Your doctor may refer you to an allergy clinic if:

• A sting or bite has caused a generalised allergic reaction.
• A sting or bite has caused a large local skin reaction with redness and swelling over 10cms.

An allergy clinic will be able to do tests to confirm which type of venom or insect you are allergic to. There are then two possible options which may be considered.

To give you a supply of emergency medication to use when necessary

Some people are given a pre-loaded syringe of adrenaline together with a written treatment plan to cope with any future reactions. You (and relatives) can be taught how and when to use the treatments provided.

Desensitisation

This is where you are given injections of tiny amounts of venom from the type of insect that causes your allergic reaction. Repeated doses of venom over several weeks can 'desensitise' your immune system, and so you will not react severely next time you are stung. There is some risk involved in this treatment of causing a severe reaction, so it is not undertaken lightly. It is only available in certain specialised centres.

Preventing insect bites and stings

When out and about

Bites and stings most commonly occur when outside, particularly in the countryside. Ways to avoid bites and stings include:

• Wear long sleeved clothing and long trousers in places where insects are common.
• Avoid brightly coloured clothes, cosmetics, perfumes or hair sprays, which attract insects.
• Rub an insect repellent onto exposed areas of skin.
• Be alert when you cook or eat outdoors as food attracts insects, especially wasps.
• Some people wear a complete head covering with a plastic viewer when out where midges are common. For example, when camping next to lakes and rivers. Many camping shops sell them.

There is no evidence that eating garlic, vitamin B1 or other foods will repel insects.

Infestations

Various types of fleas, mites, and bedbugs can infest (live on) pets, furniture, bedding, etc. These can cause recurring bites. You may realise that if you develop itchy spots or weals they are due to insect bites. However, some people do not realise that their 'skin rash' is caused by insect bites. They think they have some other skin disease. It may come as a surprise to find that their itchy spots are due to fleas living on their favourite pet!

If you have recurring insect bites, you should try to identify the source of the infestation and deal with it. For example, have pets checked for fleas. Your pet and/or your soft furnishings may need treatment with insecticide. See a vet for advice if you suspect that your pet is infested with fleas.

References

• Insect Bites and Stings Clinical Knowledge Summary SCHIN 2007

© EMIS and PIP 2007 Updated: February 2007 PRODIGY Validated

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