Insect Bite & Sting
Treatment in Miami

Walk in if the bite is spreading, warm, or red-streaked, if it is draining, or if you develop a fever or widespread rash. Come in right away if a sting is near the eye or mouth with swelling. Small itchy welts without spread are usually fine to manage at home with a topical steroid and an antihistamine. If you have any systemic symptoms (wheezing, lightheadedness, or full-body hives), that is an emergency: call 911.

Call 911 immediately. Throat or tongue swelling, trouble breathing, widespread hives with dizziness, or a feeling of impending doom signals anaphylaxis, a life-threatening allergic reaction. If you carry an epinephrine auto-injector (EpiPen), use it now. Do not drive yourself in. After paramedics stabilize you, we treat anaphylaxis on site with IM epinephrine, IV fluids, IV antihistamine and steroid, and an observation window for biphasic reactions. See our allergy and anaphylaxis page for more.

Rinse with seawater, not fresh water. Fresh water can trigger stinging cells that have not yet fired and worsen the sting. Remove any tentacles with a gloved hand or a card edge, apply vinegar for certain species, then use hot water immersion at about 43 to 45 degrees Celsius for 20 minutes to ease pain. If symptoms spread or the sting is extensive, we evaluate you in clinic and give supportive care. For a Portuguese man-of-war, rinse with seawater and use hot water immersion; vinegar is more controversial and often avoided.

No. Urine has no clinical benefit, and the idea is a myth. It can even make things worse by triggering more stinging cells to fire. Use seawater, remove the tentacles carefully, and use hot water immersion for the pain.

Yes. Sea lice (seabather’s eruption) is caused by tiny jellyfish or anemone larvae trapped under your swimsuit, and the rash appears hours later in a bathing-suit pattern. Treatment is to shower without the suit, then use a topical steroid and an oral antihistamine. Severe or widespread cases get a short oral steroid taper. Most cases resolve in 7 to 10 days. Come in if the rash is severe or widespread, or if you develop a fever.

An infected bite shows spreading redness beyond the original site, warmth, red streaking that leads away from the bite, pus or drainage, a fever, or pain that increases over 24 to 48 hours instead of easing. A bite that is getting better is usually not infected. One that is getting worse should be evaluated. Infected bites are treated with oral or, when needed, IV antibiotics.

It depends on your last tetanus booster. Adults need one every 10 years for routine immunity, and every 5 years for a dirty or deep wound. Most arthropod bites are minor and do not need a tetanus update if your last dose was recent. We review your status at every visit and update it when indicated.

Remove it with fine-tipped tweezers: grasp the tick as close to the skin as possible and pull straight up with steady, even pressure. Do not twist, burn it, or apply petroleum jelly. Clean the site with soap and water, and save the tick in a sealed container. Come in if you develop a rash, fever, or muscle aches over the next 7 to 30 days, and bring the tick if you saved it.

Native Lyme transmission in Florida is uncommon. Most Florida ticks are the lone star or dog tick, which do not carry Lyme. Travelers who return from Lyme-endemic areas such as the Northeast or Upper Midwest with a classic bull’s-eye rash or symptoms do get evaluated. Our physicians take your travel history, review the exposure, and test or treat accordingly.

Most suspected spider bites are not actually spider bites. They are skin infections, often MRSA, that started as something else. We examine the wound and treat what is really there. True black widow envenomation causes muscle cramping and systemic symptoms, and the brown recluse is uncommon in Florida. Both are evaluated in clinic when suspected, but most lesions labeled spider bites are treated as a skin infection.

Fire ant stings form a characteristic sterile pustule at 24 to 48 hours. Do not pop it. Treatment is a topical steroid, an oral antihistamine, and ice. Come in only if you develop systemic symptoms, if the area becomes truly infected with spreading redness or drainage, or if you have a known bee or wasp allergy and the reaction is escalating.

Yes. We provide pediatric urgent care for children six months and older. Kids tend to get larger local reactions and are more likely to scratch a bite into a secondary infection. Bring your child in sooner if a bite is spreading, if there is a fever, if swelling involves the face or a joint, or after any sting if your child has a known venom allergy.