Bites

Bites

37 Treatment Tips

One mosquito says to another, "I heard a bum say he hadn't had a bite in a week. So I bit him."

It's a lame joke. But bites aren't all that funny if you're on the receiving end. Fortunately, most insect bites are just annoyances that itch like crazy and produce ugly little welts that go away in a day or two. And love nips from Fifi and Fido are often more an insult than a real injury. So for those occasions when the bite is a little worse than the bark (or the buzz), doctors make the following suggestions.

FLIES AND MOSQUITOES

These pesky flying critters can make you pretty uncomfortable when they decide to munch on you. Here's what to do.

Disinfect the bite. Flies and mosquitoes can spread disease. So wash the bite area thoroughly with soap and water, says North Carolina allergist Claude Frazier, M.D. Then apply an antiseptic.

Rub in an aspirin. Herbert Luscombe, M.D., professor emeritus at Jefferson Medical College of Thomas Jefferson University, recommends an unusual aspirin treatment to help control inflammation. As soon as possible after being bitten, moisten your skin and rub an aspirin tablet right over the bite.

Relieve the itching. Fly and mosquito bites may produce swelling and intense itching that can last for three or four days. Dr. Frazier recommends the following to control these symptoms:

  • An oral antihistamine. Choose an over-the-counter allergy or cold preparation.
  • Calamine lotion.
  • Ice packs.
  • Salt. With water, moisten it into a paste and apply to the bite.
  • Baking soda. Dissolve 1 teaspoon in a glass of water. Dip a cloth into the solution and place on the bite for 15 to 20 minutes.
  • Epsom salts. Dissolve 1 tablespoon in 1 quart of hot water. Chill, then apply as above.

Practice prevention. You may be able to avoid a bite in the first place by using the repellents below. Keep in mind that the hotter it is, the more active flies and mosquitoes seem to be. And mosquitoes, in particular, are at their worst in damp areas, such as near ponds or in marshes. Some species are especially pesty late in the day and are attracted to outdoor lighting after dark. So don't let down your guard at sunset.

Thiamine chloride. Taken orally, this B vitamin may repel insects by being excreted through the skin, says Dr. Frazier. He does caution that it may cause itching, hives, and a rash in some people.

When the Itsy Bitsy Spider Turns Nasty

Little Miss Muffet was no sissy—she was just savvy enough not to risk a spider bite. Basically, says paramedic Jeff Rusteen, all spiders are poisonous. It's just that most of them aren't big enough or powerful enough to penetrate the skin and do much harm. If you do get bitten, says Claude Frazier, M.D., follow these steps:

  • Wash the wound and disinfect it with an antiseptic.
  • Apply an ice pack to slow absorption of the venom.
  • Neutralize some of the poison, adds Herbert Luscombe, M.D., by moistening the bite with water and rubbing in an aspirin tablet.

Beware, a black widow spider bite can cause intense abdominal pain that could be confused with appendicitis. Let your doctor know you've been bitten so he can administer injections of calcium gluconate, says Dr. Luscombe.

A bite from a brown recluse spider might also produce problems, he adds. If an intensely sore lump develops (sometimes weeks after the injury), consult your doctor.

DEET. He also recommends any commercial repellent containing N,N-diethyl-m-toluamide (DEET). Apply generously over all exposed skin but be careful around the eyes—it can sting badly if perspiration carries it into the eye. Do not use too often, however, especially on children.

Chlorine bleach. Dr. Luscombe recommends bathing in a very diluted solution of chlorine bleach before going out. Mix two capfuls of bleach in a tub of warm water. Soak in it for 15 minutes. Be very careful not to get the solution near or in the eyes. The repellent effect should last several hours.

Bath oil. Certain bath oils, such as Alpha-Keri and Avon's Skin-So-Soft, have a repellent effect, he says.

Sunscreen. Some sunscreens also repel insects. "Pre-Sun, for instance, seems to work as a repellent," says Dr. Luscombe.

Vicks Vapourub. Some people have success with this strong-smelling ointment, he says.

Zinc. Illinois allergist George Shambaugh, Jr., M.D., professor emeritus at Northwestern University Medical School, recommends daily doses of zinc (at least 60 milligrams) as a natural repellent. Be aware that it takes about a month to build up enough zinc in your system to discourage insects. (Take extra supplements only with the approval and supervision of your doctor.)

TICKS

Ticks are not fussy about what type of animal provides their meals. Humans are fair game to them. Here's what to do if one latches onto you.

Remove the beast. Ticks pose a special problem because they dig their little jaws into your skin and hold on for dear life. Trying to brush away a tick as you would a fly has no effect. And forcefully plucking it out may leave its mouthparts embedded, setting the stage for infection. Here are some gentler methods for loosening a tick's grip.

Ease it out. Dr. Luscombe recommends taking a pair of tweezers and very slowly pulling the tick out. "Don't pull too fast," he cautions. "And if you're not having success, you might try applying a little heat to the tick's backside. Blow out a match and carefully touch the tick with the tip. The heat may encourage it to let go."

Irritate it. Dr. Frazier says that a drop of gasoline, kerosene, benzine, or alcohol placed on the general region of the tick's head will make it loosen its grip. But be patient—it may take 10 minutes or more to work. Note that these substances are flammable and should not be used in conjunction with a hot match.

Suffocate it. A variation on that technique, says Dr. Frazier, is to cover the tick with a drop of paraffin or fingernail polish. Either substance will close off the tiny breathing openings on its side and suffocate the tick.

