Worse Than Red Ants?

Red Velvet Ants. I'd always heard about them, but finally last week I saw a victim: Dad brought in his 4-year-old daughter who was stung at a picnic table. He described a large black spider or ant with red stripes crawling out between the boards, stinging her on the arm, and crawling back in. She yelped in pain, and soon the spot was swollen and red. Since spider bites don't cause immediate pain and swelling, I knew my culprit. Red velvet ants aren't actually ants, but wingless wasps. Their nickname, “cow killer,” comes from their sting being so painful it could “kill a cow.”

In the summer, kids get attacked by all kinds of little beasts: wasps, bees, ants. In the Pediatric ER at Ochsner Lafayette General Medical Center, we mostly see infected mosquito bites because there are a lot more mosquitoes. You don't even need to go outside to get bitten. The tiny horrors slip inside through open doors and broken screens to find their next meal. The bites itch, so children scratch. If their skin or fingernails aren't clean (are they ever?), that scratching tears the skin and drives in bacteria.

The best treatment, far better than antibiotics, is prevention. Keep mosquito populations down by eliminating breeding spots: still water. Empty out buckets, old tires and ensure water features like ponds and birdbaths have fountains or drippers to discourage mosquito larvae development. Mow regularly: long wet grass hides larvae too. Keep kids' skin clean and soft with moisturizing soaps and lotions and keep fingernails short. Always apply insect repellent when outside.

Red ant, wasp, bee and caterpillar bites are harder to prevent. Statistically, any given summer, your child will get bitten by something! Wash bites with soap and cool water, apply cold clothes, and give ibuprofen or Tylenol. These bites rarely get infected. Wasp stings often swell more on the second day, but not from infection.

Now it’s summer rashes. My worst rash occurred when I was in medical school. I took a tropical medicine elective in the Philippines. I also visited the beach. The sun is so strong there near the equator that one day my shoulders got sunburned so badly they blistered. Blistering means second-degree burns, where skin layers separate. I spent the next few days lying indoors on my stomach, smearing on salves and popping ibuprofen around the clock.

Most sunburns are first-degree burns, where only the top layer of skin is cooked. They still sting and take days to heal. We often see children in the Ochsner Lafayette General Medical Center ER because sunburns can be so painful. I don’t judge people with sunburned infants either—it happened with my first baby. We took her to the beach at three weeks old and took all the precautions (so we thought): hat, tent, light blanket covers. We didn't figure on sunlight reflecting off the water, angling up underneath all that protection!

Of course, you'll do everything to prevent sunburns, but sometimes you just forget or you’re out so long that sunscreen sweats off. Fortunately, treatment is easy—cool washes, aloe-based ointments and ibuprofen or Tylenol.

In summer, we also see lots of “contact dermatitis,” aka “poison ivy.” Contact dermatitis means skin irritation from oil on plant leaves. The itchy rash tends to be streaky since kids brush the offending plants when crashing through foliage while fetching lost balls. It’s also found only on skin-exposed areas like faces and arms. Did we mention it itches like crazy? If topical salves like calamine or Benadryl by mouth don’t help, we often prescribe prednisone, a steroid, to decrease inflammation while things heal. Myth buster: steroid injections, like cortisone, don’t work faster than prednisone pills or liquids; shots are unnecessary! Ibuprofen or Tylenol can ease itching too.