When you get outside this summer, you won't be alone. Bugs are everywhere, and a few of them in Minnesota are known to bite or sting.

We asked Kavita Monteiro, MD, at HealthEast Clinic – Stillwater, what to do when a bug bites you or your family.

“In general, I recommend you wash the area with cool water and soap to remove as much of the bug’s saliva as possible,” Dr. Monteiro says. “Then avoid itching by using an ice pack or cold towel.”

Dr. Monteiro also suggests mixing water and baking soda into a paste and applying it to the bite to draw the venom out.

But not all bug bites are the same. Here's a guide to five types of bug bites and stings you may encounter this summer:

• Bees, wasps, and yellow jackets
• Biting flies or gnats
• Mosquitoes
• Spiders
• Ticks

Bees, wasps, and yellow jackets

What’s normal

These stings typically cause immediate pain, redness, and swelling at the site of the sting. Sharp pain usually subsides in 15 minutes or so. Soreness is typical for a few days after.

How to care for a typical sting

1. Remove the stinger, if there is one, by gently scraping it out with something like the edge of a credit card. Don't use tweezers, because that can push more venom into you. 
2. Use a cold pack or cool cloth to reduce swelling and pain.
3. Medications to consider: an antihistamine to keep the swelling isolated and a topical anti-itch cream or spray. 

When to see a doctor

Stings can create an allergic reaction. Seek immediate medical attention if a sting causes:

• Substantial swelling beyond the site of the sting or swelling in the face, eyes, lips, tongue, or throat
• Dizziness or trouble breathing or swallowing
• You feel ill after being stung 10 times or more at once

If a sting becomes seriously infected, contact your primary care doctor.

Due to bacteria under finger nails, scratching an itchy bug bite is the most likely way infections begin.

“You can recognize infection by its hallmarks, which include increasing redness, warmth to the touch, pain and pus,” Dr. Monteiro says. “If these symptoms are mild, you can try a topical over-the-counter antibiotic or a topical over-the-counter steroid. If that’s not helpful, you should see your doctor.”

Three ways to prevent stings

1. Be mindful of what you wear outside. Avoid floral prints and bright colors; they can look like flowers that attract the insects. Wear closed-toed shoes.
2. When eating outside, keep food covered and garbage contained. Avoid the sweet drinks these insects like. If beverages aren't in a sealed container, look before you sip.
3. Stay calm if you notice a bee, wasp, or yellow jacket nearby. Aggressive movements can lead to stings, because the insect is defending itself. Instead, walk away slowly. Do not jump into water, because bees are known to hover.

Biting flies or gnats

What’s normal

Black flies (buffalo gnats), horse flies and deer flies make small cuts to the skin to feed on your blood. Some typically bite the body or legs, while others target the head and neck. Flies may bite repeatedly.

Bites are painful and felt immediately. Swelling, itchiness, redness, and light bleeding are typical. Black fly bites can lead to swollen lymph nodes.

How to care for a typical bite

1. Clean the wounds with soap and water. Keep them clean until healed to prevent infection.
2. Use a cold pack or cool cloth to reduce swelling.
3. Use a topical cream or oral antihistamine to reduce itching.

When to see a doctor

No biting flies in Minnesota are known to transmit disease, though some deer flies in other parts of the world do.

Seek immediate medical attention if you notice difficulty breathing, swelling of the lips or eyes, or dizziness. Contact your primary care doctor if a fly bite becomes infected.

Three ways to prevent fly or gnat bites

1. Avoid the places biting flies are most active: marshy, forested, shaded areas, and areas with dense vegetation. Maintaining your yard can reduce your risk.
2. Because bites occur where skin is exposed, wear pants, a long-sleeved shirt, and a hat. Wear light colors, because biting flies are more attracted to the heat of dark clothing.
3. Insect repellents may protect you from some types of biting flies, but not all.

Mosquitoes

What’s normal

Mosquitoes bite to feed on blood, but the bites aren't always felt when they occur. For some, blister-like bumps appear moments after being bitten, then a dark, itchy, bruise-like mark develops. For others, a small, itchy, red bump can develop about a day after being bit.

How to care for a typical bite

Mosquito bites typically itch and may cause a degree of redness and swelling in children. To relieve discomfort, consider using:

• A cold pack or cool cloth
• A topical anti-itch cream or spray
• An oral antihistamine

When to see a doctor

Most mosquito bites go away after a few days without intervention. On rare occasions, however, mosquitoes are known to transmit disease, including West Nile virus. If you have body aches, diarrhea, fever, headaches, nausea, or other symptoms that appear within about two weeks of the bites and seem to be related, contact your primary care doctor.

