NHS Pharmacy First Service in England, receive advice & treatment for seven common health conditions32

Insect bites & stings are common & usually nothing to worry about. Read our top tips for treating them at home & find out when to seek medical help


The occasional bite or sting from an insect is something most of us have experienced, especially during warmer weather. It's normal to experience some itching or pain when this happens, but occasionally a bite or sting can lead to an allergic reaction or an infection. Read on for some pointers on how to recognise this, and how to treat bites and stings generally.


What are the symptoms of an insect bite & sting?


Bites and stings usually leave a red lump on the skin, which may be painful, and are often very itchy. Some people might have a mild allergic reaction, which causes a larger area around the bite or sting to become swollen, red and painful. This should pass within a week, but if it's still causing discomfort after that, it's a good idea to see your GP.


How should I treat bites & stings?


Insect bites and stings can be uncomfortable or irritating, but are usually nothing to worry about, and can nearly always be treated successfully at home. To treat a bite or sting:


• Wash the affected area with soap and water

• Use a bank card or your fingernails to remove a bee sting stuck in the skin (avoid pinching as this can worsen the sting), or use tweezers to remove ticks. (Specially designed tick removers are available, and may be a worthwhile investment if you live or work in the countryside – your pharmacist can advise on this)

• If there's swelling, apply a cold compress. Use an ice pack, or flannel soaked in cold water, for at least 10 minutes

• Raise the affected area above the level of your heart. This will help reduce swelling

• For pain, take a painkiller. Not all painkillers are suitable for everyone, so ask your pharmacist for advice if you're unsure and make sure you always read the accompanying patient information leaflet

• To help relieve itching, you can consider over the counter treatments, such as antihistamine tablets, hydrocortisone cream or crotamiton cream. Speak to your pharmacist for advice

• To reduce the risk of infection, avoid scratching and don't burst any blisters that form. If a young child has been bitten or stung, trim and clean their fingernails. For babies, you can buy anti-scratch cotton mittens


Pain, swelling and itchiness should last no longer than a few days. If symptoms don't improve, or get worse, speak to your pharmacist or GP. 


When should I worry about a bite or sting?


It's rare for an insect bite or sting to cause serious problems, but in some people they can cause a severe allergic reaction resulting in breathing difficulties, dizziness, and swelling of the face and mouth. This is a medical emergency. Other symptoms might include nausea, vomiting and a racing heart. If you've been bitten or stung, and are experiencing any of these symptoms (or if someone else has become unresponsive after a bite or sting), call 999 for an ambulance immediately. 


Bites and stings can also become infected, which, if left untreated, can lead to further problems. Early signs of infection include:


• Tenderness

• Swelling

• Fluid or pus oozing from the affected area

• Red streaks (tracks) radiating out from the bite or sting


If you have any of these symptoms, visit your GP as you may need antibiotics.


Note that if bitten by a horsefly, you're more susceptible to infection than with other bites. This is because horsefly bites cut open your skin, rather than piercing it, meaning bites are larger and slower to heal. To help prevent bites, ensure your skin stays covered if you spend time around horses.


Tick bites meanwhile, can on rare occasions cause an infection called Lyme disease. Early symptoms include flu-like symptoms such as a headache, muscle and joint pain, tiredness, and a fever. Additionally, a large ring of redness may appear around the original bite, producing a target-like appearance. If you have one or more of these symptoms, visit your GP as soon as possible. 


Which insects can bite or sting?

Wasps, bees & hornets


Stings can cause a sharp pain. Bee stings are similar to wasp and hornet stings, but the sting is barbed, so it often gets left in the skin.


Red ants


These will bite and sting when threatened, often in numbers.


Mosquitoes


In the UK, mosquito bites rarely cause anything more than itchiness, but in some overseas regions, they can spread malaria. Ensure you take precautions to help prevent malaria if you're travelling to a country where the disease can be caught. This may include taking malaria prevention tablets. Speak to your GP or pharmacist if you’re planning to visit an area with a risk of malaria well in advance of your scheduled travel.


Ticks


Tick bites usually aren't painful, but sometimes they can produce an allergic reaction. On rare occasions, they can spread an infection called Lyme disease.


Horseflies


Bites can be painful and may become infected easily. Occasionally, a horsefly bite may cause dizziness and breathlessness.


Midges & gnats


These cause itchy, sometimes painful bites, which may be accompanied by swelling.


Bedbugs


Bites are usually found in lines on the skin, and may be itchy, but aren't usually painful.


Mites


Bites cause itchy red lumps, and sometimes blisters.


Fleas


These can often be found on household pets. Flea bites are small, red and itchy, and usually occur in clusters.


Spiders


Most native UK spiders are harmless, but a few (such as the false widow) can bite. Bites may cause pain, redness and swelling.


Ladybirds


Many people don't realise it, but all ladybirds can bite. A bite from a ladybird may be painful, but usually won't cause any further problems.


Flower bugs


These feed on mites, and their bites can be painful, very itchy and slow to heal.


What if I'm bitten or stung by a mystery insect?


Most biting and stinging insects in the UK are known to us, but some are less easily identified. Stable flies, for example, closely resemble house flies, but are blood-sucking and have a painful bite. Sand flies, meanwhile, look like gnats but live around beaches, rivers and marshes, and their bites are far itchier and slower to heal. 


It's a good idea to take a picture of the insect that has stung or bitten you. If this isn't possible, make a mental note of where and when you were bitten. This can help medical professionals identify what insect bit or stung you and therefore give you the most appropriate treatment, should you need it.


Next steps


• Keep the affected area clean and use a cold compress to help reduce any swelling

• Speak to your pharmacist for advice and treatment with over-the-counter medicines, to help with pain, swelling and itching

• Speak to your GP if you’re worried, or if your symptoms don’t improve or get worse

• If you experience breathlessness, swelling of the mouth, dizziness, or a racing heart, call 999 for an ambulance immediately


How can a pharmacist help


Under the new NHS Pharmacy First Service*, our pharmacists are now equipped to provide even more support for those suffering with infected insect bites aged one year or over living in England. However, this service excludes pregnant individuals under 16.


No appointment is needed, and we can offer advice and treatment, including prescription medicines where appropriate. It's a convenient option to address minor health concerns without the need for a GP visit.


If you have an insect bite and you notice the following:


• Redness of the skin

• Pain or tenderness

• Swelling with skin feeling hot to the touch


It may be infected, and our pharmacists can be your first port of call.


If our pharmacist determines that your symptoms require further attention, they may refer you to another healthcare professional.


It's crucial to seek immediate medical attention at A&E if you:


• Have a severely weakened immune system, and have signs/symptoms of infection

• Have signs of anaphylaxis

• Have stings where there is risk of airway obstruction (e.g. in the mouth or throat) or concerns of orbital cellulitis from bite or sting around the eyes


Your health is important, and our pharmacists are here to provide personalised advice and care for your infected bite or sting symptoms. Visit your local Boots pharmacy today under the Pharmacy First scheme for assistance.


Please note, during busier periods, a pharmacist may not be available and waiting times can vary.


*Supply of treatment is subject to a suitability assessment. In most stores in England only. Subject to availability and store opening hours. Charges may apply.

32Supply of treatment is subject to a suitability assessment. In most stores in England only. Subject to availability and store opening hours. Charges may apply.