Insect bites and stings are usually due to fleas, mosquitoes and bed bugs at night. All cause a red, papular, itchy rash. Flea bites occur on skin covered by clothing or on the feet and lower legs. In contrast, mosquito bites occur on exposed skin, especially the face and hands. Bed bug bites tend to occur in rows as the bug bites as it walks along.

Children who are allergic to insect bites develop papular urticaria, which presents as raised, swollen and very itchy wheals. The papular urticaria should be managed by preventing the insect bites.

Prevent mosquito bites with insect repellent (Tabard, Peaceful Sleep). Remove any pools of standing water where mosquitoes breed, and use bed nets. As fleas often come from carpets and pets, vacuum the carpets and deflea cats and dogs. Bed bugs live in cracks in wooden beds. Therefore spray the bed with an insecticide and place the mattress in the sun.

Calamine lotion helps to relieve the itching. Oral antihistamines are useful in more severe cases. Do not use local antihistamine creams.

With bee stings, scrape the sting off with a blunt knife. Do not try to pull it out. The pain of both bee and wasp stings can be relieved by rubbing the area with ice. Bee stings can cause severe allergic reactions.