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Kids and Bugs: Stings, Bites and Allergic Reactions

Reactions to insects in pediatric patients

Reactions from insect exposure are typically due to either bites or stings. When children have a reaction to an insect bite or sting, mild redness and swelling at the site (i.e. localized reactions) are common, and are not necessarily from an allergic response. Often, these reactions are due to localized irritation from substances in the insect’s saliva. When a child has an allergic reaction, there is an immune response to the bite or sting.  

Serious allergic reactions involve symptoms away from the site of the bite or sting, such as difficulty breathing, throat swelling, dizziness, loss of consciousness, diffuse hives over large areas of the body, vomiting, diarrhea, and abdominal pain. Serious allergic reactions to insects are called anaphylaxis (an-a-fi-LAK-sis) and can be life threatening.  

Anaphylaxis is very rare following mosquito bites, and is more commonly associated with stinging insects (yellow jackets, honeybees, wasps, hornets, and fire ants).  Allergy testing is available to some stinging insects and allergy evaluation is indicated for children who have a history of serious allergic reactions to insect bites or stings. Venom immunotherapy (allergy shots) can be a very effective treatment for a child with insect allergy and a history of a severe allergic reaction. 

Read about Dr. Daniel Searing, an an allergist-immunologist at Children's Hospital Colorado.

Non-Allergic reactions

Insects can also causes serious reactions in children that are not allergic. Symptoms can be similar to allergic reactions, including nausea, vomiting, fever, fainting, seizures, flu-like symptoms and joint pain.  Some children can develop chronic, nodular, red, itchy lesions following insect bites that last for more than several days. These lesions are known as papular urticaria. There can be a delay from the time of the bite and the development of these lesions. 

Treating your child’s mosquito bites and insect stings

For localized reactions to mosquito bites or insect stings try the following treatments:

  • Wash insect bites with soap and water
  • Put a cold, damp washcloth on the area
  • For swelling and/or pain, apply ice
  • For itching, apply over the counter topical steroids or oral antihistamines
  • Consult a health care provider if the swelling and redness progresses or if you are concerned the area is becoming infected

How to avoid mosquito bites in kids:

  • Peak mosquito time is typically from dusk until dawn. Remain inside at sunrise, sunset, and early in the evening.
  • Remove and/or avoid areas of standing water. These are common areas mosquitoes hang out.
  • Have your child wear clothing that covers most of his or her skin.
  • Use insect repellent. Test on a small area of skin first. Follow label directions and do not use on the skin under clothing. 
  • Guidelines regarding safe and effective usage of insect repellents are available through the United States Environmental Protection Agency (EPA). 

How to avoid insect stings in kids:

  • Have hives and nests around your home destroyed by a trained exterminator.
  • Avoid brightly colored clothing and perfume when outdoors. 
  • Cover food and drinks when outside to help keep insects out.
  • Slowly move away in a calm and quiet manor when stinging insects are spotted near you.
  • Familiarize yourself with the appearance of different insects and their nests.

Useful links

Learn more about our Allergy Program.