BITES

What is it?

Most bites of insects and spiders are harmless even if they seem unpleasant. Most sting reactions are usually mild and can be managed at home, but in extreme cases some people overreact to bites, especially to the anaphylaxis, which causes breathing problems and severe complications requiring urgent treatment.

To prevent insect bites and it’s complications it is recommended to wear clothing that covers exposed areas of the skin. The use of insect repellents is also recommended.

Symptoms

Bee, wasps, hornets and fire ant bites are often painful; unlike mosquito, flea and mite bites which cause itching. Generally they may cause localized pain or itching, redness and swelling. It all depends on the type of insect or arachnid.

Bedbugs: Injuries are often in areas that are covered by clothes. They are small bites that are grouped together.
Mosquito: Bites are found on accessible areas. We should note that mosquitoes can transmit diseases such as malaria and dengue in areas where they are present (endemic areas) and in our geographic area they might also transmit leishmaniasis.
Ticks: usually a single lesion, most frequently affecting the scalp. Can be found attached, or they may leave a crust behind. It is important to consult with your Doctor as ticks may be vectors of diseases such as Lyme disease. (A disease that leads to muscle paralysis).
Fleas: They are usually multiple lesions found on the legs. The sting is painful. They are carriers of diseases like plague.
Spider: Usually a single bite. Its center is black.

We must watch out for signs of infection such as the appearance of a red, hot and painful area that grows in size; or anaphylaxis, such as difficulty breathing, swelling on the face or throat.

Diagnosis

Your dermatologist can diagnose it clinically by examining the skin. He will ask questions about your medical history. There are cases in which the diagnosis is difficult as there are other diseases that can mimic bites, and sometimes they are defined by performing a skin biopsy (taking a sample of skin) to confirm the diagnosis. Depending on the immune state the patient can present a cutaneous lymphoma.

Many times the origin of bites are a mystery so a good strategy is needed along with an experienced dermatologist.

If it is suspected that an infection was transmitted, testing may be done such as a blood test.

Treatment for Bites

Treatment includes antihistamines and topical corticosteroids. If there are signs of an infection a topical antibiotic is added. In cases of severe infection, oral antibiotic might be taken. If there are any signs of anaphylaxis (trouble breathing) go to the hospital immediately. Treatment with epinephrine and supportive measures will be required. Prevention and tips are important to follow.

Dr. Pablo Umbert Millet

Director of Instituto Pablo Umbert · Dermatologist and Dermatopathologist

Dr. Pablo Umbert is one of the leading experts in clinical dermatology, dermatopathology, and Mohs micrographic surgery in Spain. With over 30 years of experience, an international career at the Mayo Clinic and Saint-Louis Hospital in Paris, and more than 100,000 biopsies signed, he remains active as an emeritus professor at Hospital Universitario Sagrat Cor, where he supervises clinical cases and trains new generations of dermatologists.