WebMD Ask the Pharmacist

Bug Bites, Burns, First Aid: Ask the Pharmacist

Pharmacist Kristen Binaso, RPh, answers your questions about bug bites, burns, and first aid.

Question:

I was bitten by a bug or spider on the inside of my forearm and now more than half of the inside of my arm is very swollen, red and hot and it is painful. Should I be concerned or will some Benadryl do the trick?

Answer:

Unfortunately spider bites have a tendency to cause infection and I believe we may be at this point in this situation. This could be the start of cellulitis which is a bad skin infection. I would advise seeing a health care provider as soon as possible. An antihistamine like Benadryl will not help.

Question:

I burnt my finger. According to the description it is a second-degree burn - white blister that turns red when you touch it. The only thing that seems to help is constant ice. Is there anything else I can put on it to soothe it?

Answer:

It is not recommended that you apply ice to a burn because the ice can stick to the skin and do additional damage. You do not want to puncture the blister because that could bring on an infection. Continue to watch it and for the pain, you can try taking an acetaminophen product like Tylenol. If it continues to get worse you will need to see a health care provider.

Question:

If a bug bite swells up bigger than normal because you know your kids are allergic, should you take them to the ER if the swelling doesn't go down with Benadryl or hydrocortisone?

Answer:

One of the questions I need to ask this parent is if they used an antihistamine like Benadryl orally or just topically and does the pediatrician know about this condition? I also advise parents to use topical hydrocortisone and antihistamine products sparingly since it can be absorbed through the skin. What you really want to watch out for is if your child is having problems breathing or seems really tired or nonresponsive. In that case, they need to go to the emergency room immediately. If these symptoms are not present, I would schedule an appointment with the pediatrician for further evaluation. If you have any questions about proper medications to use in children, ask your pharmacist. Thanks for submitting a great question.

Question:

What can you put on bites from fire ants?

Answer:

If you have been stung by a fire ant, you should softly wash the skin with a mixture of soap and water; this will get rid of the venom on the surface. If you have rubbing alcohol around, you also should disinfect the area of the bites. You can then put some ice in a washcloth and hold it next to the bites for about 15-20 minutes. That will help keep down swelling and make it a little less irritating the next day. Fire ant stings are also accompanied by a lot of itching so you may want to use a hydrocortisone or diphenhydramine-based cream. Be careful and don't scratch! This could lead to secondary skin infections, a trip to the doctor, and possibly antibiotic treatment.

Question:

Is it OK to take Atarax for poison ivy?

Answer:

Atarax is a prescription medication that is an antihistamine. It can be used for the treatment of poison ivy when it is severe. It can cause drowsiness, so you want to be very careful when taking it, especially if you have to drive or operate machinery.

Question:

Are there any over the counter-the-counter treatments for cold sores?

Answer:

There are some topical medications that can be used for cold sores, such as Abreva. It comes in a pump dispenser that contains a cream that can be applied. The cold sore may not go away immediately. You may need to use the medication for a few days.

Question:

I have a burn on my hand, and it has a slight red line that goes past my wrist. It was redder last night. The Epsom salt seemed to help. Is the antibiotic salve good enough with a bandage to not have infection?

Answer:

If you have a red line running from the burn on your hand past your wrist it could already be infected and I would advise that you see a health care provider as soon as possible. You should not use Epsom salts for a burn, or ice. You can submerge the area in cool water. I would also not advise putting any antibiotic ointments or dressings until a health care provider has evaluated it.

Question:

My fiancé and I have this rash or something on our arms and hands, and some on our backs. The place we are staying has bed bugs, but I don’t think that is what it is. It is too spread out and itches real bad off and on during the day and night. It looks like bite marks, but way too many to be bite marks. It’s like an allergic reaction to something but we can’t figure it out. I am also five months pregnant and not really sure what I can do or take for the itching. It’s driving us up a wall. Any way you can help?

Answer:

One of the questions I have to ask is "how long have you had the rash?" Sometimes people break out from foods, new laundry detergents or new soap. This could be a possible cause if it not due to the bed bugs. Due to the fact you're pregnant, I would recommend using a colloidal oatmeal bath like Aveeno, and if it continues, see your health care provider.

Question:

I can't get rid of scabies. Is there a new medicine for scabies?

Answer:

There are actually no new medicines for scabies. One of the things I would ask this patent is if they had seen a health care provider for treatment. There are two prescription medications that can be used to treat scabies. The patient may also want to consider preventative measures like washing all bedding, sheets, etc. in hot water. Also take any household pets to the veterinarian for examination.

Question:

I have two spider bites on my upper arm. It appears they are possibly from a brown recluse. One is a week old and the other a few days ... or possibly occurred at the same time but I wasn't aware. Two or three weeks ago a similar bite was on my ankle, it isn't red and doesn't itch anymore, but the bite mark is a scab. I am a student and have no health insurance but I am getting worried. What should I do?

Answer:

I would watch the bites because spider bites can cause serious skin infections, which usually require antibiotics. Check the area where you sleep, vacuum the area, and make sure you keep windows and doors closed to prevent the spiders from coming inside.

Question:

I burnt my hand on hot water today and now it’s starting to blister. Do I need to see a doctor or are there any at-home things I can do to promote healing?