Try the Benforado Method. When Joseph Benforado, M.D., professor emeritus at the University of Wisconsin-Madison, was a Boy Scout camp physician some years ago, he devised this foolproof way to remove ticks:

Take a large nail (8- or 10-penny size) and warm the tip in a match flame. Slide the flat side of a pocketknife blade under the tick's abdomen. Place the heated nail tip on the tick's back so it's sandwiched between the knife and the nail. When the tick's legs begin to wiggle in response to the heat, turn the knife blade 90 degrees so the tick is standing on its head. Keeping it sandwiched, gently pull the tick up and away from its grip. If the legs do not wiggle, the nail is not warm enough. Try again. "The object is to annoy the tick rather than roast it," says Dr. Benforado.

Clean up. Once you've removed the tick, wash the bite area with soap and water, says Dr. Frazier. Then apply iodine or another antiseptic to guard against infection.

Be vigilant. Although June and July seem to mark the height of tick season, ticks are a danger from early spring until fall. If you're spending any time outdoors, especially in wooded or high-grass areas—even grassy dunes—take the following precautions.

  • One way to discover if there are ticks in an area, says Dr. Frazier, is to tie a piece of white flannel to a string and drag it through the grass or underbrush. Examine it frequently. If ticks are present, they will cling to the cloth.
  • If you're in a tick area, leave as little skin exposed as possible, says Dr. Benforado. That means wearing long pants, high socks, and long sleeves.
  • Before going to bed at night, he adds, inspect your body for any freeloading ticks. Certain species can be quite small, and you might otherwise overlook them.

DOGS AND CATS

Here's what to do when a four-legged friend gets unfriendly.

Assess the damage. Seek medical help for all but the most minor wounds, say doctors.

Thoroughly wash the bite. Animal bites—especially from cats—may transmit infections, says Stephen Rosenberg, M.D., associate professor of clinical public health at Columbia University School of Public Health. He advises that you cleanse the wound thoroughly with soap and water to remove saliva and any other contamination. Continue washing for 5 full minutes.

Control bleeding. If there is any minor bleeding, cover the entire wound with thick sterile gauze or a clean cloth pad, says Dr. Rosenberg. If you have no appropriate bandage, thoroughly cleanse your hand and press it firmly against the wound. You may also put some ice against the pad (not directly on the skin) and elevate the wound above heart level to help stop bleeding.

Bandage the area. When the bleeding has stopped, says Dr. Rosenberg, cover the bite with a sterile bandage or clean cloth. Tie or tape it loosely in place.

Reduce pain. Use aspirin or acetaminophen to reduce pain, says Rusteen. This is appropriate even if the bite did not break the skin. Elevate the area and apply ice if there is any swelling.

Get a tetanus shot. Any animal bite can lead to tetanus, says Dr. Rosenberg. If you haven't had a booster shot within the last five to eight years, get one now.

MEDICAL ALERT

Keep Up Your Guard

Any bite could develop complications. Stay alert for these potential problems:

Infection. Examine any animal wound periodically, says paramedic Jeff Rusteen. If it gets red, painful, or hot, infection has probably developed. Get professional help.

Crush injury. Sometimes a large dog, such as a German shepherd, will bite without breaking the skin. If you can see bite marks on both sides of an extremity, there may be internal damage, says Rusteen. If tingling develops or if the extremity changes color (turns blue, for instance), there may be structural damage. Get to a hospital or call paramedics.

Rabies. All warm-blooded animals may carry rabies, says Stephen Rosenberg, M.D. Contact the animal's owner to see whether its rabies shots are up-to-date. Rabies treatment may be safely delayed as long as the animal shows no symptoms, he says, providing the bite was not too severe or too close to the head. You may be required to report all bites to the authorities, he adds; check with the police.

Rocky Mountain spotted fever. If you were bitten by a tick, a rash may develop around your wrists or ankles and spread to the rest of your body, says Herbert Luscombe, M.D. A high fever and terrible headaches can follow. The disease can be deadly, so if symptoms appear, see a doctor immediately.

Lyme disease. Also caused by ticks, Lyme disease starts as a ringwormlike spot at the site of the bite, says Dr. Luscombe. Although very serious if not treated, the organism is easily killed with antibiotics. Symptoms may not develop for a few weeks, so you should keep an eye on the bite area.


PANEL OF ADVISERS


Joseph Benforado, M.D., is professor emeritus of medicine at the University of Wisconsin-Madison and vice president of the U.S. Pharmacopoeia, which sets American drug standards. He spent many summers as a physician at a Boy Scout camp in northern Wisconsin.

Claude Frazier, M.D., is an allergist in private practice in Asheville, North Carolina. He is the author of Coping with Food Allergies and Insects and Allergy and What to Do about Them.

Herbert Luscombe, M.D., is professor emeritus of dermatology at Jefferson Medical College of Thomas Jefferson University in Philadelphia, Pennsylvania. He is also senior attending dermatologist at Thomas Jefferson University Hospital in Philadelphia.

Stephen Rosenberg, M.D., is associate professor of clinical public health at Columbia University School of Public Health in New York City. He is author of The Johnson & Johnson First Aid Book.

Jeff Rusteen is a firefighter-paramedic with the Piedmont Fire Department in Piedmont, California. He teaches emergency medical technology at Chabot College in Hayward, California. He is the author of a videotape and companion booklet called Until Help Arrives.

George Shambaugh, Jr., M.D., is a medical otologist and allergist in private practice in Hinsdale, Illinois, a member of the staff at Hinsdale Hospital, and professor emeritus of otolaryngology, head and neck surgery, of Northwestern University Medical School. He writes a health and nutrition newsletter that he sends to his patients.

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