Definition

• Stung by a fire ant
• Fire ant stings are more common in the Southern U.S.

Health Information

Symptoms

• Pain, burning, swelling and redness at the sting site.
• Pain and burning at the site usually lasts 10 minutes. The intensity is far less than that of a bee sting.
• Itching follows the pain and can last for weeks.
• Hive-like bump occurs at sting site within 30 minutes (100%). This looks like a red spot with raised white center.
• Pimples with yellow fluid (pustules) occur at the sting site within 24 hours (96%). These pustules are almost diagnostic for fire ant stings. They are very itchy. They usually open on their own by 3 days. Then, they dry over. Sometimes, they can last for up to a week.
• Swelling. Normal swelling from venom can increase for 24 hours after the sting. Stings of the upper face can cause severe swelling around the eye. This is harmless.
• Severe or Extreme Swelling. Sometimes, fire ant bites can cause severe swelling. Hand or foot bites can cause swelling that crosses the wrist (or ankle). The degree of swelling can interfere with function and require steroids. These do not carry an increased risk of allergic reaction with future stings.
• Redness. Stings can normally become red. That doesn’t mean they are infected. Infections rarely occur in stings.

Cause

• The sting involves injecting venom into the human from the fire ant’s stinger.
• A fire ant attaches to the skin with its jaws and swivels its body. It stings multiple times with its back stinger.
• One fire ant can leave a semi-circular pattern of several stings.
• Symptoms are all from the venom.

General Information About Fire Ants

• In infested areas, fire ants cause many more stings than bees or yellow jackets.
• Over 50% of people living in infested areas are stung each year.
• Fire ants are found throughout the Southern U.S., from Florida to Texas. More recently, they have also appeared in California, New Mexico and Arizona.
• Colonies of fire ants live in small mounds of dirt, usually 6 inches tall.
• When the mound is disturbed, hundreds of fire ants stream out and attack.
• The fire ant causes an immediate ‘burning’ sensation at the site of the stings. This is how it got its name.

Prevention of Fire Ant Stings

• Avoidance of fire ants is the only way to prevent stings.
• Teach your children to recognize their colonies (mounds) and to keep their distance.
• Insect repellents (including those containing DEET) are not effective in preventing fire ant stings.
• Wear socks. Fire ants cannot bite through socks.

Care Advice

1. Overview:
   • Pain from a fire ant sting is less severe than with a bee sting. It’s usually gone in 10 minutes.
   • Fire ant stings normally develop a pimple and become red. That doesn’t mean they are infected.
   • Here is some care advice that should help.
2. Pain:
   • For pain relief, can give acetaminophen OR ibuprofen if needed.
3. Steroid Cream:
   • For relief of itching, apply 1% hydrocortisone cream. Use 3 times per day. No prescription is needed.
4. Allergy Medicine for Itching:
   • For severe itching or swelling, give Benadryl by mouth. No prescription is needed.
   • Use 3 times per day as needed.
5. Pustules (Pimples):
   • By 24 hours, a small blister (sterile pustule) will form over the sting.
   • Do not open them.
   • Try not to scratch them.
   • If you open the blisters, they often become infected.
   • Left alone, they usually dry up in 4 days.
6. Antibiotic Ointment:
   • If the pimples break open, apply an antibiotic ointment. No prescription is needed.
   • Use 3 times per day to prevent skin infections. Continue for 1 or 2 days.
7. What to Expect:
   • Severe pain or burning at the site lasts 5 to 10 minutes.
   • Itching follows the pain and is the main symptom. It can last a week.
   • Swelling: Normal swelling from ant venom can increase for 24 hours following the sting.
   • The redness can last 3 days and the swelling 7 days.

Call Your Doctor If

• Redness lasts over 3 days
• Swelling becomes huge or spreads beyond the wrist or ankle
• Sting begins to look infected (redness gets larger after 48 hours)
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

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