Answer:

This all depends on how much of your hand was burned – if it is a large area, you will want to be seen by a health care provider as soon as possible. Do not puncture the blisters and do not put anything on the burn like butter, mayonnaise or ice. Even if it is a small area, you will want to watch it for signs of infection which includes redness, swelling, continued pain, and possible oozing or a "wet" appearance.

Question:

Can I ever have grapefruits again if I take a statin?

Answer:

We are learning more and more each day about drug interactions with food, especially juices like grapefruit. Grapefruit juice has the ability to interact with certain enzymes in the body – the same enzymes that help break down medicines like statins so your body can use them. This can lead to high levels of the drug in the body and lead to a variety of health problems. It is best to avoid grapefruit while on this class of medications. You can also talk to your doctor or health care provider to see if you can be switched to a different class of medications for your cholesterol; we have a few other options besides statins. If you have any questions about drug/food interactions, talk to your pharmacist. We are happy to help.

Question:

What can I use to treat a spider bite?

Answer:

This is a good question because you really have to watch spider bites. You will want to look for redness, tenderness, warmth, and pain around the area. If you notice a red streak traveling up the leg or arm, seek medical attention immediately since this could be a sign of a serious infection.

Question:

I had my teeth whitened (not by a dentist) and I received burns to my lips inside and out. I tried oral gel for mouth sores and that burned too much. Can you recommend something for the pain?

Answer:

I would have your mouth looked at as soon as possible by a dentist. There is a possibility that you could also have an infection due to the burn.

Question:

I have a bad burn on my hand from a campfire. I am using antibiotic cream and keeping it clean. I need to know, do I keep it covered or leave it uncovered?

Answer:

I am a little concerned about the fact that this patient called it a "bad burn." Based on that description, my fear is that there could be a skin infection possibility and it may not be healing properly. If the skin has blistered or is broken, it needs to be evaluated by a physician or health care provider as soon as possible. I would not recommend putting antibiotic ointment on it due to the fact that there is limited data that it evens helps – you usually need oral antibiotics to help the skin layers underneath and leave uncovered.

Question:

I have contact dermatitis and I was wondering if there was an over-the-counter ointment that I could buy to help heal this up?

Answer:

This is a popular question that I get at the pharmacy. Typically the topical hydrocortisone products are very effective to use as long as the skin isn't broken or bleeding. If the itching is really bothersome, an antihistamine like Benadryl or Zyrtec may be appropriate as well. Be sure to have your medication list handy when you are talking to the pharmacist and let us know any other over-the-counter products you may have tried already too, so we can help make the best decision.

Question:

What is the best medicine to use against chigger bites?

Answer:

Thanks for asking this question because many people don't know that chigger bites differ from mosquito bites in the fact that they leave an open wound rather than a red bump. You can apply a triple antibiotic ointment with a "pain relief" component (which is usually a numbing agent) for these types of bites. If you need help in finding these products in a pharmacy, just ask, we are more than happy to help you.

Question:

What can I use to treat bed bug bites?

Answer:

This is a popular question due to many people reporting "bed bugs" in hotels. You can use a topical hydrocortisone-based product to the bites for itching. Ointment may be a better choice since it has a petroleum jelly base so it will stay on the area longer than the cream. If the bites are bleeding you do not want to apply the hydrocortisone, instead wash the bites with hydrogen peroxide and use a triple antibiotic ointment.

Question:

What is the best OTC medicine for any skin infection?

Answer:

Good question. This really depends on what type of infection and how severe it is. Typically if you have a small cut, you can wash with soap and water and then apply a triple antibiotic ointment. If the infection on the skin appears red, warm to the touch, painful, or oozing, you will need to see your health care provider. Skin infections can be very difficult to treat and can require prescription antibiotics if not taken seriously.

Question:

We just went for a walk and I got bit by mosquitoes. But on one part of my leg there is a large rash ... which isn't a bump like a normal bite. I have a history of being extra sensitive from mosquito bites, but should I be worried about this rash?

Answer:

I would monitor the rash and if it appears to be getting worse -- warm to touch, swollen, or spreading -- you will need to go to the doctor for evaluation. Since you are sensitive to these types of bites, have you considered applying a topical product before you go out to avoid bites? There are a variety of different products on the market in various forms. There are even some sunscreens that now contain repellents.

Question:

I'm pretty certain that I have a sinus infection as well as a bad case of poison ivy. I lost all health insurance back in February of this year and cannot afford to go to a doctor’s office. My friend has the remainder of a prescription that she was willing to give me that she thought might help but I do not want to take it until I find out if I should. Could you please tell me what sulfameth/TMP DS tab is and what it is used for and if I should take them as I am desperate to get some relief. Her husband had been prescribed them for an abscess on his back so I'm thinking that it is some type of antibiotic.

Answer:

You never want to take someone else's medication; this is risky and not safe. Antibiotics do not help with poison ivy. I would recommend calling your local hospitals to see if they have a clinic or try visiting the "in-store clinics" that are in some drugstores. You can try products like Zanafel, Ivy Dry, and Tecnu that can help with drying up the oils causing the itching.

Question:

I accidentally swallowed my dog’s antibiotic pill instead of my daily vitamin. Should I be worried? It was Cephalexin 250 mg.

Answer:

You should be OK. You want to make sure that you keep your pet's medication in a separate area from your medications, including vitamins and over-the-counter medications. Also, make sure you are familiar with what your pills look like before you swallow them. Always better to be safe than sorry.

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