Three ways to prevent mosquito bites

1. Remove standing water — a breeding ground for mosquitoes — from around your home. Check after it rains; water may pool in unexpected places.
2. Wear light-colored clothing that covers your skin and apply a repellent, but only after you’ve applied sunscreen. Take special care to follow instructions when applying repellent to children, and don’t use it on babies younger than 2 months. 
3. Stay inside at dawn and dusk, when mosquitoes bite most. 

Spiders

What’s normal

Most spider bites are misidentified; they're actually bites from other bugs or an unrelated skin irritation. Typical reactions to a true spider bite include swelling, redness, pain, and itching, though some might hardly be noticeable.

How to care for a typical bite

1. Clean the wound with soap and water. Keep the wound clean until healed to prevent infection. 
2. Use a cold pack to reduce swelling and pain.
3. If the bite is on a leg or arm, rest with the leg or arm elevated.
4. Medications to consider: an antihistamine to keep the swelling isolated, a topical anti-itch cream and an over-the-counter pain reliever.

When to see a doctor

Some people have allergic reactions to spider bites. Seek immediate medical attention if a spider bite leads to difficulty breathing or swelling in the face and neck. Proper diagnosis is more likely if you are able to take a picture or capture the spider that bit you, even if it's no longer alive. Do not swat the spider against your skin.

Poisonous spiders are rare in Minnesota. Symptoms of a poisonous spider bite develop within 30 minutes to eight hours and include:

• Cramping
• Fever
• Nausea
• Severe pain
• An ulcer at the site of the bite

If a spider bite becomes seriously infected, contact your primary care doctor.

Three ways to prevent spider bites

1. Insect repellents on clothes and shoes can keep spiders away. Take special care to follow instructions when applying repellent to children, and don’t apply to children under 2 months old.
2. Keep the outside of your home clear of woodpiles and tall grass where spiders like to hide. Inside, ensure window and door screens are in good repair, seal any cracks where spiders can enter, and vacuum under beds and furniture.
3. When cleaning up areas of the house where spiders may live — including attics, basements, garages and gardens — wear a hat, gloves, long-sleeved shirts, pants, and close-toed shoes. Inspect items carefully before moving them.

Ticks

What’s normal

When ticks bite, it isn’t typically painful, but it is noticeable. Ticks remain attached to the skin and attempt to crawl underneath. It’s normal for a small bump to develop where you’ve been bitten, but not a rash.

How to care for a typical bite

Ticks are small – even as small as a poppy seed – so careful detection is key to removing them and preventing complications.

1. Using tweezers, grab the tick as close to your skin as you can.
2. Gently pull the tick straight out, making sure to pull out the entire insect. Do not jerk or twist, and avoid crushing the body.
3. Wash your hands and the bite site with soap and water.

It’s helpful to have a way to identify what kind of tick bit you, in case you develop an infection. You can photograph the tick before removing it, or place it in a small container and freeze it after removal.

When to see a doctor

Some ticks are known to carry disease, but not every tick bite requires a trip to the doctor. Dr. Monteiro explains:

“A black legged tick, also known as a deer tick, that has been attached for more than 24 hours is concerning, because these ticks can carry disease. After 24 hours, they’re more likely to transmit Lyme disease. Some studies indicate it could be less than 24 hours, which is why doctors recommend checking your skin for ticks every day. Personally, if I can pull the ticks off before that 24-hour mark, I feel pretty comfortable that I won’t get Lyme disease.”

Lyme disease symptoms usually show up three to 30 days after the tick bite. Contact your primary care doctor if:

• You can’t completely remove the tick that bit you.
• The tick has been under your skin for more than 24 hours.
• You develop flu-like symptoms, such as a fever, body aches or joint pain.
• You develop a rash, and the rash gets bigger or is shaped like a bulls-eye.
• The bite appears infected.

Three ways to prevent tick bites

Ticks tend to be found in areas with tall grass, bushes, and lots of trees and bite only when you brush up against the plants they're climbing. To prevent tick bites:

1. Use clothing as protection: wear a hat, long sleeves and closed-toed shoes, and tuck your pants into your socks to keep covered. Ticks can’t bite through clothes and are easier to see on light-colored clothing.
2. Insect repellents can keep ticks away. Take special care to follow instructions when applying repellent to children, and don’t apply to children under 2 months old
3. If you’re going to spend time in a wooded or grassy area, stay on paths and trails. Check your skin — and your pets — for ticks before you leave those areas and after you’ve gone inside. Showering within an hour or two can help you do a full inspection.

To visit a Fairview clinic, call 855-FAIRVIEW or pick a Fairview provider and choose from their available times. For HealthEast clinics, call 651-326-CARE.