Bites and Stings
Many insects, animals, and fish can bite or sting. Most people know about it when they get bitten, although occasionally the first obvious sign is a swollen, localised area of skin, especially if the person has been bitten by a small insect while asleep.
Bites and stings can be either venomous or non-venomous.
Bees, hornets, jelly fish, and the katipo and red-back spider are venomous.
Fleas, lice, mosquitoes, scabies, and ticks are non-venomous.
Venomous stingers
In general, venomous stingers or biters inject a toxic and often painful venom into their victim as a defence mechanism to ward off attack. This usually causes a stinging sensation or pain in the area which becomes red and swollen. Sometimes it may itch as well.
Non-venomous biters
Non-venomous biters pierce the skin and feed on their victim's blood, resulting in a small, raised red spot at the site of the bite and usually intense itching. Infection of this wound commonly occurs due to scratching. Outside of New Zealand, many non-venomous biting insects carry diseases (for example, malaria or dengue-fever carrying mosquitoes – see also travel health).
Severe allergic reaction (anaphylaxis)
In most people, a bite or sting causes a mild reaction, however, a more serious allergic reaction known as anaphylaxis can occur in people who are sensitive to a particular venom (see also Allergies). These results in facial swelling, difficulty breathing and an itchy rash over most of the body (see also urticaria). You should ring an ambulance immediately if this happens to you or somebody in your care.
Bites caused by animals with sharp teeth have the potential to become infected or bleed excessively. Immediate first aid may be required, and you should always seek further medical advice, even if the wound is not particularly bad.
Symptoms needing urgent attention
Seek urgent medical attention if you have any of the following symptoms after a bite or sting:
You feel unwell and are dizzy or vomiting
You have significant swelling, especially in your face, eyes, lips, tongue or neck
If you have a fever, wheezing, tight chest, difficulty breathing or swallowing
If you have had severe reactions before.
See Your Pharmacist or Medical Professional
If you have a weakened immune system, serious medical condition, or if the bite is very severe and/or bleeding a lot, always talk to a pharmacist. Also talk to a pharmacist if:
The redness or swelling around the site of the bite or sting spreads out a long way
You have had a previous bad reaction to a bite or sting
You are stung by a spiny marine creature or have an open wound
The bite looks infected, with pain, blisters, pus or crusting
You are pregnant or breastfeeding – some medicines may not be suitable
The person with the bite or sting is a young child
You have allergies to any medicines.
Treatment Tips
Spider bites
New Zealand has many species of spider but only the red-back and katipo are considered poisonous
Numbers of red-back spiders in NZ are increasing, but an anti-venom effective for both red-back and katipo spiders is available throughout NZ
No deaths from katipo spiders have been reported since the 19th century
Contact the Poisons Centre (0800 POISON – 0800 764 766) or your local doctor immediately if you are bitten by a red-back or katipo spider
Ring for an ambulance if the person is having difficulty breathing or significant swelling especially in the face, eyes, lips, tongue or neck occurs (see general information above)
Although the white-tail spider has a reputation for biting, its venom rarely causes harm, although some people do develop an allergic reaction to the venom which can cause serious side effects. For this reason, you should contact your doctor if you get bitten by a white-tail spider and the wound looks bad, or if a young, elderly, or unwell person gets bitten.
Mild venomous insect stings
If you are bitten by a bee or wasp, do not try and squeeze the stinger between your fingers to remove, as it could release more venom. Instead, gently remove it by pushing it out from the sides or scraping it away with something blunt – the side of your fingernail, credit card or blunt knife can help
Clean the area with a mild antiseptic and apply ice or a cold pack
Apply a topical corticosteroid cream several times a day until the area feels better. Take oral antihistamines if you have had multiple stings or if the site of the sting is really itchy
If you have a severe allergy, carry an Anapen or Epipen [a PHARMACIST ONLY product] and wear a medical alert bracelet (such as Medic-Alert or Mediband)– ask your doctor for more information.
Insect bites
Treat with a topical corticosteroid, antihistamine, or local anaesthetic cream to prevent itching
Contact your doctor if you received your bites while overseas
If you are travelling to an overseas country that has biting insects that carry diseases, always use insect repellents and take other measures to avoid getting bitten.
Advice for avoiding mosquito bites
Try not to go outside at dusk and dawn when mosquitoes are most active
Wear densely woven, light-coloured clothing and spray insect repellent on exposed parts of the body and clothing if going outside
Avoid wearing perfume or other strong-smelling substances
Use a bed net while sleeping
If going overseas to a country where mosquito-borne illnesses (e.g., malaria, dengue fever) are common, higher-strength insect repellents may be necessary, as well as malaria tablets. Ask your pharmacist or doctor for more information (see also our Travel health page).
