“Most bug bites and stings can be safely treated at home with topical medication, such as hydrocortisone cream or ointment, or an oral antihistamine to reduce the itch,” said board-certified dermatologist Margaret E. Parsons, MD, FAAD, associate clinical professor of dermatology, University of California, Davis. “Sometimes, however, a bug bite or sting could turn into something serious, particularly if you have been bitten or stung by many insects at the same time.”

Black-legged tick
Ixodes scapularis, a Black-legged tick/CDC

Dr. Parsons advises going to the emergency room immediately if you experience any of the following symptoms after a bug bite or sting:

  • Difficulty breathing
  • The sensation that your throat is closing
  • Swollen lips, tongue or face
  • Chest pain
  • A racing heartbeat that lasts more than a few minutes
  • Dizziness
  • Vomiting
  • A headache
  • A red, donut-shaped or target-shaped rash that develops after a tick bite: This could be a sign of Lyme disease, which should be treated with antibiotics.
  • A fever with a red or black, spotty rash that spreads: This could be a sign of Rocky Mountain spotted fever, a bacterial infection carried by ticks, which should be treated immediately.

“Although most bug bites and stings do not turn into a severe or even fatal illness like Rocky Mountain spotted fever, it’s important to pay attention to your symptoms,” said Dr. Parsons. “If you feel tired all the time, you have a headache, fever or body aches, or you develop a rash after a bug bite, see a board-certified dermatologist immediately.”

These tips are demonstrated in “Bug Bites and Stings: When to See a Dermatologist,” a video posted to the Academy website and the Academy’s YouTube channel.