Uptown Office: 450 West End Avenue • New York, NY 10024 • 212-769-3070 • Fax: 877-451-0227

Downtown Office: 2 Fifth Avenue • New York, NY 10011 • 212-353-0072 • Fax: 877-451-0227

Uptown Office: 450 West End Avenue • New York, NY 10024 • 212-769-3070 • Fax: 877-451-0227

Downtown Office: 2 Fifth Avenue • New York, NY 10011 • 212-353-0072 • Fax: 877-451-0227

Insect Bite

Main Symptoms

  • Itchy Insect Bites: Bites of mosquitoes, chiggers (harvest mites), fleas, and bedbugs usually cause itchy, red bumps
  • Painful Insect Bites: Bites of horseflies, deer flies, gnats, fire ants, harvester ants, blister beetles, and centipedes usually cause a painful, red bump. Within a few hours, fire ant bites can change to blisters or pimples
  • This topic excludes bees, ticks and spiders
  • A severe life-threatening allergic reaction is called anaphylaxis

See More Appropriate Topic If


Call 911 Now (your child may need an ambulance) (for symptoms of anaphylaxis) If

  • Difficulty breathing or wheezing
  • Hoarseness or cough with rapid onset
  • Difficulty swallowing or slurred speech with rapid onset
  • Previous severe allergic reaction to bite from the same type of insect
  • NOTE: Anaphylaxis can occur with bee, yellow jacket, wasp, or fire ant stings (rarely with other insects). Onset usually is within 20 minutes but can occur up till 2 hours after the bite

First Aid Advice for Anaphylaxis

  • Give epinephrine injection if you have an anaphylactic kit
  • Inject it into the muscle of the upper outer thigh

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Hives or swelling elsewhere on the body
  • More than 20 fire ant stings in a child < 1 year old

Call Your Doctor within 24 Hours (between 9 and 4) If

  • You think your child needs to be seen
  • Severe pain is not improved after 2 hours of pain medicine
  • New redness or red streak occurs around the bite after the first 24 hours
  • Scab that looks infected (drains pus or increases in size) not improved after applying antibiotic ointment for 2 days

Call Your Doctor during Weekday Office Hours If

  • You have other questions or concerns

Parent Care at Home If

  • Normal insect bite and you don't think your child needs to be seen

Home Care Advice for Insect Bites

  1. Itchy Insect Bites (including all mosquito bites)
    • Apply calamine lotion or a baking soda paste
    • If the itch is severe, use 1% hydrocortisone cream. Apply 4 times a day until the itch is less severe, then switch to calamine lotion
    • Also apply firm, sharp, direct, steady pressure to the bite for 10 seconds. A fingernail, pen cap, or other object can be used
    • If the bite is very itchy after local treatment, try an oral antihistamine (e.g. Benadryl). Sometimes it helps, especially in allergic children
  2. Painful Insect Bites
    • Rub the bite for 15 to 20 minutes with a cotton ball soaked in a bakind soda solution. This will usually relieve the pain (Caution: don't use near the eye)
    • If not available, use a baking soda solution on a cotton ball
    • If neither is available, apply an ice cube for 20 minutes
    • Give acetaminophen or ibuprofen for pain relief. See Dosage table. Antihistamines don't help
  3. Antibiotic Ointment: If the insect bite has a scab on it and the scab looks infected, apply an antibiotic ointment 4 times per day
    • Cover the scab with a Band-Aid to prevent scratching and spread
    • Repeat washing the sore, the antibiotic ointment and the Band-Aid 4 times per day until healed
    • Caution: For spreading infections (redness or red streaks), your child needs to be seen
  4. Expected Course: Most insect bites itch or hurt for 1 to 2 days. The swelling may last a week
  5. Call Your Doctor If
    • Severe pain persists > 2 hours after pain medicine
    • Infected scab doesn't clear after 48 hours of antibiotic ointment.
    • Bite looks infected (redness, red streaks, increased tenderness)
    • Your child becomes worse or develops any of the "Call Your Doctor" symptoms