Jelly fish
Wash jellyfish stings with sea water to flush off tentacles then apply an ice pack to the area for 10-20 minutes to cool the skin, and relieve pain and swelling
Do NOT apply vinegar. This is only effective against Australian box jellyfish stings and may make other jelly fish stings more painful
Always wrap ice in a towel to protect skin – do not use for longer than 5 minutes on the hands or feet.
Treatment Options
Talk to a health professional before taking pain relievers, unless you have been stung by a common insect that is not poisonous, such as a bee, or you do not have allergies
People with skin reactions to stings and bites should keep oral antihistamines with them to take as soon as they are stung
Some products should not be applied to open wounds or extensive areas of skin – see product directions
Caution is needed with some products during pregnancy, check with your pharmacist.
Always discuss treatment options with your pharmacist to ensure the best outcome.
Oral antihistamines
Skin reactions occur when the body releases histamine, leading to swelling and itching
Antihistamines block the action of histamine and relieve itching – there are two main types:
– Older sedating antihistamines that cause drowsiness
– Newer non-sedating antihistamines that do not typically cause drowsiness
Although antihistamines can reduce your reaction, the bite mark may last longer
Oral antihistamines treat multiple bites and stings more effectively than having to apply topical preparations all over the body.
Newer non-sedating antihistamines
[PHARMACY ONLY]
e.g., Allerid-C, Aerius, Claratyne, Lorfast, Razene,Telfast, Xergic, Zyrtec
Non-sedating antihistamines may rarely cause drowsiness – do not drive or operate machinery or drink alcohol if you are affected.
Older sedating antihistamines
[PHARMACIST ONLY]
e.g., Allersoothe, Phenergan, Polaramine
These products may help if the itch is severe and interferes with your sleep
These products can cause drowsiness, sometimes the next day, so it is important you do not drive or operate machinery, and avoid alcohol
These products are not recommended for the treatment of allergies in infants under two years old – check product directions for other age groups or conditions
Sedating antihistamines are not suitable for everyone – check with your pharmacist
If you have other medical conditions, such as glaucoma, epilepsy or prostate problems, or you take antidepressants, check with your pharmacist before taking.
Antihistamine creams
[PHARMACY ONLY]
e.g., Anthisan cream
Anthisan can be applied externally on insect bites or nettle rash
Do not apply to open wounds or use for other skin conditions
Only use short-term, for up to three days
Stop using this product if you experience a skin reaction after applying.
Anti-itch and healing/soothing preparations
[GENERAL SALE]
e.g., Bepanthen, Calamine Lotion, Click That Itch, Eurax, Pinetarsol, Stingose
These products soothe skin irritations and promote healing
Click That Itch should be used as soon as possible after being bitten or stung as it uses a mild electric current to relieve the pain
Tar products help relieve skin itching but can discolour clothes
Calamine lotion has a soothing, cooling effect but it may dry skin, so avoid if you have eczema
Stingose lessens the reaction to stings.
Topical steroids
[PHARMACY ONLY]
e.g., DermAid 0.5%, Skincalm 0.5%
[PHARMACIST ONLY]
e.g., DermAid 1%, Skincalm 1%
Hydrocortisone products help relieve itch and redness of bites and stings
Apply thinly to skin and wash hands afterwards & avoid contact with eyes.
Use short-term, up to one week, and seek medical advice if reaction does not improve or gets worse.
Local anaesthetics
[PHARMACY ONLY]
e.g., Medicreme Antiseptic cream, Soov cream, Soov Bite (with cetrimide)
Local anaesthetic products numb pain and may relieve the initial sharp pain of stings
Many also contain an antiseptic to prevent infection
They are not suitable if you have eczema.
Insect repellents and bands
[GENERAL SALE]
e.g., Aeroguard range, Bushman's range, EG Waterproof anti-mosquito bracelet, Mosquito-band Anti-insect band, Repel New Era, Skin Technology
Chemical insect repellents contain either DEET (N, N-Diethyl-meta-toluamide) or picardin
Plant-based insect repellents contain substances such as citronella, eucalyptus, soybean, but have not been shown to be as effective as DEET or picardin
Tropical strength insect repellents may be necessary in high-risk areas where mosquito-borne illnesses (e.g., malaria, dengue fever) are common
Avoid heavy use of chemical repellents, such as DEET (N, N-Diethyl-meta-toluamide), in children and during pregnancy
DEET may melt plastic and dissolve paint so always wash hands after use
Anti-insect bands contain natural oils and continuous band-wearing helps protect against biting insects.
More Information
Information on first aid for specific stings or bites is available at www.toxinz.com or www.poison.co.nz. However, this should not replace medical advice.
For more information on extreme allergic reaction see anaphylaxis on www.everybody.co.nz
For information on poisons prevention and education see www.poison.co.nz
Availability of medicines
GENERAL SALE available through pharmacies and possibly other retail outlets.
PHARMACY ONLY available for sale through pharmacies only.
PHARMACIST ONLY may only be sold by a pharmacist.
Consumer Medicine Information on some medicines is available at the government website www.medsafe.govt.nz
