The outside joys of summer come with a dark side – or, more accurately, a red and swollen side. The Centers for Disease Control and Prevention has noted that diseases from mosquito, tick, and flea bites are on the rise. So even if you’ve been getting bitten your whole life without much consequence, it’s time to take bug bites more seriously.

Peaceful Coexistence

Many insects and spiders bite, but only a few do so intentionally – they usually only bite to defend their territory, or because you’ve done something to disturb or alarm them. In many cases, staying out of a bug’s way can save a conflict that might leave you smarting.

In addition to avoiding obvious nests or hives – and hiring professionals if you must have one removed – there are other ways to lessen the likelihood of landing on a bug’s radar. Consider the following when you’ll be spending time outdoors:

– Apply insect repellent, especially those made with DEET, picaridin, PMD, or IR3535 insecticide;
– Keep food and drinks covered;
– Skip perfume and scented lotion;
– Use citronella candles;
– Wear neutral colors and hats and clothing that cover your skin.

Know Your Biters

Despite your best efforts, bug bites are almost guaranteed when you spend enough time outside. Most bites are relatively harmless, but some bites can cause disease or generate severe allergic reactions. In North Carolina, here are a few bugs to be wary of:

– Mosquitoes: All too familiar to most of us, mosquito bites leave a raised, itchy pink bump on the skin. Most of the time, these itchy welts are the worst of it, but mosquitos can also carry viruses such as Zika, West Nile, Chikungunya, and more. It’s worth noting when you get mosquito bites, and paying attention to any changes in your health or unusual symptoms if they arise after a bite.

– Ticks: Tick bites are more common than many of us realize, and they can result in everything from mild and fleeting symptoms to severe, sometimes long-term infections. Sometimes you’ll find the tick itself on your skin, but it’s easy to miss tiny ticks. Following any bug bite, see your doctor immediately if you experience any of these symptoms: significant rash or skin ulcer around a bite – bites from ticks carrying Lyme disease sometimes (but not always) generate a rash that looks like an expanding bullseye, while Rocky Mountain spotted fever also generates a rash, but its appearance varies greatly from person to person; fever and chills; headaches, muscle aches, and joint pain; or swelling of lymph glands near the bite, usually in the armpit or groin.

– Spiders: Spider bites usually only cause minor symptoms like red skin, swelling, and pain at the site. In North Carolina, few spiders are truly poisonous – the two best-known are the black widow spider and the brown recluse. The initial bite from a black widow spider is often so mild that it might go unnoticed. The wound may appear as a bluish-red spot, surrounded by a whitish area. Severe bites from a black widow spider can cause pain in the lymph nodes, nausea, muscle pain, abdominal pain, sweating, and tremors within the first hour after the bite, and require immediate treatment. The brown recluse is actually quite rare in our area – most often, other brown spiders are mistaken for this one.

– Bees, yellow jackets, wasps, and hornets: The stinging insects are perhaps the best known for their risk of generating severe allergic reactions, though not everyone will have an acute reaction. Stings cause a red skin bump with white around it, and mild swelling, pain, and redness at the site of the sting is normal. Signs of a severe allergic reaction come on quickly and require immediate medical treatment.

– Fire and carpenter ants: Ant bites generate a sharp pain and a burning sensation and usually leave behind red, sometimes itchy skin bumps. Fire ant bites sometimes become white, fluid-filled pustules or blisters a day or two after the sting. These last three to eight days and may cause scars. Fire ant bites can cause a severe allergic reaction in some people.

– Biting flies and gnats: Fly bites usually show up as small red bumps that are itchy. Bites from horse flies, deer flies, black flies, midges, and no-see-ums can be painful and cause bleeding, swelling, irritation, numbness, or soreness – but all should disappear, depending on the fly, in a few days. And gnats? Well, it turns out that “gnat” is more of a description than an actual insect. They might bite, they might not. Go figure.

– Chiggers: Chiggers are a form of mite that do not usually cause serious disease, but their bites can irritate the skin and cause intense itching. The bites usually go unnoticed until itchy, red marks or welts develop that may look like a skin rash. In response to a chigger bite, the skin around the bite hardens. The main risk from chigger bites – like most fly bites – is secondary infection caused by scratching.

– Fleas: Flea bites usually come in groups, often on the ankles and legs, but may also appear in your armpits, around your waist, and in the bends of your knees and elbows. They can cause hives, sores, or a rash of small, red bumps that may or may not bleed. A flea-bite rash turns white when you press on it and gets larger or spreads over time.

If you aren’t sure what bit you, keep an eye on the bite. If it doesn’t heal over the course of a week, or the symptoms are getting worse, check in with your doctor sooner than later.

How Bad Is It?

We’re all allergic to bug bites, at least a little bit – the itchy swelling spots are an allergic reaction to the venom that a creature leaves behind after it stings or bites you. After a bug bite, it is normal to experience a range of symptoms, including heat on or around the bite or sting; itching; mild swelling; numbness or tingling in the affected area; pain near the bite site; and redness or minor rash near the bite. These symptoms should not be severe and should go away within a week or so. If the wound appears to be getting worse or hasn’t healed after a couple of weeks, it’s time to make an appointment to get it checked out.

In addition to the symptoms specific to the viruses, bacteria, or toxin in the venom of some bugs, it’s also possible to have a severe allergic reaction requiring immediate, emergency medical treatment. Call 911 if any of the following develop following a bite or sting: confusion, difficulty breathing, fever, loss of consciousness, muscle spasms, nausea or vomiting, rapid heartbeat, swelling of the lips and throat, or tremors. If you feel ill or experience flu-like symptoms in the days following a bite, whether you know what bit you or not, see your doctor.

After the Sting

Almost all bites and stings can be treated at home, especially if your reaction is mild. Always wash the affected area and remove any remaining stingers or bug pieces. For painful bites, take an over-the-counter painkiller, such as acetaminophen or ibuprofen. Always follow the directions on the label and use the correct dose. For bites that itch, apply an ice pack or an over-the-counter anti-itch cream, or take an over-the-counter oral antihistamine. To reduce swelling, apply an ice pack to the bite.

What not to do? Don’t scratch that itch! While sometimes a seemingly impossible proclamation, the less you scratch the less likely you are to have scarring or to develop secondary infections. Try to resist and let your body heal, so that the bugs of summer will be a fading memory when fall rolls around.