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Doctors' Answers to "Frequently Asked Questions" - Insect Bites

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Fire Ant Bite and Epinephrine [posted 1/14/99]
Question: I recently had a violent reaction to a fire ant bite, and now carry an EPIPEN. Even with extra precautions (and believe me, I am taking them) it is a safe assumption that sooner or later I will get bitten again? I live in an area that is pretty well infested with these critters. Is it also safe to assume that each successive bite will react worse than the one before? Will the EPIPEN allow me some degree of safety in the future? Or is it possible that the reactions may reach a level of severity that the epinephrine will not work properly. I am not an alarmist, but we have actually considered relocating a bit further north.

Answer: How about desensitization? Most allergists would have venom, which would accomplish this and is recommended for severe cases.

Insect Bite [posted 1/14/99]
Question: Three days ago I felt a bite on my chest. It was at night laying in bed and it itched. So I scratched it as if it were a mosquito bite. However, we all have gotten bit by a mosquito and the next morning I realized it wasn't a mosquito! Anyway I developed a red rash and it was still a little itchy, but I wouldn't scratch it to make it worse. I took Benadryl. There was a tiny white head and when I popped it, it was just watery. I put cortisone on it for the past 2 days and it seems to be going away. However, I am scared because I have never experienced a bite like this and I don't know if it was a spider bite or tick bite! Do tick bites itch? Would I get the rash back if it were a tick? It was not a circular rash it was a pretty decent size rash and it was more splattered than circular. Can you give me some advice?

Answer: Tick bites would be in the outdoors or woods, not at home. Also, you would see the tick. Spider bites are pretty common, but usually produce a large red area with a necrotic center, depending on the type of spider. Probably of no concern at this point.

Spider Mites [posted 11/5/98]
Question: I was told by a doctor that I had spider mites under my skin. The only thing he gave me to help remedy this problem was lindane lotion. What does this do and what else can I use to rid myself of these mites? They are getting to me. Also, they are increasing. What can I do? I am desperate.

Answer: Did he see a mite? You would need to eliminate the source while treating yourself. This would mean finding the source. Lindance should work, but a very uncommon problem.

Allergy to Bee Stings[posted 10/16/98]
Question: When I was a kid (I'm 41 now), I had severe, life-threatening allergies to bee stings. In fact, I had a sting that almost took my life when I was 12....swelled up, hard to breathe,itchy, rushed to ER. I took a series of shots after that time. However, I haven't been stung since (that I know of). Am I still allergic? I have an Epipen at home, just in case, but don't really carry it with me. I certainly don't want to "test" the hypothesis ...but what do you think? Do I need to keep updating my perscription to a Epipen?

Answer: I'd keep the Epipen. As to the shots, it depends on how often you are exposed to bees. If you are around them a lot, I'd keep the shots up.

Chigger Bite[posted 10/10/98]
Question: Your advice concerning the treatment of chigger bites by applying nail polish to suffocate the imbedded insect implies that the insect is indeed still under the skin. According to other articles I have read, the chigger itself does not burrow inside, but rather injects a fluid to kill the tissue and then sucks out the liquified tissue. They can easily, even accidentally, brushed off. You may be thinking of tick bites in which the insect itself burrows under the skin and remains there until removed. Even so, ticks are best removed by pulling gently, but steadily, with a tweezer, not coating with nail polish.

Answer: Thanks for the input.

Insect or Spider Bite
Question: I was bitten by something almost a week ago. It was night, and I was sitting on an old couch which I guess was the home of whatever bit or stung me. I don't think it was a sting because I didn't see a stinger, and I have been stung before with no real reaction. I did have a reaction to this though. The bite hurt as bad as a sting and it didn't stop hurting for a good twenty four hours or so. I put ice on it and that stopped the hurt, but as soon as I took it off it would be painful again. There was a lot of swelling in the area (the initial bite occurred just below and to the right of my right knee) and the area grew out for a few days then branched down like it was in my veins or something. I went to the doctor, but she didn't know what it was. It had sort of a dull ache for a couple days and a bit of a burning sensation. Then it became extremely itchy for a couple of days. Now the swelling has gone down but there is no sign of the redness disappearing. It is about as big as a lemon with a branching off at the bottom. Where the skin was punctured is a little red dot in a little white circle. It looks sort of like a port wine birth mark. In the last two days I have noticed purpley/red dots that look like when your skin has been pinched hard. Any ideas what this can be? I have never been allergic to anything before that I know of.

Answer: Most likely a spider bite. They persist and occasionally will result in necrosis(death) of some of the tissue around the bite. Unfortunately, there is no good treatment to minimize or prevent the effects. It will take another two to three weeks to declare if any of the tissue will slough.

Spider bite
Question: What does the bite of a Brown Recluse spider look like? Would it be composed of a number of small blisters, half the size of a BB and clustered in a circle pattern? What, other than insect bites, could cause that type of reaction?

Answer: The bite of the brown recluse doesn't start off any different than any other insect bite. This is usually a red and occasionally raised area that is tender. However, it continues to spread usually to a one to three inch circle that becomes more painful and more discolored. This eventually leads to the central area necrosing or dying and a large ulcer. Your bite sounds like some other critter.

Chigger Bites
Question: Recently I have just returned from a canoe trip down the Gunnison River in Colorado. Apparently, somewhere on the trip, I received numerous (40-50) chigger bites. At the moment, I am trying to treat them with Benadryl lotion and by applying nail polish to the surface of each bite. I was told by a friend that by applying nail polish, the chiggers, which have infested my skin, will suffocate. I would very much like to know what is the best and quickest treatment to rid myself of these pesky insects.

Answer: This is time honored advice in chigger country and seems to be reasonable. Systemic benadryl will also help.

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