Clinical Reference Systems: Pediatric Advisor 10.0
Itchy or Painful Insect Bites
Bites of mosquitoes, chiggers (harvest mites), fleas, and
bedbugs usually cause itchy, red bumps. The size of the
swelling can vary from a dot to a centimeter (half inch).
The larger size does not mean that your child is allergic to
the insect bite. Mosquito bites near the eye usually cause
massive swelling for 2 days.
Clues that a bite is a mosquito bite are itchiness, a
central raised dot in the swelling, presence of the bite on
a surface not covered by clothing, summertime, and the
child's being an infant (because an infant can't protect
himself). Some mosquito bites in sensitive children form
hard lumps that last for months. In contrast to mosquitoes,
fleas and bedbugs don't fly; therefore, they crawl under
clothing to nibble. Flea bites often turn into little
blisters in young children.
Bites of horseflies, deerflies, gnats, fire ants, harvester
ants, blister beetles, and centipedes usually cause a
painful, red bump. Within a few hours, fire ant bites
change to blisters or pimples.
- Itchy insect bites
Apply calamine lotion or a baking soda paste to the area
of the bite. If the itch is severe (as with chiggers),
apply nonprescription 1% hydrocortisone cream four times
a day. Another way to reduce the itch is to apply firm,
sharp, direct, steady pressure to the bite for
10 seconds. A fingernail, pen cap, or other object can
be used. Encourage your child not to pick at the bites
or they will leave marks.
- Painful insect bites
Rub the area of the bite with a cotton ball soaked in
meat-tenderizer solution for 20 minutes. (Avoid the
area around the eyes.) This will relieve the pain.
If you don't have any meat tenderizer, baking soda is a
fair substitute. If these substances are not available,
an ice cube may help. Give acetaminophen or ibuprofen
for pain relief.
- Mosquitoes and chiggers
Many of these bites can be prevented by applying an
insect repellent sparingly to the clothing or exposed
skin before your child goes outdoors or into the woods.
Repellents are essential for infants (especially those
less than 1 year old) because they cannot bat the
The bed and baseboards can be sprayed with 1% malathion,
but young children must be kept away from the area
because this substance is somewhat poisonous. You may
need to call in an exterminator.
Usually you will find the fleas on your dog or cat. If
the bites started after a move into a different home,
the fleas are probably from the previous owner's pets.
Fleas can often be removed by bringing a dog or cat
inside the house for 2 hours to collect the fleas (they
prefer living on the dog or cat to living in the carpet)
and then applying flea powder or soap to the animal
outdoors. Careful daily vacuuming will usually capture
any remaining fleas.
- Precautions with DEET insect repellents
Insect repellents containing DEET must be used with
caution. DEET can be absorbed across the skin into the
bloodstream and products with high concentrations can
cause seizures or coma. Young children may also have
reactions to DEET from licking it off the skin. To
prevent harmful reactions, take the following
- Use DEET products formulated for children. These
contain 10% or less DEET. Even adults don't need
more than a 30% DEET concentration.
- Apply repellent mainly to clothing and shoes.
- To prevent contact with the mouth or eyes, don't put
any repellent on the hands.
- Don't put any repellent on areas that are sunburned
or have rashes because the DEET is more easily
absorbed in these areas.
- Warn older children who apply their own repellent
that a total of three or four drops can protect the
- Because one application of repellent lasts 4 to
8 hours, apply it no more than twice a day.
- If repellent is put on the skin, wash it off after
your child comes indoors.
CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:
- A bite looks infected (red streaks, increased
CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:
- Itching or pain is severe after treatment.
- You have other questions or concerns.