A Ped’s Perspective: Bug Bite or Cellulitis?

Jul 3

A common summertime office visit is concern for bug bite vs cellulitis (infection). Bug bites often can appear as large, red, raised lesions so it is understandable it raises concern for infection.

HOW TO KNOW IF ITS A BUG BITE:

We often do not see our kiddos get bit by the bug, and they cannot always tell you… so how can you tell if it is a bug bite? Look in the center of the lesion for a “central punctuate” or a tiny indented area in the lesion. This is usually evidence of it being a bug bite.

Kiddos skin is often more sensitive to bug bites, and some respond more severely to bug bites than others. Lesions can get pretty large and red, so it is understandable why parents worry for infection.

LETS TALK ABOUT INFECTION

Any opening in the skin has the risk for a secondary skin infection or cellulitis, bug bites are no exception. There is a higher risk for a secondary skin infection if your kiddo tends to pick at or itch lesions because germs harbor under finger nails.

signs of infection:

Redness
Swelling
Tenderness to touch (sometimes hard to tell with kiddos who say ouch to everything!)
Streaking: a red line that travels from the lesion
Fever > 100.4 without accompanying symptoms or reasons for the fever.

Bug bites can often feel firm and sometimes warm to the touch, but is not necessarily a sign of infection. KEY POINT: a bug bite will start to resolve after 24-48 hours, but an infection will continue to worsen!

PREVENTION:

Bug sprays are very important to prevent bug bites from happening, especially when spending time outside in the evenings. There is a time a place to use bug sprays with DEET to prevent communicable disease, but in the day to day, we love to make our own natural bug spray using essential oils. I have all of the details on our natural insect repellent spray here. Young Living also has a premade insect repellant as well as insect repellent wipes for on the go that work great too!

Keep in mind whenever using an aerosol spray around kiddos, it is preferred to spray onto your hand, and rub on their skin to avoid inhalation of the spray (especially when using a chemical based bug spray option).

SUPPORTIVE MEASURES FOR BUG BITES:

Clean with warm/soapy water

Apply lavender essential oil

Cool compresses (I love to put soft wet washcloths in the freezer)

Hydrocortisone 1% cream or Benadryl cream, as needed if very itchy

If you notice your kiddo itching or picking at bug bite lesions often, I recommend using the hydrocortisone or Benadryl cream to reduce risk for a secondary infection.

Bug bites are going to happen, I hope this helps to provide some insight on when it’s just a bug bite vs when there is concern for infection requiring further medical evaluation.