Insect bites - how to treat them

Insect bites are a seasonal summer hazard that can ruin a day (or night) in the great outdoors – and in your back garden. Itchy red bumps, painful stings or even allergic reactions are the nasty bugs' calling cards.

Here's our guide to avoiding some of the worst offenders, and treating their bites if you do get nipped or stung.

General avoidance tactics

• Don't go out at dawn and dusk: Warm, sunny, windless weather, at dawn and dusk are the favourite conditions for many insects. So keep an eye on the overall forecast as you may want to stock up on insect repellents, to keep the bugs at bay. If you are taking other medication ask your chemist which repellent would be best for you.
• Burn citronella outside: Most bugs hate the smell of citronella oil and eucalyptus oil, so these should help keep your garden or patio a bug-free zone. Eucalyptus oil may also help keep mosquitoes away. You can also buy insect repellents containing DEET, although this may not suit everyone, and should not be used on infants. If you are regularly taking other medication, check with your chemist or GP before using over the counter medicines.
• Avoid wearing bright colours and cover up: Insects are attracted to bright colour, so wear neutral colour and cover up well, with long sleeves and trousers and a hat. And don’t have your picnic on a brightly coloured rug.
• Be vigilant when sitting by water or walking in woodland/long grass: Horseflies and mosquitoes are attracted by water so if you’re walking near water make sure your arms and legs are well-covered. Ticks love long grass and woodland so if you’re planning on walking anywhere near them, don't wear shorts.
• Avoid waving your arms around at wasps: This is likely to make them cross, and increase your chances of being stung. If there are wasps around, move away from them slowly and calmly.

Mosquitoes

What are they? Mosquitoes are small flies. There are lots of different kinds of mosquitoes in the UK, but luckily they don’t usually carry the unpleasant viruses that mosquitoes in other countries do (such as malaria and the Zika virus).

How to treat mosquito bites

• If you are bitten by a mosquito put a cool, damp cloth over the bites to stop you scratching and breaking the skin.
• If the itching is uncomfortable or stopping you sleeping ask your chemist for a cream to soothe the area. Hydrocortisone cream can help relieve the itching.
• Antihistamine tablets or syrup can help reduce the itching, stop you scratching and help you sleep. Ask your chemist which antihistamine would best suit you. Make sure you let them know all the medication you are currently taking.

Gnats and midges

What are they? These small creatures fly around in swarms, gnats (also known as midges), and love damp, cloudy weather. They deliver bites that hurt, swell up out of proportion to their size, and are also very itchy.

How to treat gnat and midge bites: Ask your chemist to recommend something to soothe the itching, such as a cream containing hydrocortisone. Try not to scratch the bites as this could damage your skin and lead to an infection. If the bites don’t clear up or become infected, see your chemist or your GP.

Bees

What are they? There are two types of bees in the UK, honey bees which are the more aggressive type, and bumble bees. Honey bees leave their sting behind, when they sting you, which means they die. Bumble bees can sting you without losing their stings.

How to treat bee stings: If you are stung by a bee in most cases you’ll feel some pain, and the site of the sting will swell up. This swelling is likely to last for over 24 hours. This is known as a localized reaction. If you are stung by a honey bee, it will leave its sting behind. Remove the sting as soon as you can, by scraping it out using a hard, flat surface, for instance a bank card, or a fingernail.

A step up from this is when you have a mild systemic (whole body) reaction. In these cases you’re likely to have hives and swelling in other parts of your body that aren’t near the sting.

When this happens in adults and older children it can be a sign that these people may be at risk of a stronger reaction to bee stings in the future.

Allergic reactions to stings

If you are allergic to insect stings – particularly from bees and wasps - make sure that you are always prepared. Some people have very severe and potentially fatal reactions to insect stings. These are known as generalised local reactions.

If you know that you (or anyone with you) have this problem make sure that you always have your adrenalin (epinephrine) pen with you. If you are stung, use your adrenalin pen straight away and call an ambulance, explaining that you (or the person with you) are having an anaphylactic reaction.

Wasps

What are they? Often unwelcome guests at picnics, wasps can deliver a painful sting, as well as ruining the party. Wasps are responsible for the highest number of allergic reactions to insect stings in the UK.

How to treat wasp stings: If you’re stung by a wasp you’re likely to see swelling around the sting. This can last for over 24 hours. If you have a stronger reaction to the sting you may have swollen skin and hives in other parts of your body. This can be an indication that you might have a more severe reaction if you’re stung again in the future.

In this case it’s a good idea to talk to your GP about having an adrenaline (epinephrine) auto-injector, which you can carry with you, in case you are stung.

If you have a severe reaction to the sting you are likely to have more symptoms, and, depending on the extent of your reaction, may need emergency medical help. This type of reaction is known as anaphylaxis.

The symptoms can include swelling in your throat and mouth, trouble swallowing and speaking, and difficulty breathing. If you have a severe systemic reaction you may have trouble breathing, and may become unconscious.

If you – or anyone with you – have an anaphylactic reaction to a sting, you need immediate medical help. Use the adrenaline injector and call 999 straight away.

Horseflies

What are they? These large, dark, hairy, flies, like warm, sunny weather. Streams and woodland are among their favourite locations. When they bite, they tend to cut skin, rather than piercing it. This makes for a painful bite – often around your head and shoulders - that takes longer to heal than bites from some other flies.

How to treat horsefly bites: Horsefly bites can create a wheal around their bite, and in some cases may cause hives – a number of red and itchy wheals. See your chemist or GP for advice if the wheals don’t stop itching or become infected. They may suggest using hydrocortisone cream for bites that are very itchy. And you may be prescribed antibiotics if your bites have become infected. 

Black flies

What are they? These are similar in size to mosquitoes, but have a fatter body and only bite in daylight. They are most likely to bite you around the head and neck, back, legs and arms. These insects fly in swarms, which can make them a real nuisance. They tend to like wooded areas, pastures and moorlands.

How to treat black fly bites: If you are bitten by a black fly, the site of the bite may become swollen and itchy. Their bites can be painful because they cut into your skin when they bite. Ask your pharmacist for advice on the best treatment for these symptoms

Ticks

What are they? These eight-legged creatures live mostly in woodland, pasture, moorland, parks, and even gardens. It’s important to know about them because some ticks carry Lyme disease (see below). They feed on animal and human blood, often hitching a ride as an unsuspecting meal walks by.

Ticks don’t hurt when they bite, so you may not know that you’re carrying one until you undress. They usually attach themselves to adults’ legs, so do check when you come back in from a walk, or in the garden.

Removing a tick If you spot a tick attached to you, try to remove it, carefully. You can buy specialist tick removers, or pointed tweezers. For more information on how to remove a tick go to https://www.gov.uk/guidance/tick-surveillance-scheme

Related: Walkers beware tick bites

Lyme disease and how to deal with it

Ticks carry the bacteria that cause Lyme disease. When an infected tick bites, it passes the bacteria on. If you have been bitten by an infected tick and developed Lyme disease you are likely to see a distinctive bull’s eye shaped rash, between three to 30 days later.

Not everyone develops this symptom, instead you may have fluey symptoms, such as headaches, joint and muscle pain and a stiff neck.

If Lyme disease isn’t caught in its early stages, it can be more difficult to treat, and can cause more serious health problems. These can include meningitis, heart failure and arthritis.

If you have found a tick attached to you, or think there is a possibility that you have had one, and may have Lyme disease, see your GP. This disease causes fewer health problems when treated early.

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