Ouch! Your Guide to Bites and Stings.
- Serena Larsen, MD
- 10 hours ago
- 5 min read
The warm weather brings lots of great activities to the pacific northwest. The proximity of the water and forests bring along another element to the long summer days: bugs! While bugs are an important part of our ecosystem, their bites and stings can be a nuisance or sometimes even dangerous to our health. We will talk about how to prevent bites/stings, what to watch out for, and what to pack in your camping pack for the ultimate pest-free summer.
Types of bites/stings
There are various bugs and critters we could talk about today for bug 101. However, we will be focusing on some of the most common insects that bother campers, hikers, and those enjoying the great outdoors in the PNW. While you may be traveling this summer to other climates (scorpions in Arizona?!), we will mainly be covering the bites/stings that pester us here in the Evergreen State.
Our main bugs: mosquitos (#1), bees, fleas, chiggers (harvest mites), and non-poisonous spiders, to name a few. People are often worried about ticks: while they can be present in our state, Washington ticks rarely carry any diseases. It is still important to know how to prevent a tick bite, since stress googling “how to remove a tick” is rarely on anyone’s summer bucket list. In fact, if you would like to know how to do this, check out this article: www.healthykids.org/how-to-remove-a-tick
Bite Prevention
ENVIRONMENT
Time of Day
Bugs are most active during sunrise/sunset, avoiding these times (or gearing up with the proper clothes so you can still enjoy that beautiful sunset) can be helpful!
No water zone
Dumping out unused buckets/tubs of water helps prevent mosquito environments + nesting.
Fans
Using fans outside, especially in eating areas, can help prevent mosquitos.
WHAT YOU PUT ON
Clothes
One of the best ways to prevent bites/stings is proper clothing. Long pants/socks and long sleeves can help in preventing pesky bug bites.
Soaps/shampoos (mosquitos)
Avoiding perfumed soaps/shampoos can help prevent mosquitos
SPRAYS/REPELLENTS
DEET: Bug spray with DEET is very effective in repelling bugs and can be important if you are going to be going to known tick areas.
Important things to know about DEET:
-Use 10% DEET for kids under 2 yrs old sparingly if needed. After 2yrs, 30% DEET is ok
-10% DEET: protection for 2 hours. 30% DEET: protection for 6 hours.
-Do not spray near eyes/mouths, on hands (as kids will often stick their hands in their mouths), or on skin with rashes or sunburns (can be more absorbable in these areas).
-Some DEET repellents are also SPF, SPF needs to be applied more often than DEET. So if you get a DEET + SPF, it is important to carry a second regular DEET-free SPF for sunscreen reapplication.
Permethrin: This is a product used on clothing or outdoor items to help repel bugs.
Oil of Lemon Eucalyptus:
-There are products with this ingredient registered with the EPA (Environmental Protection Agency).
-Do not use in kids younger than 3 (due to risk of “allergic skin reactions” per the CDC).
-Oil concentration of 8-10%: protection for 2 hours. Oil concentration of 30-40%: protection for 6 hours.
-Pure concentration of oil has not been tested for safety.
Natural repellents:
-Ingredients of citronella, geranium, peppermint, soybean oil. These have not been approved for effectiveness by the EPA, but are deemed to be safe. This may be a good option if you are wanting to prevent bites and are not concerned about more serious bug borne illnesses (for ex: ticks in a Lyme disease region).
Tip: it is important to test products (especially these ones) on a small part of your kids skin first before applying it in large areas as sometimes these ingredients can be irritating for some people.
Not sure which repellent to pick? Check out this site from the EPA! You can search what you are looking for in a bug repellent and it gives you options to pick from. www.epa/find-repellent-right-you
Bite Treatment
Home Treatment
Treatment of bits + stings are all about symptom control. You want to try and control itch as much as possible, while avoiding infection. One of the most important (and hardest!) things to do is to try and prevent itching as this can lead to worsening swelling and delayed healing. But we do the best we can!
