Severe reaction to insect bites is a feature that is experienced by many people with lupus. Lupus patients are susceptible to insect bites and tend to have severe and prolonged reactions.
“I was bitten by horseflies one very hot summer. I didn’t feel the bites but during the night I woke feeling chilled to the bone and shaking, then burning up alternately. I spent the night on the settee with ice wrapped in a flannel to apply to the burning on my legs. I felt unwell but stuck it out until morning when the chills stopped, the bites were nasty. I ordered creams online. I didn’t want to trouble to my GP. Anthisan was one and I applied that for a few days which helped. When a family member saw the bites she insisted I go to Boot’s chemist. I spoke to a lady in there who was satisfied the bite wounds were nice and clean and said I’d done the best I could, but if they worsened in any way to see my GP. They didn’t get any worse but they’ve left grey coloured scarring on both legs.”
What is it that causes a reaction when an insect bites you?
When an insect bites, it releases saliva. The saliva that is injected into your body can cause your immune system to respond. Often, your body’s immediate response will include redness and swelling at the site. Minor delayed reactions can include itching and soreness. The severity of the bite can depend on the type of insect and the sensitivity of the person. In rare cases, some people can have a serious allergic reaction (anaphylaxis) to a bite or sting that requires immediate medical treatment.
There are a few different types of insects that bite in the UK. You can find details of these insects and the kind of reactions they can cause HERE.
When to Seek Medical Help
If you’ve been bitten or stung and there’s a lot of swelling and blistering or if there’s pus (which indicates an infection), then you should see your GP. All people who have SLE should see their doctor immediately if they have an infection. If it is after hours, a weekend, or your doctor is not available, you may be directed to go to the local A&E. Although a visit to A&E can end up being a long waiting affair, it is very important to do this because a potential infection could be very dangerous if not diagnosed and treated promptly.
Dial 999 and ask for an ambulance if you experience any of these symptoms after a bite or sting;
- wheezing or difficulty breathing
- nausea, vomiting or diarrhoea
- a fast heart rate
- dizziness or feeling faint
- difficulty swallowing (dysphagia)
- confusion, anxiety or agitation
“I was on honeymoon in 2003 in Lanzarote when I got bitten (by an unknown insect). At this time I had no idea I had lupus, in fact I did not get diagnosed until 2014! The bite would not heal and turned very quickly into an ulcer. Over the course of the next ten years I had various investigations, got prescribed many antibiotics, lotions and potions, underwent more pressure bandaging than I care to remember and spent many nights pacing the floor in pain (a pain I cannot even begin to describe). Eventually a skin graft took and I had respite for two years until in 2013 when I found a dark spot in the grafted area. With the suspicion of melanoma a biopsy was performed and again I was left with an open wound, and again the same round of trial and error treatments until another graft was performed. I now use max strength Jungle Spray Boots’ sun cream with insect repellent at the very least to try and ensure I am not bitten.”
Treating Insect Bites
Most insect bites and stings cause itching and swelling that usually clears up within several hours.
Minor bites and stings can be treated by:
- washing the affected area with soap and water
- placing a cold compress (a flannel or cloth cooled with cold water) over the affected area to reduce swelling
- not scratching the area as it can become infected
See your GP if the redness and itching gets worse or doesn’t clear up after a few days.
“There is a very good stick you can buy in Boots which has witch hazel at one end and tea tree in the other; one is for day one and one for night. I put it on the minute I get bitten and it works. If I scratch I infect, so fast application is best.”
“Lavender roll-on; it always takes the itching away for me”
“Lavender oil helps soothe I’ve found, without reaction to my skin.”
“Aloe Vera gel is amazing and helps reduce the itching and pain.”
“Run a metal spoon under hot (not boiling) water and hold the spoon on the bite. Apparently it kills the protein in the bite and relieves the itching.”
If the bite or sting is painful or swollen, you can also:
- wrap an ice pack, such as a bag of frozen peas, in a towel and place it on the swelling
- take painkillers, such as paracetamol or ibuprofen (please be aware that these medications may not be suitable for everybody with lupus and you should check with your GP or consultant for suitable pain relief if you are unsure)
- use a spray or cream that contains local anaesthetic, antihistamine or mild hydrocortisone (1%) on the affected area to prevent itching and swelling (please be aware that these medications may not be suitable for everybody with lupus and you should check with your GP or consultant for suitable pain relief if you are unsure)
- take an antihistamine tablet to help reduce swelling (please be aware that these medications may not be suitable for everybody with lupus and you should check with your GP or consultant for suitable pain relief if you are unsure)
If you have an allergic reaction after being bitten or stung, even if it’s just a skin rash (hives), your GP may prescribe an adrenaline pen (an auto-injector) and show you how to use it. You’ll also be referred to an allergy clinic for further tests and treatment. Many people who have SLE also have allergies and often wonder if this is due to their altered immune systems from their lupus. Although some earlier studies suggested the possibility of more allergies in people with lupus, studies that are more recent have failed to show this association. One popular therapy for allergies is to have allergy shots or what doctors call ‘allergy immunotherapy’. Due to the increased formation of auto-antibodies after immunotherapy, in 1989 the World Health Organisation (WHO) recommended that people who have autoimmune diseases (such as SLE) should not receive immunotherapy. Therefore it is most likely better to try other therapies to control allergies instead of immunotherapy. This is not to say that allergy shots absolutely cannot be given to people with SLE. However, if immunotherapy ends up being the only way a person who has lupus can get relief from allergies, then it is important to realise that there is always a possibility of their SLE flaring after the treatment.
