What Chigger Bites Look Like, Care, and Preventative Measures

The chigger (trombiculidae) is a mite closely related to spiders and ticks. Chiggers are so small that they are difficult to see with the naked eye. Larvae of the chigger mite feed on the skin of their host (human or animal) until they mature into adult mites and fall off. Chiggers are an outdoor insect that feeds on blood and can be found on plants in grassy or wooded areas near water. Hotter summers mean more activity from these creatures.

Chigger Bites: What Are They?

The larvae of chiggers attach to fibers in clothing and crawl to the skin. The chigger larva injects a digestive enzyme (a liquid chemical) into the skin, killing the skin cells. The chigger uses the tiny straw-like structure (stylostome) formed by the dead skin cells to ingest the tissue beneath your skin. The itch caused by the chigger's chemical is at its worst within the first 24 to 48 hours, subsiding gradually over the next two weeks. Scratching will cause the chiggers to fall off your skin.

The people who are susceptible to chigger bites

Anyone spending time in grassy, wet, or wooded areas may bring chiggers back to their home and be at risk for chigger bites.

Where can you find chiggers?

Chiggers attach themselves to your skin when you're in grass or a wooded area. Waistbands, bra lines, sock creases, and other areas of close contact between your skin and clothing are prime locations for their feeding. Chiggers usually bite in these locations:

• Ankles
• Lower legs
• In back of your shins
• Waist
• Groin

What is the incidence rate of chigger bites?

In the warm to hot summer months, chigger bites are extremely common. Chigger bites are extremely itchy, but many people don't bother to report them.

What kind of physical reactions should I expect from chigger bites?

Chigger bites are not always obvious. Symptoms may not appear for up to three hours after a mite has made contact with your skin. Scratching in the area around a bite from a chigger.

The effects of a chigger bite include:

• Red dots or pimples dotting your skin in a splotchy pattern.
• Bite marks found in concave areas where garments are snug
• Extreme itching

Chigger Bites: How They Happen

The following are examples of places you might encounter chiggers and suffer a bite:

• Wild, overgrown grasslands
• Forested regions
• Gardens
• Saturated ground close to water
• Places where the humidity is consistently high (80%+)

Those pesky chiggers will hop right off your clothes and onto your skin to start biting.

Chigger bites can be identified by their linear pattern and the areas where snug clothing has rested, both of which your doctor will notice during a visual examination. It will be easier to diagnose this condition if you can remember the specific outdoor locations where you were when the bites occurred, such as grassy, wet, or wooded areas.

Since chiggers don't embed themselves in the skin and the rash typically appears after the mites have detached from the skin, treatment to remove the mites is unnecessary. In contrast, the goal of treating chigger bites is to reduce itching, which can be accomplished by:

• Treatment with a topical cream or lotion (such as calamine lotion)
• Using antihistamines like diphenhydramine (Benadryl ®)
• Parasite-fighting drug (permethrin)
• Using an icy compress
• Washing the area with soap and water frequently

Antibiotics may be prescribed if red, swollen, or pus-filled skin develops as a result of persistent scratching.

The duration of chigger bites

Within the first 24 to 48 hours after a bite, you'll experience the worst itching. After two weeks, you should start to feel better.

Do chigger bites respond to any home remedies?

At-home remedies for chigger bites include applying an anti-itch cream, such as calamine lotion, and/or taking antihistamines. Because chiggers do not cause serious skin irritation by burrowing, there is no need for any additional home treatment.

When will I start to feel better after treatment?

Applying an anti-itch cream or taking an antihistamine will provide instant relief, but the symptoms may persist for up to two weeks, albeit with diminishing severity.

To avoid getting chiggers, you should:

• Covering up when outside (long-sleeved shirts, tall socks, long pants tucked into boots).
• Insecticides should be applied to clothing before going outside to keep bugs and mites at bay.
• Putting on some kind of insecticide or mosquito spray
• When temperatures are high in the summer, it's best to stay inside instead of spending time in grassy, wet, or wooded areas.

Bites typically occur in places where clothing fits snugly, such as sock lines and waistbands, so itchy skin is a common symptom. Usually, chigger bites go away on their own after a few days, but they can linger for up to two weeks.

Always apply an anti-itch cream or lotion to the bite site after you get bit. If you have the itch to scratch, you may want to shorten your fingernails first to prevent further irritation and possible skin tears. Clothing should be washed in hot water or treated with pyrethroid insecticides to prevent bites.

When should I next see my doctor?

If you have any of the following symptoms, see your doctor immediately:

• The itchiness is very bothersome.
• Scratching causes the bites to open up.
• After two weeks, the itch still persists.
• The area of skin around the bite becomes inflamed and may drain pus.

What Should I Discuss with My Doctor?

• Should I take an anti-parasite drug?
• What kinds of anti-itching creams or lotions do you recommend?
• Do antihistamines help with the itchiness?

In many ways, chiggers (or "red bugs") are similar to spiders (arachnids) and get their common name from that. Chigger characteristics that can be used to identify the insect are:

• Typically very small, averaging (3 mm)
• The larvae are yellow or orange, and the adults are a brilliant red.
• The larvae have six legs, and the adults have eight.

Where do chigger bites stand in relation to those of other common pests like bed bugs, fleas, and mosquitoes?

Bugs like chiggers, bedbugs, fleas, and mosquitoes can all bite and cause irritation.

• Chigger Bites: Chigger Bites appear as red spots or pimples and are very itchy. They tend to cluster along the seams of tight-fitting clothing.
• Infestations of bed bugs can cause itchy, red bumps on any part of your body that comes into contact with the bed, including your arms, legs, face, and back. They cause red bumps to appear on your skin, which at first cause pain or burning and then itching.
• Flea bites look like a zigzag pattern, and they tend to occur on the legs and waist. Flea bites look like tiny red dots and can be very uncomfortable.
• Mosquito bites are itchy red bumps caused by mosquitoes puncturing the skin. Bites from mosquitoes typically occur on arms and legs that haven't been covered with a repellent.

Please read this note from the Cleveland Clinic

When it comes to avoiding chigger bites, prevention is often easier said than done. You might not be able to enjoy the outdoors as much if you get to scratch the bites these tiny bugs leave on your skin. Fortunately, chiggers are easily brushed off the skin at the first sign of itching, and the itching and discomfort typically subside within the first 48 hours. Apply anti-itch cream to the bite to reduce irritation.

• Osteopathic Medical Association of the United States Chiggers (https://www aocd org/page/Chiggers) 6/7/2022 Access Date
• R.J. Pollack & S.A. Norton Arthropod Bites and Other Injuries Caused by Ectoparasites The authors (Jameson, Fauci, Kasper, Hauser, Longo, and Loscalzo) eds The 20th Edition of Harrison's Essentials of Internal Medicine (2018, McGraw-Hill) Last accessed on: 6/7/2022
• Schneir A, Clark RF. Punctures and Bites For inclusion in: Tintinalli JE, Ma O, Yealy DM, Meckler GD, Stapczynski J, Cline DM, Thomas SH. eds Study Guide for Tintinalli's Emergency Medicine, Ninth Edition A McGraw-Hill Publication, 2020 Last accessed on: 6/7/2022
• Alexander, L., Buckley, C.J. Stings Like Chiggers (https://www ncbi nlm nih gov/books/NBK538528/) [Apr. 30, 2022: Revised] Referenced in: StatPearls (Online Database) StatPearls Publishing; 2022 Jan. ; Treasure Island (FL): Checked on June 7th, 2022

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