Itch control:
-Hydrocortisone 1% cream: you can apply this 2-3x a day to help with inflammation and itch
-Antihistamine: Loratidine/Cetirizine. Dosing: 10mg for ages 6+ yrs. 2.5-5mg for ages 2-6 yrs. Cetirizine is approved for kids under age 2yrs: 2.5 mg
-Physical barriers: for those who have a hard time not itching, a physical barrier can be helpful, either to help block or as a helpful reminder. For example: a bandaid or a tegaderm clear bandage.
-Heat: There is actually some evidence that heat can help with itch control when applied soon after the feeling of itching starts!
-Pressure: You can also apply firm steady pressure for about 10 seconds as this can help for some.
Pain control:
-Baking soda: A Seattle Children’s article recommends soaking a cotton ball in baking soda solution to help with painful bites. You can rub it on the bite for 15-20 min once.
-Ice: You can also use an ice cube in a wet washcloth for 20 min, this will help with pain + swelling.
Infection prevention:
-Bacitracin: A topical antibiotic can help prevent infection, specifically if there is any open skin from scratching or the bite itself. A lot of people use various types of other topical antibiotics that include more ingredients (ex: triple antibiotic), however a triple antibiotic can sometimes cause skin irritation.
When to seek care
-INFECTION: If you think there is an infection with symptoms of spreading redness/pain, especially with streaking, or yellow crusting please seek care for evaluation.
-ANAPHYLAXIS: This is rare, however it is important to know the signs to look out for. If you see signs of an allergic/anaphylactic reaction, such as hives, facial swelling, mouth/tongue swelling, breathing difficulty, vomiting, light headedness, then seek IMMEDIATE care for this (ER/911). If your child has hives by itself without other symptoms, then you should treat with an antihistamine and seek care/give us a call, but you do not need to call 911. Allergic reaction symptoms will typically start within 2 hours, with most starting within 20 min.
To note: some people can have a larger local skin reaction to bites. The area of swelling/redness can be more exaggerated and end up being a few inches. This is due to a localized reaction (can occur with mosquito bites) and is different from anaphylaxis/an infection. If you are not sure, give us a call!
What to pack in your camping bag!
-Antihistamine: Loratadine or Cetirizine. Diphenhydramine (aka Benadryl) used to be a common allergy medicine in travel packs, however now we are recommending a non-drowsy allergy medicine with less potential side effects.
-Tylenol/Ibuprofen
-Hydrocortisone 1% lotion: available over the counter!
-Bacitracin
-Non scented soaps/wipes
-“Anti-bug” clothing: long sleeves/pants/socks
-Your choice of bug repellent
Wrap up
Although bugs are important for our planet, we all have experienced the negative impacts of their bites and stings. We hope this guide is a useful tool that helps you feel more equipped on how to avoid bites, how to treat them at home (or on the trail), and provides reassurance/guidance on when to give us a call. We hope you have fun exploring the great outdoors this summer!
Sources Cited:
CDC. Mosquitos, Ticks, and Other Anthropods. Available at: https://www.cdc.gov/yellow-book/hcp/environmental-hazards-risks/mosquitoes-ticks-and-other-arthropods.html. Accessed May 2026.
HealthyChildren.org. How To Choose An Insect Repellent For Your Child. Available at: https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Insect-Repellents.aspx. Accessed May 2026.
Metz M, Elberskirch M, Reuter C, Liedtke L, Maurer M. Efficacy of Concentrated Heat for Treatment of Insect Bites: A Real-world Study. Acta Derm Venereol. 2023 Jun 26;103:adv11592. doi: 10.2340/actadv.v103.11592. PMID: 37358395; PMCID: PMC10309056. Heat control with itch
MotherToBaby | Fact Sheets [Internet]. Brentwood (TN): Organization of Teratology Information Specialists (OTIS); 1994-. Insect Repellents. 2024 Aug. Available from: https://www.ncbi.nlm.nih.gov/books/NBK582767/
Seattle Children’s Hospital. Mosquito Bite. Available at: https://www.seattlechildrens.org/conditions/a-z/mosquito-bite/. Accessed May 2026.
Seattle Children’s Hospital. Insect Bite. Available at: https://www.seattlechildrens.org/conditions/a-z/insect-bite/. Accessed May 2026.
