Bug bites come in all shapes and sizes, from itchy and red to stinging and swollen. While most are just annoyances that disappear within a few days, others can present serious health concerns.
How can you tell the difference between benign and dangerous bug bites? Some of that depends on your symptoms. If you simply can’t stop scratching but otherwise feel fine, you might just get by with home remedies like a cold compress or an over-the-counter anti-itch cream. If you’re experiencing shortness of breath, nausea, stomach cramping, sweating, chills, body aches or swelling away from the original site, you could be having an allergic reaction that requires immediate medical attention. Though this is rare, the Centers for Disease Control and Prevention estimates that up to 100 Americans die each year as a result of insect bites and stings.
The kind of culprit responsible for your bite can help you assess what kind of treatment plan to follow — and whether or not you need to see a doctor. Unfortunately, some bites can be hard to distinguish unless you catch the perpetrator in the act. With millions of species of insects in our environments, both indoors and out, it’s helpful to keep track of some of the most common offenders and what dangers, if any, they may pose to our health.
Ants
Famous for disrupting picnics and swarming tiny scraps of food, most ants are harmless. If they do bite you, it’s a quick pinch and maybe some localized swelling. Fire ants, however, are a whole different issue, and they act as aggressively as their name suggests. When disturbed, they can attack with a powerful, venomous sting, causing a burning sensation. Within a day or so, the site can bubble up into red bumps or a pus-filled pimple that might take a few days to heal.
Do you need to see a doctor?
Only if you experience any severe chest pain, nausea, sweating, slurred speech or loss of breath.
Avoid fire ants by taking care not to disturb their nests and mounds when walking or working in regions where they’re most common. Fire ants are usually found in Southern states like Texas and Florida, as well as parts of California.
Bedbugs
These miniscule menaces are especially hated, given that they attack us in the very place we feel safest. Bedbug bites can sometimes be confused with mosquito bites; they’re usually small, red, puffy bumps that appear in lines or clusters on the parts of our skin that are exposed. To be sure that bedbugs are behind your bites, closely examine your room, especially the corners of your pillows and mattress. If you spot any droppings or the bugs themselves, you have to completely exterminate them from your home.
Do you need to see a doctor?
It’s unlikely. Bedbugs don’t spread the kinds of parasites that other insects do. Their bites are likely to just cause an annoying itch.
Avoid bed bugs by regularly washing and heat-drying your bedsheets, blankets, bedspreads and any clothing that touches the floor. If you’re staying somewhere new, carefully check the mattress and pillows before settling in for the night.
Bees and Wasps
Both of these critters use stingers to inflict pain on their victims, so they’re often grouped together. Bee and wasp stings usually manifest as red, itchy bumps that sometimes cause the surrounding area to swell. In people without allergies, they can take about a week to fully subside. However, people with allergies need to be very careful, as bee and wasp stings can cause life-threatening anaphylactic shock.
Do you need to see a doctor?
If you experience severe swelling of the face, lips or throat; hives or itching in areas of the body not affected by the sting; breathing difficulties, such as wheezing or gasping; loss of consciousness; nausea or vomiting; or weak or racing pulse, you must seek emergency medical attention immediately. If you already know that you’re allergic to stings, carry an EpiPen with you at all times.
Avoid bees and wasps by being careful outdoors around flowers and plants that may attract them. Wear long sleeves and pants to cover exposed skin.
Chiggers
Also known as berry bugs or harvest mites, chiggers are tiny, red mites that are hard to see with the naked eye. Their bites are usually painless, and can show up as flat red patches or raised red bumps after a day or so. The accompanying itch can be severe and may last up to two weeks.
Do you need to see a doctor?
Probably not, as chiggers don’t spread disease and don’t inject dangerous venom.
Chiggers are prevalent in grassy areas, so wear high socks or pants to prevent them from biting your ankles or crawling up your legs.
Fleas
While fleas usually prefer your pets, they’re not too picky — humans, especially kids, will satisfy them just fine. Their bites tend to appear as small, red bumps in a line or cluster, similar to lice and bedbugs, sometimes with reddish halos around them. Fleas usually strike around the ankles or in warm places on the body, like the back of the knees, armpits and groin. While not serious, they can cause a nasty, painful itch and even a rash around the infection site.
Do you need to see a doctor?
Not unless your scratching leads to an infection, or if your symptoms persist and get worse.
The best way to avoid fleas is by keeping them off your pets. Make sure to groom and bathe them often, and keep them up-to-date with flea-prevention medication. If you expect to come into contact with an animal that could have fleas, wear long sleeves and pants to minimize exposure to bites.
Flies
Fly bites can be a downside to outdoor excursions, especially in hot weather.
