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What do I do if I am bitten by red ants?

 

Andy Halberg, MD, is a third-year resident in Banner Good Samaritan Medical Center's Family Practice program in Phoenix.

Question: I was bitten by red ants. I have high blood pressure what can I take or do to stop the itching? 

Answer: In Arizona, we have two types of red ants.  We have a native, Southern Fire ant and we also have the Red Imported Fire ant (RIFA) which originates from Brazil. 

Most likely you were stung by the more common, southern fire ant, given your primary complaint of itching. 

Anaphylaxis is the most worrisome allergic reaction from an insect sting.  This may start as hives and progress to difficulty swallowing, weakness, wheezing, difficulty breathing and/or shock. 

Epi-pens contain self injectable epinephrine, the main treatment of anaphylaxis or allergic shock.  They are prescribed by physicians and recommended to be on hand by those people who have had severe allergic reactions. 

If someone is experiencing a severe allergic reaction to an insect sting and they are alert and able to swallow, an over-the-counter (OTC) antihistamine such as diphenhydramine/Benadryl® 50 mg or cetirizine/Zyrtec® 10 mg for adults, half this dose for older children, could be considered while waiting for emergency assistance. 

However, the most important thing to remember if there is concern of a severe allergic reaction is to call 9-1-1 immediately. 

Itching is a more common allergic reaction. The treatment of hives and or itching related to insect stings may include an OTC anti-histamine such as cetirizine (Zyrtec®) or loratidine (Claritin®) which tend to be non-sedating, or diphenhydramine (Benadryl®) which is often sedating and therefore should generally be avoided in the elderly or those planning to drive.

In addition, 1% hydrocortisone cream, which can be purchased over-the-counter, should be applied after the area is washed with cool (not hot) soapy water.

Any rash/bite that appears infected (oozing, red, tender, warm to the touch), covers a large area, or does not improve should be evaluated by a health care provider.  To avoid infection, do not scratch the rash/sting.  In addition you might want to make sure your tetanus vaccine is up to date.
 
In regards to your concern about having high blood pressure, the medications listed above are considered safe for infrequent use, especially if your blood pressure is under good control. 

You may have asked this question due to a physicians recommendation against taking decongestants, such as pseudoephedrine (Sudafed®) with a history of high blood pressure.

As a Family Medicine practitioner, prevention of illness is especially important.  To avoid ant stings, know the area you are in and avoid those with heavy ant activity or mounds/nests.  Ants will not sting through fabric, so wear socks and shoes when outdoors, and consider gloves and long sleeves when gardening.  Further, call a local exterminator if you reside near a heavy fire ant population.  Note that insect repellant does not prevent fire ant stings.

Reviewed August 2010

Page Last Modified: 08/27/2010
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