This week's guest columnist is Bradley Ber, MD, family practice resident at the Ochsner University Hospital & Clinics.
Spring has come early, tricking flowers and trees into bloom. The coulee creatures are coming out as well. I killed my first mosquito in the house last night.
One spring, a childhood friend inherited an old mud boat from his great-uncle. We spent the Sunday after Lenten Mass fixing it up. The next day at school, he said, “Man, my behind is hurting!” We figured he leaned against a bolt for too long. Later, he confessed, “I got a black spot there now!” Next time at the boat, we found the culprit: a brown recluse spider had made its home underneath the seat. My buddy's butt recovered, but we learned a lesson: look under things before you put your hands or other parts there.
When kids get abscesses (aka boils), parents often assume they're spider bites. However, brown recluse bites act differently. Like on my buddy's backside, the bite develops a black spot where the spider venom eats away skin. Then it opens like a crater, eventually filling back in as it heals. Abscesses start with any break in the skin, sometimes as innocuous as a scrape or scratch. Then bacteria residing on the skin's surface get into the break and spread; there is no black spot. A pus-filled boil develops, ruptures and then heals without crater formation.
If abscesses don't pop and continue growing, that needs attention. We often lance the abscess and may start an antibiotic. Either way, home treatment for spider bites or boils is the same: wash with soap and water after a warm soak. If fluid forms under the skin, you can try to drain it yourself after softening the skin with that warm soak. If it ruptures, wash it again and bandage it.
Being from Thibodaux, I love hunting and fishing. Mosquitoes love hunting and fishing too, or at least the humans who do. A lot of yummy, blood-filled victims sitting still in their boats and blinds. Mosquitoes are like family: annoying, but they carry your blood (get it?)!
Some people claim that mosquitoes "love" them more than others, and they're right. Recent research has revealed that mosquitoes do find some humans to smell better and bite them preferentially. Also, some people just think mosquitoes like them better because they itch worse and swell more. This doesn't mean they taste better; their skin's response just makes them notice the bite more than their neighbors.
Like we said above, most abscesses aren't from spider bites. Actual brown recluse bites look and act differently than boils. Boils happen with any break in the skin; bacteria on the skin surface get into scratches and spread, causing redness, swelling, pain and pus. Most boils are due, not to spiders, but to mosquito bites that cause kids to scratch and tear their skin.
Treating mosquito bites is important to prevent children from scratching too much. Itching can also drive kids crazy, particularly at night when they're trying to sleep. First, wash the bite site with soap and lukewarm water. Hot water might prevent infection but can make itching worse. After washing, apply a moisturizer. Give your child medicine, like loratadine (Claritin) or cetirizine (Zyrtec), or Ibuprofen or Tylenol, to take the edge off the itching. When kids go outside, apply DEET-containing repellent to their skin and clothes. Those pests (the mosquitoes I mean) can bite through thin clothes!