If you develop blisters after being bitten by an insect, don’t burst them because they may become infected. Blisters don’t usually cause pain unless they rupture (burst) and expose the new skin underneath. If possible, use an adhesive bandage (plaster) to protect the blistered area.
See your GP if the bite or sting fills with pus and feels tender to touch, your glands swell up and you feel unwell with flu-like symptoms. Your GP may prescribe oral antibiotics (medicines to treat infections caused by bacteria). You’ll need to take these as instructed, usually two to four times a day for seven days. People who have SLE need to remember that they should always list sulfa antibiotics as one of their allergies, even if they have never taken them before. Sulfa antibiotics can cause lupus to flare, and people who have lupus have a high chance of being allergic to them as well.
“I always take antibiotics on holiday as I have been known to get blood poisoning from being bitten.”
Preventing Insect Bites
There are a number of precautions you can take to avoid being bitten or stung by insects.
It’s particularly important to follow this advice if you’ve had a bad reaction to an insect bite or sting in the past. Some of the precautions you can take to minimise your risk of being bitten or stung by an insect are listed below;
- cover exposed skin – if you’re outside at a time of day when insects are particularly active, such as sunrise or sunset, cover your skin by wearing long sleeves and trousers
- wear shoes when outdoors
- apply insect repellent to exposed areas of skin, particularly in summer or early autumn, when stings are most likely to occur – repellents that contain diethyltoluamide (DEET) are most effective
- avoid using products with strong perfumes, such as soaps, shampoos and deodorants – they can attract insects
- avoid flowering plants, outdoor areas where food is served, rubbish and compost –regularly and carefully remove any fallen fruit in your garden and keep a well-fitting lid on dustbins
- wear neutral colours and avoiding floral patterns
- avoid camping near water, such as ponds and swamps – mosquitoes and horseflies are commonly found near water
- keep food and drink covered when eating or drinking outside, particularly sweet things
- keep doors and windows closed or put thin netting or door beads over them to prevent insects getting inside the house – also keep the windows of your car closed to stop insects getting inside
“I use Avon’s ‘Skin So Soft’ spray! They hate it. If it works for Scottish midges it will work for anything!”
“Avon’s ‘Skin So Soft’ spray is my preference and I find it works!”
“I have been taking vitamin B1 for two years and it works perfectly for me. I take them on recommendation from Holland & Barrett.”
“I have found that if I want to use my back porch (unscreened) the only thing that really works for all bugs is a Citronella candle. They come in small pales and you place them at the base of a seating area, around the perimeter, not at table height. You may or may not like the scent but they absolutely do work.”
“Citronella candles if sitting outside helps, or a lemon spray on me and the surrounding seat.”
“Take garlic capsules, vitamin B and antihistamines. The first two make you give off odours the mossies don’t like and the antihistamine reduces impact after being bitten.”
“I always use tea tree oil. Bugs hate it and if you do happen to get a bite or sting, it’s great to dab on for relief. I add about a dozen drops to a cup of water, soak some cotton wool pads (or rinsed out wipes) in the solution then wipe over all exposed skin and through my hair. A couple of drops can be added to your sunscreen (we all wear it anyway!) or to your final hair rinse, used in an oil burner or as a final rinse in your washing machine (I don’t use fabric conditioner); there are loads of ways to use it.”
An important note concerning insect repellents
The following is taken from ‘The Lupus Encyclopedia’ by Donald E. Thomas, Jr. M.D.;
“Pesticides may increase the risk for developing SLE; however, studies are inconclusive. The Women’s Health Initiative (a large, ongoing study of women looking at multiple health issues) showed an increased risk of autoimmune disease (including lupus) in women who used and mixed insecticides compared to women who did not. This risk was highest in women routinely exposed to these pesticides.
“In 2003, researchers reported that a group of chemicals called phthalates caused the immune systems of lupus-susceptible mice to become more active and produce high amounts of anti-ds DNA (a very important lupus auto-antibody). Other researchers have since reproduced these results. This is of concern because phthalates are used in so many products in our society. There is a legitimate concern that these products could potentially increase the occurrence and activity of autoimmune disorders such as SLE. At this time, there are no studies addressing this in people who have SLE, but doctors and scientists are investigating this possibility.
“If a person who has SLE wishes to minimise their exposure to phthalates, they would have to try to use as many naturally occurring products (especially plant-based) as possible and avoid manufactured plastics, cosmetics, paints, rubber, toys, paints and cleaners. Looking for the words ‘phthalate-free’ on cosmetic products and ‘VOC-free’ in paints is a good place to start.”
If you’ve got green fingers then you may want to consider introducing a few plants that naturally repel insects into your garden. You can learn about these plants HERE.
***Please note that this article is written for informational purposes only and should not be a substitute for professional medical advice or treatment. Do not delay seeking or disregard medical advice based on information here. Always seek the advice of your local family physician or other qualified health professional before starting any new treatment or making any changes to existing treatment. It is also advisable to consult a medical professional before making any changes to diet or starting alternative remedies, which may interact with other medications. It is important to remember that lupus is a very varied condition and what works for one person could be potentially harmful for another***
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