Ouch! Insect bites, Stings and Other Summer Itches

ADC allergists have advice on common summer skin problems.

bee crawling on flower center

It’s summertime and the living is easy. Well, easy except for the bug bites, insect stings, poison ivy and heat rash!

Although the major allergy seasons are over, there are other allergies out there that you may not think about. Warmer weather, family vacations and the chance to enjoy the great outdoors also mean exposure to hot, humid weather, insects, and poisonous plants. But despite the possibility of discomfort from bites and rashes, Texans still enjoy activities such as hiking, camping, boating, biking, and swimming.

“Skin conditions common in the summer can be bothersome, uncomfortable, and even painful,” explains John Villacis, M.D., an allergist with The Austin Diagnostic Clinic. “Since people want to spend time outdoors, it’s helpful to have information about some of the skin problems or other allergies you might encounter—particularly those that can be more serious.”

Some skin irritations such as heat rash clear up by themselves. Others, such as an allergic reaction to an insect sting, require medical treatment. Here’s a look at these seasonal skin discomforts, their causes, and some advice on when you might need to see your doctor.

Fire Ants, Wasps and Bees

fire ants crawling on moundFor most people, insects like fire ants, bees, yellow jackets, hornets, and wasps are just a summer nuisance. A sting may be painful, but over-the-counter remedies can treat the redness, stinging, and itching. But for the estimated 6.5 million adults in the United States who are allergic to insect venom, one sting can be life threatening.

“A normal reaction to an insect sting typically means redness, swelling, and itching at the site of the sting,” explains Dr. Villacis. “A person with a severe allergy may develop symptoms that can cause death in just minutes. This reaction requires immediate emergency medical treatment.”

Serious, life-threatening symptoms, referred to collectively as anaphylaxis or a systemic allergic reaction, can affect the whole body. In case of an insect sting, look for signs such as difficulty breathing, swelling of the tongue or throat, tightness in the chest, weakness, nausea, itching, dizziness, and severe hives.

“If a person is experiencing any of these symptoms, the fastest way to treat them is with an injection of epinephrine, a naturally occurring hormone that increases heart rate and opens the airways to improve breathing,” says Dr. Villacis. “Most people who know they have a severe allergy carry a small prescription device (commonly known as an EpiPen™) that can auto-inject epinephrine into the thigh. If one isn’t available, call 911 or get to a hospital without delay.”

People with known insect allergies should carry an EpiPen™ as well as antihistamine tablets that can help reduce the effects of a sting. They should also wear an identification bracelet that states they’re allergic to stinging insects. “People who are allergic to stings need to remember to always use epinephrine first when they are stung,” points out  Scott Oberhoff, M.D., an allergist with The Austin Diagnostic Clinic, “Antihistamines help, but it may take 30 to 60 minutes for it to start working. Epinephrine is immediate and the first-line treatment.”

If you’ve had a serious reaction in the past, you should talk to your allergist about allergy testing and possible desensitization.. If you are diagnosed with a severe insect allergy, your Board-Certified Allergist may recommend allergy shots—also called immunotherapy treatment—to decrease sensitivity to the venom. A patient receives a series of shots that, over time, contain increasing amounts of venom.

“Larger and larger doses are given until the patient builds up enough immunity to tolerate a dose several times larger than a single insect sting,” explains Dr. Villacis. “The vaccination program prevents future life-threatening reactions in about 98 percent of patients. It’s not an exaggeration to say that this type of immunotherapy can be truly life-saving.”

Chigger Bites

While an allergic reaction to an insect sting can be a life-threatening encounter, other summertime bug bites are merely bothersome. Chigger bites fall into this category.

Chiggers are the larvae of tiny mites found in tall grass and weeds. Chiggers attach to your skin with their claws and feed on juices inside your skin cells. After a few days, the chiggers fall off, leaving behind an itchy, red welt where they attached. Even with treatment, redness and intense itching can last several weeks for each bite.

Dr. Villacis adds that old wives’ tales on how to treat chiggers range from coating the bite with clear nail polish as a means of suffocating the little mite to using rubbing alcohol or hot baths to drown it.

“In most cases, the chigger has already fallen off when the redness appears,” says Dr. Villacis. “So these treatments don’t help get rid of the chigger bite. But over-the-counter treatments may temporarily relieve itching.”

Because of the intense skin irritation and itching, chigger bites can develop into a secondary infection.

“If your skin appears infected or if bites appear to be spreading, see your doctor,” advises Dr. Villacis.

Poison Ivy and Poison Oak

close up of plant leaves

Hikers and campers often encounter poison ivy or poison oak, taking home with them an irritating reminder of their time outdoors. Contact with these poisonous plants usually causes red, swollen skin, blisters, and severe itching. The rash – a form of contact dermatitis – can erupt within hours of exposure or appear several days later. The reaction is caused by exposure to a resin–a colorless, oily substance contained in all parts of these plants. The resin transfers easily from clothing or pet hair to your skin.

“A poison ivy or oak rash usually resolves itself, but can take several weeks, without medical treatment. Non-sedating oral antihistamines and hydrocortisone cream can help ease the itching,” Dr. Oberhoff says. “If you have a severe reaction or if your eyes or face are involved, see your doctor for additional treatment, such as prescription cortisone cream, steroids, or antihistamines.” Treatment usually works best if it is started early.

Heat Rash

Another summertime itch-producer is heat rash. Heat rash can take two different forms. One type of heat rash appears as red clusters of small blister-like bumps that can produce a stinging sensation. The second type of heat rash appears as clear, fluid-filled bumps that produce no other signs or symptoms. Caused by active sweat glands, heat rash usually develops on the neck, upper chest and groin, under the breasts, and in the elbow creases.

These rashes aren’t serious. They often go away with proper self-care methods, such as keeping the affected areas cool and dry, avoiding tight, restrictive clothes, and not using heavy ointments or creams as the outside temperatures rise.

While the great outdoors carries its own risks of skin irritation or even life-threatening conditions, with a little preparation and knowledge, everyone can enjoy the next several months of Texas heat.

For more information or to make an appointment with an ADC allergist, call 512-901-4052.