Patient information · Urgent care
Insect bites and stings
including safe tick removal and Lyme disease
Most bites and stings cause redness, swelling and itching that peaks over a day or two and then fades. The three things worth recognising are a severe allergic reaction, a bite that has become infected, and the rash that follows a tick bite.
Call 999 immediately if there is
- swelling of the lips, tongue, mouth or throat, or a hoarse voice
- difficulty breathing, wheezing, or a tight chest
- dizziness, collapse or loss of consciousness
- a widespread rash or hives spreading beyond the bite
- sudden vomiting, abdominal pain or a feeling that something is badly wrong
This is anaphylaxis. If an adrenaline auto-injector has been prescribed, use it into the outer thigh straight away, call 999, and lie the person flat with their legs raised. A second dose may be given after five minutes if there is no improvement. Do not stand them up, even if they feel better.
Straight after a sting
- Remove a bee sting quickly. Scrape it out sideways with a fingernail or bank card rather than squeezing it with fingers or tweezers, which pushes more venom in. Speed matters more than method.
- Wash the area with soap and water.
- Apply something cold — a wrapped ice pack or cold flannel for around ten minutes — to limit swelling.
- Raise the area if it is on an arm or leg, and remove rings or watches before swelling starts.
- Take an antihistamine for itching, and paracetamol or ibuprofen for pain.
Redness is not the same as infection
A bite or sting commonly produces a red, hot, swollen, itchy area that gets larger over the first 24 to 48 hours — sometimes 10cm across or more. That is a normal inflammatory reaction to venom, not an infection, and antibiotics will not help it. Infection develops later, typically after two or three days, and tends to worsen when the reaction should be settling.
Signs a bite has become infected
- increasing pain and spreading redness after the first two days
- pus, or fluid weeping from the site
- a temperature, shivering or feeling unwell
- swollen, tender glands in the armpit or groin
Removing a tick
Ticks are found in grassland, woodland and parks across the UK, including in and around London. Removing one promptly and properly substantially reduces the risk of Lyme disease.
- Use fine-tipped tweezers or a tick removal tool. Grasp the tick as close to the skin as you can.
- Pull steadily upwards. Do not twist, jerk or rock — the aim is to lift the whole tick out, mouthparts included.
- Do not burn it, or smother it with petroleum jelly, alcohol or nail polish. These make the tick regurgitate into the wound, which increases the risk.
- Clean the bite with soap and water or antiseptic afterwards, and wash your hands.
- Note the date, and photograph the bite. If part of the mouthparts stays behind, leave them — the skin will expel them.
The Lyme disease rash
Between three days and three weeks after a tick bite, watch for a spreading circular or oval rash, often clearing in the centre so it looks like a bullseye. It is usually not itchy or painful, and it expands over days. If you see it, or you develop flu-like symptoms, headache, joint pains or extreme tiredness after a tick bite, contact us — Lyme disease is treated with a course of antibiotics and treating it early prevents later problems. Not everyone with Lyme disease gets a rash, so the absence of one does not rule it out.
If you have been bitten abroad
A fever within a year of returning from a country where malaria occurs is a medical emergency until proven otherwise — seek help the same day and say where you have travelled. Tell us about any bite abroad that blisters, ulcerates or fails to heal.
Preventing bites
- Use an insect repellent containing DEET on exposed skin, reapplied as directed.
- Cover ankles and legs in long grass, and tuck trousers into socks in tick country.
- Check yourself, children and pets for ticks after being outdoors — behind the knees, in the groin, armpits, waistband, hairline and behind the ears.
- Keep food and sugary drinks covered outdoors in late summer, when wasps are most aggressive.
- Do not swat at wasps or bees; move away calmly.
Book an appointment if a bite is spreading and painful after two days, you develop a rash after a tick bite, you have been bitten abroad, or you have had a severe reaction before and need an allergy assessment or an adrenaline auto-injector prescription. We offer allergy testing and travel advice on site.
Seen today, not next week
Same-day appointments most days, seven days a week, 9am–7pm, on Whitechapel Road.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.