What Insect Bit Me?

This patient was bitten by a mite or bug called Chiggers or Trombiculid mites.  They are also called berry bugs, harvest mites, red bugs or scrub-itch mites. The usual reaction to insect or chigger mite bite is a small itchy bump (papule) or a hive or even a blister. Chigger bites usually cause lesions that are often in a group and on the lower leg. They also occur next to elastic barriers on the skin from tight fitting clothing. They are therefore also found at the waist or near elastic waistbands. Other favored areas for chigger bites are close to the groin, behind the knees, or in the armpits where the skin is thinner. This patient had the rare bullous reaction (fluid-filled sac), seen with insect and chigger bites.

He was treated with OreganKnow healing ointment. More about treatment of chigger bites later.

The larva stage of biting chiggers are reddish-orange in color and have 6 legs.

After they have a blood meal they drop off from the skin and become adults with eight legs. Chigger bites are extremely itchy especially if the person has been exposed in the past. Some boys get a swollen itchy penis with burning on urination from chigger bites. This is called Summer penile syndrome.

Chiggers love moist grassy areas such as near to a lake or a river but also are found in fields of grass and next to forests and gardens. The larva is ready to bite for a blood meal during warm weather like later spring, summer, and early fall. They are found in the south, mid-west and south-east USA but bites are reposted as far north as New York State and as far west as Colorado.

Bullous bite reactions on the skin are seen from many bugs that suck blood for a meal. Insects, such as cat and dog fleas, bed bugs, mosquitoes and the larval (immature) stage of the chigger mite.

The saliva from the bite of these organisms results in a local allergic reaction. Bullae especially occur when there is a lot of salvia exposure in a susceptible individual who was exposed to the same saliva in the past. Rarely, this fluid filled bullous reaction to bites can be the first sign of underlying blood cancer such as leukemia.

Treatment and avoidance of Chigger bites.

1.Wash the bullous or blistering bite reaction with soap and water and apply OreganKnow healing ointment two times a day until the rash heals. This will soothe the area of the bite, prevent a secondary infection, speed healing and minimize scarring. The OreganKnow healing ointment also helps even if there are no blisters but just itchy bumps.

2.Topical steroids, such as OTC 1% hydrocortisone ointment is also sometimes needed to decrease severe itching of fresh bite papules or bumps. 

3. Sometimes OTC oral antihistamines are needed to manage itching.

4. For very severe itching visit your dermatologist for a prescription, more powerful topical steroid or even oral steroids

5. Treatment of exposed skin with DEET is a useful strategy for prevention.

6. Apply Permethrin to clothing, hiking boots, and your backpack. These are not to be applied to the skin and are sold under the brands Permanone and Duranon.

7. Wear long pants with sneakers or hiking boots. 

8. Choose tightly woven fabrics for working or walking in chigger-infested areas. 

9. Stay on the trial avoiding meadows or other high vegetation areas.

10.  Avoid Chigger-Infested Places