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Ask a Dermatologist Free: Insect Bites

Dear Doctor

Good day. I have these bumps that keep recurring. First occured on both collar bones months ago, one bump still there, the rest have gone.

Now I have two that have popped up lower on my chest. I have been to a GP, but no answer.

Antibiotics, bactroban topical, antihistamine creams, and cold sore patchs (herpatch) don’t have any effect. They are itchy as h***, feel like needles sticking into me when I touch them.

My biggest concerns are that it is contagious (I’m a tattoo artists), and that it could be herpes simplex on a mission, I’ve had fever blisters try to migrate up my face before.

Any help you could give me would be greatly appreciated. Kindest regards.

ask a dermatologist free

Dear Patient

These red, itchy bumps seem more like insect bites than herpes.


Insects which bite or sting humans include:

1. Fleas

Fleas are usually found on pets like dogs (Ctenocephalides felis ) and cats (Ctenocephalides canis).

Symptoms of flea bites include red, itchy swellings which are grouped in clusters. Blisters (fluid filled swellings) can also develop.


2. Bed bugs

The common bed bug (Cimex lectularius) feeds on human blood and is rarely seen since it usually hides in cracks and crevices in bed frames.

Symptoms of bed bug bites include red, itchy swellings which are usually not painful. They also tend to have a linear pattern with 3 to 5 bites.

Signs of bed bug infestation and bites include red spots of blood on the bed sheets, mattresses or upholstered furniture like headboards which may be the result of the bug being smashed as it was feeding or bleeding from the bite site. Black spots may also be seen on the bedding which represent bed bug feces. Their egg cases and shed exoskeletons (exuviae) may also be seen. Bed bugs also produce a sweet, musty odor which can also be smelt on the bedding.


3. Mosquitos

There are numerous mosquito species and those which cause malaria include Anopheles quadrimaculatus, Anopheles gambiae and Anopheles freeborni.

Symptoms of mosquito bites include a stinging pain as it pierces the skin which is followed by the development of an itchy, red papules (small lumps). These bites can be on the arms, legs or other parts of the body. Fever, headaches and other systemic symptoms can also develop if the mosquito transmits diseases like malaria.


4. Midges

Midges are small flying insects from the Chironomidae family.

Symptoms of midge bites include itchy papules on the skin. Midges usually bite persons who spend the early morning and evening hours outside like fishermen and campers.


5. Bees

Bees are flying insects and the scientific name for the honey bee is Apis mellifera.

Symptoms of bee bites include a sharp pain that occurs as the bee stings. This is associated with a red swelling at the sting area which may gradually enlarge over the next one or two days. In some cases a serious allergic reaction known as anaphylaxis can develop which is associated with difficulty breathing (dyspnea), wheezing, difficulty swallowing (dysphagia) and angioedema (swelling of the tongue and eyelids).


6. Wasps

Wasps are flying insects from the Vespidae family which includes hornets and yellow jackets.

Symptoms of wasp bites are similar to those of bees and include a sharp localized pain that occurs at the time of the sting. This is usually followed by the development of an itchy, red swelling. Anaphylaxis can also develop.


Bed Bug Treatment

From your history and from the linear pattern seen in the picture, I think you may be dealing with bed bug bites. Treatment of bed bug bites includes:

1. Washing the area with soap and water.

2. Applying a cold compress to reduce itching and swelling

3. Applying a mild steroid cream like 1% Hydrocortisone to reduce the itch.

4. Not scratching the bites since this can lead to infections. Consider taking an over-the-counter oral antihistamine if the itching is severe.

5. If you have symptoms of a severe allergic reaction like those of anaphylaxis, you need to consult your doctor to receive injections of antihistamines, adrenaline and corticosteroids.

6. Call a pest exterminator to assess your home and get rid of the bed bugs if you are getting bitten while sleeping at home.

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