mosquitoes are most active during twilight periods at dawn and dusk or in the evening, so avoid outdoor activities during these periods. Wear long-sleeved shirts, long pants and hats to minimize exposed skin areas. Shirts must be tucked into pants.
  • Use insect repellents. Agents applied to clothing, shoes, tents, mosquito nets and other equipment will improve protection.
  • Use DEET, a strong mosquito and tick repellent.
  • Prevent a tick bite by always staying on the paths, tucking in your trouser legs with your socks and carrying out a thorough tick check as soon as you get home. If necessary, also use an anti-tick spray that often protects against tick bites for up to 6 hours.



Most people respond well to self-care measures or emergency treatment for insect bites or insect stings. People with very severe allergic reactions or those who do not respond to initial treatment often require hospitalization for further treatment and monitoring. A severe episode of insect venom aphylaxis can be fatal despite adequate medical treatment.For people who contract a disease transmitted through insect stings or insect bites (such as Lyme disease), the outlook depends on the disease transmitted, how quickly it is diagnosed, whether it is treated appropriately, and the overall health of the individual . . The prognosis varies per disease from good to sometimes poor if organs are permanently damaged.

read more

  • Recognizing insect bites: dots, spots, bumps & swelling
  • Strophulus: symptoms of itchy bumps caused by insect bites
  • Angioedema (fluid retention): symptoms and treatment
  • Inflamed insect bite: symptoms, causes and treatment
  • Inflamed mosquito bite: symptoms, causes and treatment