DEAR DR. GOTT: I am a 42-year-old female with no known issues. I take OTC vitamins. When I get a bug bite, it seems that my body’s reaction is severe. After about 12 hours, the bite has swollen to several inches (4-5 around), is very hard, hot, red and tender. I am very careful not to scratch it as this just makes it worse. This will last a few days before it subsides. This week I was bitten near the hairline on my temple. A day later, it looks like I have a black eye.
I don’t remember having had this response as a child. It just seems to be getting worse over time. Short of going to the doctor every time I get a bug bite, what can I do to mitigate the symptoms? Thank you for your time.
DEAR READER: Fortunately for many of us, most reactions to bites are rather mild and cause little more than an itch and swelling that will disappear within a day or two. Delayed reactions that don’t disappear as quickly can result in fever, swollen glands, hives, and painful joints. The symptoms you experience fall into this latter category and result from venom or other substances the insects have injected into your skin. And, because you appear to have extremely sensitive skin, you suffer a more acute reaction than do most people.
Those bites most troublesome and most common include mosquitoes, yellow jackets, bees, hornets, fire ants and wasps. While you don’t indicate any symptoms other than the size and irritation of the bite, allergic reactions to these and countless other insects can include nausea, diarrhea, abdominal cramping, and enlargement of the lesion which can range from pinpoint to fist size. If you are stung by a bee, it may leave the stinger behind and cause a more severe reaction. If this is the case, it is important to remove the stinger.
You can consider putting ice over the site immediately following the bite. If you keep a cold pack in your freezer for easy access, that would suffice. You can also grab that bag of frozen peas or corn which will work just as well. Or, keep a box of baking soda available and make a paste using a small amount of water to cover the area with. Then take an over-the-counter pain reliever such as ibuprofen or acetaminophen. Numerous topical creams are available commercially at your local pharmacy or grocery and an appropriate one should include hydrocortisone or lidocaine. Consider keeping the antihistamine diphenhydramine (Benadryl) for emergencies. Others, such as loratadine (Claritin) or cetirizine (Zyrtec) can also be used. They are non-sedating but may be less effective.
It appears your symptoms worsen as time goes on. I urge you to speak with your primary care physician to determine if he or she feels you are a candidate for an EpiPen if you advance to severe symptoms such as chest tightness, difficulty breathing, swollen lips or throat, or a rapid heartbeat. Extreme allergic reactions, known as anaphylaxis, can be serious and even life-threatening in some instances. An EpiPen is an epinephrine injector used for the emergency treatment of an allergic reaction caused by unknown triggers, exercise and allergens such as insect bites. It is a single-dose unit that is injected into the outer thigh only. Clearance must be given for its use by your physician, as extremely serious side effects of the EpiPen can occur if you are on any asthma medication or other specific drugs or have coronary heart disease. If the EpiPen is right for you, you would be instructed on how to inject yourself and would keep the instrument with you on a 24/7 basis.
Readers who would like related information can order my Health Reports “Allergies” and “More Compelling Home Remedies” by sending $2 US (per report) check or money order to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) when writing or print out an order form from my website www.AskDrGottMD.com.
