insect bites

Definition

Insect bites are usually caused by mosquitoes (including anopheles: the type of mosquito that transmits malaria), wasps, wasps or bees. Signs and symptoms of an insect bite are caused by injecting a venom or other substance under the skin1 . Insect bites usually do not have serious consequences (they are benign), however some allergic people (about 3% of the population) should be particularly careful and consult a doctor in certain cases, such as when there is difficulty breathing. In an allergic person, the diameter of the bite can reach 10cm and become quite swollen, when this occurs, it is necessary to urgently consult a doctor.
The pain and symptoms are caused by the injection of substances (eg venom) into human skin by the insect.

Women tend to get more mosquito bites just before menstruation (a phenomenon related to hormones secreted into the air by women before menstruation, which attract mosquitoes).

Causes

Insects (mosquitoes, wasps, bees) sting to feed or defend themselves.

– Female mosquitoes bite to feed and draw their source of nutrients in human blood through the shedding of saliva. Mosquito bites cause (strong) itching in humans.

We observe that certain skins are much more bitten than others, however there are still no scientific conclusions that can explain this fact. It is assumed that this occurs due to differences in the sweat (perspiration) of each individual, which would more or less attract the mosquito.

– Hymenoptera: wasps, bees,… sting to defend themselves. This is why the excitement provoked by a person who is afraid of being bitten can lead to an increase in the frequency of bites. However, we emphasize that most of the time the bites are the result of chance. Hymenoptera bites are, in general, very painful, especially when they occur on the feet, however they disappear with time. Allergic people should be aware of the evolution of the bite.

Symptoms

The symptoms of an insect bite are generally the same as those of an inflammation, that is: redness, pain, heat and localized swelling. An insect bite makes the skin red, itchy and painful.

– Mosquito bites mainly leave us with a constant urge to scratch.

– The stings of wasps and bees in particular cause redness and inflammation of the skin, associated with pain, which is usually very intense. Most bug bites are mild, causing a mild itching or tingling sensation and mild swelling that goes away in a day or two.2 .
Delayed reaction: 
A delayed reaction, that is, appearing hours or even days after the insect bite, can sometimes occur with symptoms such as fever, hives, painful joints and swollen glands .

Reminder: people with allergies should be especially careful and in certain cases (such as when breathing is difficult) they should immediately consult a doctor. There are desensitizing treatments for insect bites, talk to your doctor about them.

In most cases, the symptoms left behind by insect bites disappear within a few days, often within 24 hours.

Treatments

We distinguish the treatments that will act in the prevention of those that will act in the cure.

1. Preventive treatment for insect bites (DEET,…)

The most effective treatments to prevent insect bites (in particular mosquitoes and anopheles) consist of using sprays, lotions or gels based on DEET (diethyltoluamide).
Associated with other molecules (alcohol,…), this mixture forms an excellent repellent (= anti-insect protection, through the deposit of a film on the skin, which prevents mosquitoes from adhering, that is, it will repel insects). These sprays are sold in pharmacies and can be applied to the skin as a very effective means of prevention. It is advised to apply them all over the body and reapply them after a swim. Attention, these sprays are not indicated for small children (under 2 years old), as their skin is much thinner and may suffer from some side effect. For these children, give preference to other techniques: dress the child properly and use a mosquito net.
That said, the Centers for Disease Control and Prevention (CDC )mentioned on their website , in July 2018, that repellents were contraindicated in babies younger than two months and not younger than two years, so there are differences between regions or countries. Consult your pharmacist and read the packaging.

– Another means of prevention consists of using mosquito nets or anti-insect sprays (available in pharmacies, supermarkets, etc.), known as insecticides (which kill insects) which contain chemical products that exterminate insects. In the United States, the Centers for Disease Control and Prevention (CDC) mentioned on their website a 5th molecule, 2-undecanone, as an effective repellent.

– Note: the use of vitamin B1 was once recommended to prevent insect bites, however recent research ruled out the effectiveness of this vitamin as a repellent, so do not use this vitamin for this purpose!

Scientific study on DEET, comparison with citronella The most effective product for preventing insect bites, including mosquito bites, is DEET (diethyltoluamide), according to a US study. Although the study is several years old, published in 2002, in the New England Journal of Medicine (DOI: 10.1056/NEJMoa011699) , it is still current according to Prof. Stephen Gluckmann of the University of Pennsylvania. For the American professor and specialist in infectious diseases, interviewed in July 2018 by the Wall Street Journal (WSJ) 
, this is the most complete comparative study. In this study, volunteers applied 16 products sold as anti-mosquito products to the skin of their arms. Then they put their arms in a cage full of mosquitoes. The best product was one that contained 24% DEET, protecting the volunteers for 301 minutes. In comparison, the best product containing a natural product, citronella essential oil, protected volunteers for 20 minutes.
In the interview given to the WSJ in July 2018, Prof. Gluckmann made another interesting point about the safety of using DEET, he said, so far, there has been no credible study showing a side effect of DEET other than an allergic reaction.

