Diagnosing & Treating Bug Bites Online

There are hundreds of thousands of bugs that exist on Earth. Getting bit by one of these pesky insects is never fun – the bites can be itchy, red and annoying. However, there are bug bites that are more common than others, including:

• Mosquito bites
• Bed bug bites
• Spider bites
• Brown recluse spider bites
• Black widow bites
• Tick bites
• Flea bites
• Bee stings
• Lice bites
• Ant bites and stings
• Mite and chigger bites

There are over 20,000 different species of spiders in the Americas, but only 60 are capable of biting humans. Of this small group, only four spiders are known to be dangerous to humans. These spiders are:

• The brown recluse
• The black widow
• The hobo or aggressive house spider
• The yellow sac spider

Of these four species, only the brown recluse and black widow have caused significant disease and reports of death.

Brown Recluse Spider

1 [Brooks, Andrew J. (Artist).  (1973).  Brown Recluse Spider [Image].  CDC public domain. Retrieved July 11, 2017, from https://phil.cdc.gov/phil/advancedsearchresults.asp ]

These spiders are native to the Midwestern and Southeastern states – including California, Arizona, and Texas. It is very rare for one to find a brown recluse spider outside of these states.

These spiders are not aggressive and usually only bite when threatened. The bites will often go unnoticed because usually they are painless. Symptoms will start to develop 2-8 hours later, which is when one would notice that they have been bit. If you have been bit by a brown recluse, your skin may form a rash like the above image. Other symptoms may include:

• Severe pain
• Severe itching
• Nausea
• Vomiting
• Fever
• Myalgias (muscle pain)

If you or someone you know things they have been bitten by a brown recluse spider, you should see your physician immediately. If you have killed the spider, you can show it to your online physician or bring it into your PCP’s office for examination. Options for treatment of a brown recluse bite may include:

• Apply ice to decrease pain and swelling
• Elevate the area above the heart
• Wash the area with cool water and mild soap
• Avoid strenuous activity
• Use acetaminophens for pain relief i.e. Tylenol, Advil
• In severe cases, a referral to a specialist for blood and/or lab tests

Black Widow Spider

[Gathany, James. (Artist).  (2007).  Black Widow Spider [Image].  CDC public domain. Retrieved July 11, 2017, from https://phil.cdc.gov/phil/advancedsearchresults.asp ]

The black widow is a nocturnal, medium-sized spider that has red marks on its under belly, as seen in the above image. These spiders tend to prefer dark corners or crevices and will avoid humans unless threatened. Only the female black widow bites humans, and she will typically only bite when disturbed, especially if she is protecting her eggs.

If you have been bit by a black widow, your skin may form a rash. Other symptoms may include:

• Local pain
• Muscle cramps
• In severe cases, abdominal pain
• Blood pressure and heart rate may be elevated

If you have been bitten by a black widow, you should go to the emergency room immediately. Treatment for serious reactions to a black widow bite will be beyond the scope of most medical offices and urgent care centers. Home remedies for black widow bites are limited, but you can try these for pain relief:

• Cold and warm compresses
• Hot baths
• Over-the-counter pain relievers i.e. ibuprofen, Tylenol

You and your online doctor can help determine what type of bug bite you may have and what type of treatment is needed, or if a referral to a specialist is required.

During a video consult on TelaCare your doctor will ask you a series of targeted questions to determine if your symptoms point to bug bites. Then your provider will proceed to determine the best treatment plan for you. Your provider may recommend in-person examination by a specialist if this is needed. Your treatment plan is based on the duration and severity of your symptoms and your medical history.

Our platform has an image upload feature that is extremely helpful for both providers and patients. With this feature, our physicians can get a precise, detailed look at your bite or sting before the visit even begins. This feature is also very useful to see how your bite has progressed. If the outbreak has been present for a few days and you have a picture from the first day, it is helpful for our providers to see the comparison. If your outbreak is on your face, this feature is specifically useful for those that wear makeup – you can take a picture when you have a clean face, save it and upload before your visit! For best results we recommend pictures be taken in bright, natural light, close to the rash and from a few different angles. If you can give a size perspective, like laying a dime near the bite or sting, this can be extremely helpful, as well.

Once a diagnosis has been made, your doctor will go over the risks and benefits of the various treatment plans. Treatment for bug bites are different depending on severity and type of bite. Sometimes, a consistent skin care routine is imperative for successful treatment. This is sometimes difficult for adolescent patients, so follow up visits, especially in the beginning of treatment, will be important.