Decoding Red Skin Bumps: Bug Bite or Something More?

While many red bumps on the skin turn out to be no big deal, some can be a sign of something more serious. Here, Cameron Rokhsar, MD, spokesperson for the American Academy of Dermatology, breaks down five common causes behind bumps, how to treat them, and the warning signs you should never ignore.

BUG BITE

What it looks like: A bite’s appearance depends on the type of critter that nipped you. It could run the gamut from a line of three red bumps (a classic sign of a spider bite) to a small welt (a mosquito bite) to a studding of tiny pus-filled bumps (ant bites) to a single pink or red bump (bee sting).

At-home treatments: Whether the bite is from a mosquito, a spider, fire ants or some other critter, wash and clean the affected area with an antibacterial soap and apply an over-the-counter 1% hydrocortisone cream for a few days to reduce redness and inflammation.

When to call the doctor: If there is no improvement after a few days, or the condition worsens, it’s time to see a dermatologist for a prescription strength hydrocortisone cream. Also alert your doctor to changes in the bite site or your health, especially after a mosquito or tick bite. Zika virus and West Nile virus, for example, can both be transmitted from mosquitos and can result in such symptoms as fever, headache, joint paint or a rash. A red, bulls-eye rash that appears around the site of a tick bite could be a sign of Lyme disease.

FOLLICULITIS

What it looks like: This inflammation of the hair follicle presents as a red, swollen bump. It can be the result of trauma, waxing, shaving, threading or a bacterial infection.

At-home treatments: The best course of action is to wash the area with antibacterial soap, Dr. Rokhsar says, and skip the OTC antibiotic ointments, it will heal itself over time. “These will further clog the follicle,” he explains. If you see any ingrown hairs, don’t try to remove them, as this could cause further inflammation.

When to call the doctor: If the affected area looks worse after a few days, visit a dermatologist. Further along folliculitis usually responds to a prescription-strength topical cream or oral antibiotic.

SCABIES

What it looks like: Scabies is caused when tiny mites (Sarcoptes scabiei) burrow and lay eggs inside the skin. This results in a smattering of small red bumps and severe itchiness that may keep you awake at night. “Since the mites are barely visible, this condition is difficult to diagnose, even for primary care physicians,” Dr. Rokhsar says.

At-home treatments: Forget the OTC remedies—instead, make an appointment with a board certified dermatologist who will treat the scabies with anti-scabies pills and cream.

When to call the doctor: When you suspect you have them—scabies is highly contagious.

BOIL

What it looks like: This skin infection occurs around an oil gland or hair follicle and looks an awful lot like a big pimple—red, swollen, tender and pus-filled. Multiple boils, called carbuncles, may also crop up in the area.

At-home treatments: Resist the urge to pop it; squeezing could cause the infection to spread and even lead to scarring. Instead, the AAD recommends applying a warm compress for 10-15 minutes, three or four times a day for a week or two, until the pus is expressed. Once that happens, cover the wound with sterile gauze or a bandage to prevent infection, and keep the area as clean as possible. You can also take acetaminophen or ibuprofen for the pain.

When to call the doctor: If pain or swelling worsens, the boil hasn’t resolved itself after a few weeks, you develop a fever, or multiple boils crop up, call your dermatologist. “Such infections may require oral antibiotics and the expertise of a dermatologist to drain them,” Dr. Rokhsar says.

CELLULITIS

What it looks like: The classic signs of this common, potentially serious bacterial skin infection include swelling, redness, pain and skin that is hot to the touch. While primarily found in the lower legs, cellulitis can affect all parts of the body.

At-home treatments: None. “Do not treat cellulitis at home,” Dr. Rokhsar advises. “Rather, seek the help of a board-certified dermatologist. Usual treatment includes oral or intravenous antibiotics.”

When to call the doctor: When you suspect you have it. Left untreated, cellulitis can spread to the lymph nodes and bloodstream.