According to European authorities, there are three other substances other than DEET that act as skin repellents and effectively repel mosquitoes. These substances are: icaridine (picaridin or KBR3023), EBAAP (ethyl-butyl-acetylaminopropionate or IR3535) and citriodiol (PMDRBO, obtained from the Eucalyptus citriodora plant).
It is estimated that these 4 repellents are effective for a period of 2 to 5 hours after application, with variations depending on the concentration of the active ingredient and the outside temperature. (Source: Pharmavista.net, accessed July 18, 2014).

2. Curative treatment of insect bites

– In case of a wasp or bee sting, after removing the stinger with tweezers, disinfect the area (with 70% alcohol, for example, with dexpanthenol-based gel or cream) and then use an ointment, a soothing cream (at base of an antihistamine or a local anesthetic such as polidocanol), or apply cold compresses to reduce pain and inflammation.

– In case of mosquito bites, use creams, gels, ointments or lotions based on an antihistamine (H1), a local anesthetic or a hydrocortisone derivative, against itching and pain, (available in pharmacies)
The use of cold packs can also help reduce pain and inflammation and therefore be very helpful.
Diphenhydramine (Benadryl®) is an antihistamine medication often used by mouth, in pill form, or topically, such as cream or gel, after a mosquito or insect bite.

Herbal medicine

Note : if you are scheduled to travel to an endemic area for malaria (paludism) or other serious tropical diseases (yellow fever), it is highly recommended to use a repellent (anti-insect protection) based on DEET (diethyltoluamide) and not a plant-based biorepellent (citronella, lemon balm), as their effectiveness is still fully proven.

Generally known as bio-repellents, various plants or essential oils have a mild (not scientifically proven) preventive effect on insects (see note above).

The medicinal plants (essential oil based) most used in spray or steam (to be used in a room or on a table) are:

– lemongrass , the plant most used for this purpose.

– lemongrass

– the thyme

– mint

– of lavender

Note: As with all essential oils, there is an allergic risk, so consult an expert for more information.

– Onion (as therapy)

insect bite tips

Prevention

– Cover up as much as possible. When it’s very hot, apply skin repellent to uncovered areas (read treatments). It is also advisable to wash the insect bite site with a little soap and water.3.

– Avoid turning on the light in the rooms at night (especially where you sleep) to avoid attracting insects.

– You should be more attentive at night, as it is during this period that insects, especially mosquitoes, are most numerous. Attention, the dengue mosquito  also bites during the day.

– When eating outdoors in summer, avoid sugary foods or drinks, such as soft drinks, as these can attract wasps and bees. The ideal is to cover them.

– Avoid excessive perfume, insects are attracted by the smell.

– Wear light and loose clothes, covering the body well. Wearing very dark (black) or very colorful clothes can attract insects, especially mosquitoes.

– You can prevent mosquitoes from coming by using coils (available at pharmacies or supermarkets). Candles, lamps and ultrasound devices seem to be less effective.

Malaria (malaria)

– The use of mosquito nets against mosquitoes or anopheles (the agent of malaria) is one of the most effective measures against mosquitoes, especially for young children and babies who cannot use repellents on their skin. The ideal is to impregnate the mosquito nets with insecticide.

– If you are going to travel to an area endemic for malaria (paludism) or other serious tropical diseases ( yellow fever and dengue ) it is highly recommended to use repellent (anti-insect protection) containing DEET (diethyl toluamide) and not based on plants (citronella and melissa).

Treating Bug Bites

– After a bug bite you can use vinegar, rub a small amount on the bite. The acidity of vinegar (low pH) can exert a favorable antiseptic effect.

– To relieve pain, apply cold (eg ice pack) for a few minutes on the insect bite.

Sources & References:
Mayo Clinic , Swiss Allergy Center, The Wall Street Journal, US CDC, The New England Journal of Medicine (DOI: 10.1056/NEJMoa011699), Pharmavista.net (Swiss drug reference site).

Responsible person involved in the writing of this file:
Xavier Gruffat (pharmacist and editor-in-chief of Create health.com.br).

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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