Though these bites vary by species and by person, they often manifest as raised red bumps or welts. Some, especially horsefly bites, might bleed, while blackfly bites often swell. Other types of biting flies include deer and stable flies. While annoying and often painful, they’re usually innocuous.
Do you need to see a doctor?
Likely not. In rare cases, deer flies can pass on the bacterial disease tularemia, which can lead to a painful ulcer, and blackfly bites can cause a flu-like condition called blackfly fever. If you develop those kinds of symptoms, consult a medical professional.
The best way to avoid flies is by wearing long sleeves and pants in the outdoor environments that they call home. If that’s not an option, there are a multitude of natural fly repellents on the market, as well as more potent products that use the chemical DEET.
Head Lice
If you’re unlucky enough to catch a case of head lice, don’t panic. While it’s certainly not pleasant to think about these parasitic little bugs feeding on your scalp, chances are you’ll spot them in the nit stage, which is when they’re eggs, or feel them crawling around in the nymph stage, which is when they’re tiny. By the time they reach the adult phase, they’re about the size of sesame seeds, and their bites leave patches of red, raised spots around the scalp and neck. As your skin reacts to the bugs’ saliva, the bites can become very itchy, so you’ll definitely notice them at that stage.
Do you need to see a doctor?
Probably not, unless your scratching has caused you to develop sores. Just focus on getting rid of the infestation: The CDC recommends using an over-the-counter medication that contains either pyrethrins (naturally occurring pyrethroid extracts from the chrysanthemum flower) or permethrin (a similar synthetic pyrethroid), which should kill the live bugs. To help with the scratching, doctors recommend taking an antihistamine like Benadryl or Allegra.
Avoid head lice by checking your hair often, especially if you have school-aged kids, who are more likely to get infected by sharing hats or brushes with other children. If you do spot head lice in your home, take care to wash your clothes and bedding on high heat and vacuum thoroughly.
Mosquitoes
These summer pests can be exasperating, ruining barbecues and sunset strolls by leaving itchy, swollen bites, often before we can swat them away. If you didn’t catch them in the act, you can identify their bites as small white bumps of skin with a red dot in the middle. The surrounding area can become puffy, swollen and itchy, but usually will disappear in a few days. However, mosquitoes can often carry diseases: Malaria, yellow fever, Zika and West Nile viruses are the most common and can be pretty serious.
Do you need to see a doctor?
If you notice a fever, headache or flu-like symptoms after a bite, you could be experiencing something more serious.
Mosquito bites can be largely prevented by wearing long-sleeved shirts and pants, using effective repellent sprays or burning citronella candles. If you’re in a tropical area that’s known for mosquitoes, it’s a good idea to use a bed net at night.
Spiders
Spider bites and the dangers associated with them can range widely, depending on the eight-legged offender. They’re usually noticeable as a red mark on your skin with two tiny puncture wounds, potentially causing some itchiness and swelling. While the majority of spider bites will go away after a few days, bites from black widow and brown recluse spiders are definitely ones to worry about.
Do you need to see a doctor?
If you spot a brown recluse or black widow spider crawling away from a bite on your skin, yes. Also contact a medical professional if you experience body aches, nausea, a rash, fever or an ulcer around the bite that turns purple or black.
Avoid spiders (especially the dangerous ones) by wearing long sleeves and pants when working outside and by making sure that doors and windows around your house do not stay open for long periods of time. Common insecticides and repellents that contain DEET can also deter these creepy crawlers.
Ticks
It’s usually easy to spot a tick bite, given that the tick is usually still attached to the skin, feeding on blood. If you see your bite after the tiny assailant has already scurried away, you might notice a dime-sized red spot with another ring around it, like a bullseye. This could be a sign that your tick was carrying Lyme disease, a serious illness with symptoms that include fever, headache, fatigue and a characteristic skin rash called erythema migrans. If left untreated, the infection can spread to a person’s joints, heart and nervous system.
Should you see a doctor?
If you begin to experience any of the above symptoms after being bitten by a tick, then yes. Even if you know that a tick has bitten you but do not feel anything strange, it’s a good idea to consult a medical professional, just in case. If caught early, Lyme disease can be treated successfully with a few weeks of antibiotics, so it’s wise to be proactive.
Tick bites are best prevented by wearing long pants and socks while hiking, especially through long grass, where ticks like to hide out. Insect repellent is also helpful. If you do spot a tick on you, remove it as quickly as possible.
To Sum It Up…
Though bug bites are most often summertime nuisances, they can still happen in the winter, when insects seek warmth inside our homes. It’s also important to be aware of bugs while traveling, as they might pose risks that we’re not used to considering. In some cases, a photo sent to your doctor could be enough to diagnose your bite — or at least to help determine whether or not a bug is to blame for a particular rash or bump. As always, be sure to contact urgent care if you’re experiencing any serious symptoms.