Local Allergic Reaction to Insect (Child)

Your child is having a localized allergic reaction to an insect bite or sting. The venom or poison from an insect causes the body to release chemical substances. One substance, histamine, causes swelling and itching. Some children's immune systems are very sensitive to an insect sting or bite. Any insect can cause an allergic reaction. Usually the reaction is only at the site, but sometimes it can affect the entire body.

Common insect stings causing problems are wasps, yellow jackets, bees, hornets, and fire ants. Common bites are from spiders, mosquitoes, fleas, or ticks. Other types of insects may be more common in different parts of the country or world.

Symptoms include:

  • Rash, hives, redness, welts, blisters

  • Itching, burning, stinging, pain

  • Dry, flaky, cracking, scaly skin

  • Swelling around the bite or sting, sometimes spreading to other areas

Immediately after the sting or bite, the area may be very painful or pain may be felt later on. The skin will become reddened and swollen. The pain may last several days and there can be itching. Depending on the type of insect, the area may become hard and develop surrounding red scales. Sometimes the skin may blister.

Symptoms usually respond quickly to antihistamines, steroids, and pain medicine. Untreated, a localized allergic reaction may subside within a few hours, or may last several days.

Home care

Your child's healthcare provider may prescribe medicine to relieve swelling, itching, and pain. Follow the instructions when giving this medicine to your child.

  • If your child had a severe reaction, the provider may prescribe an epinephrine auto-injector. Epinephrine will stop the progression of an allergic reaction. Before you leave the hospital, be sure that you understand when and how to use this medicine.

  • Oral diphenhydramine is an antihistamine available at pharmacies and grocery stores. Unless a prescription antihistamine was given, this may be used to reduce itching if large areas of the skin are involved. Some over-the-counter antihistamines may cause drowsiness, so it may be best to give in the evening. Check with the healthcare provider for instructions before giving any medicine to your child.

  • Don’t use antihistamine cream on your child’s skin. It can cause a further reaction in some people.

  • Call your child's healthcare provider and ask what to use to help stop the itching.

  • You can use over-the-counter children's pain medicine to control pain, unless another pain medicine was prescribed. Check with your child’s healthcare provider about what type of pain control is best before giving anything to your child. Don’t give ibuprofen to a child younger than 6 months old. Don’t give aspirin (or medicine that contains aspirin) to a child younger than age 19 unless directed by the provider. Taking aspirin can put your child at risk for Reye syndrome. This is a rare but very serious disorder that most often affects the brain and the liver.

General care

Try to identify and teach your child to stay away from the problem insect. Future reactions may be worse. Teach your child these things:

  • Don't walk in grass with sandals or without shoes.

  • Don't leave food uncovered when eating outside. Sweet treats, watermelon, and ice cream attract insects.

  • Don't drink from uncovered sweetened drinks in cans when outside. Insects are attracted to soda drink cans and sometimes crawl inside them.

  • Don't wear bright colored clothes with flowery prints and patterns when outside.

  • Don't wear perfume when outside. The smell of perfume can attract insects.

  • Be aware that honeybees nest in trees. Wasps and yellow jackets nest in the ground, trees or roof eaves. Avoid garbage containers when outside.

Stings

Wasps, yellow jackets, and hornets don’t leave a stinger behind. But if a honeybee stings your child, a stinger may stay in the skin. The stinger of a honeybee releases a substance that will attract other bees to your child. So try to move away from the nest immediately. Once your child is away from the nest, then remove the stinger as quickly as possible by doing the following:

  • Scrape the stinger out with the edge of a dull knife or plastic card (credit card).

  • Don't use a tweezer or your fingers to remove the stinger since that may squeeze more toxin from the stinger. 

  • Wash the affected area with soap and warm water 2 to 3 times a day. Don't break a blister, if present. 

  • Next apply an ice pack for 5 to 10 minutes. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Don’t put ice directly on the skin.

  • Contact your child's healthcare provider and ask what can be used to help decrease the swelling and itching to the affected area. 

  • To prevent an infection, don't scratch the affected areas. Always check the sting area for signs of an infection. This includes increased redness, swelling, or pain to the affected area.

Ticks

If you try to remove a tick, do the following:

  • Use a set of fine tweezers and grip the tick as close to the skin as possible.

  • Pull up, using even, steady pressure. Don’t jerk or twist the tick. Don’t squeeze, crush, or puncture the tick’s body. Its bodily fluids may contain infection-causing organisms. Don’t use remedies such as nail polish, petroleum jelly, or heat sources to detach the tick from the skin. Remove as instructed rather than waiting for it to detach. .

  • If any mouth parts of the tick remain in the skin, try to remove them with tweezer. If you can’t remove the mouth easily with clean tweezers, leave it alone and let the skin heal. 

  • After the tick is removed, clean the bite area with rubbing alcohol, soap and water, or iodine. 

  • Put the tick in a sealed container and completely cover it with alcohol. Never try to kill or crush a tick with your hand or fingers.

After an allergic reaction

  • Keep a record of symptoms, when they occurred, and any problem insects. This will help your child's healthcare provider determine future care for your child.

  • Inform all care providers and school officials about your child’s allergic reaction. Tell them how to use any prescribed medicine.

Follow-up care

Follow up with your child's healthcare provider, or as advised. Ask your child's provider about a safe insect repellant that can be used on your child's skin or clothes.

Call 911

Call 911 if any of these occur:

  • Trouble breathing or swallowing, wheezing

  • Cool, moist, pale or blue skin

  • New or worsening swelling in the mouth, throat, or tongue

  • Hoarse voice or trouble speaking

  • Confusion

  • Very drowsy or trouble awakening

  • Fainting or loss of consciousness

  • Rapid heart rate

  • Feeling dizzy or weak with a sudden drop in blood pressure

  • Feeling of doom

  • Severe nausea or vomiting or diarrhea

  • Seizure

  • Swelling in the face, eyelids, lips, tongue, or mouth

  • Drooling

When to seek medical advice

Call your child’s healthcare provider right away or seek medical attention right away if any of these occur:

  • Spreading areas of itching, redness, or swelling

  • Signs of infection:

    • Spreading redness

    • Increased pain or swelling

    • Fever (see fever section below)

    • Fluid or colored drainage from the affected area

Fever and children

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit (axillary) temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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