A normal bite reaction (and what's not normal)

A typical bite from a mosquito, midge, or sand fly leaves a small red bump with intense itching. It comes up within minutes to hours, peaks at around 24 hours, and settles over two to three days. You may have several from one outdoor evening. Bee and wasp stings hurt more and swell more at first but follow the same broad pattern.

Three things change the picture.

  • A larger local reaction. Some people develop redness, swelling, and itch that spreads several centimetres beyond the bite, peaking 24 to 48 hours later. This is still a local reaction, not an infection, but it can be unpleasant and worth treating actively.
  • An infected bite. A bite that gets scratched and broken can be invaded by bacteria from the skin. The hallmarks are increasing redness, pain, warmth, and sometimes pus, building over days rather than hours, often with a red line tracking up the limb.
  • A systemic allergic reaction. The body reacts to the venom or saliva not just where the bite happened but across the whole body. This is much less common but much more serious. See the next section.

Anaphylaxis — call 112 first

Anaphylaxis — call 112 immediately

Any of these symptoms after a bite or sting need an ambulance, not an online consultation.

Difficulty breathing, wheeze, or noisy breathing. Swelling of the lips, tongue, mouth, or throat. A widespread rash, hives, or flushing across the body. Sudden dizziness, faintness, or collapse. A sense of impending doom. Vomiting alongside any of the above.

If the person has an adrenaline auto-injector (EpiPen or equivalent), use it immediately and still call 112. Lie the person down with their legs raised. Anaphylaxis can kill within minutes — call first, ask questions later.

The Holiday Doctor cannot help with anaphylaxis. The right place is hospital, by ambulance.

When you need to be seen in person

Beyond anaphylaxis, some bite reactions need in-person care rather than an online consultation.

Get seen in person — do not wait
  • Signs of significant skin infection — increasing redness, warmth, and pain spreading from the bite over days; pus; a fever; a red line tracking up the limb (lymphangitis)
  • A bite or sting near the eye, particularly if the eyelid is swelling closed
  • Multiple stings (more than ten), or a sting to the inside of the mouth or throat
  • Tick bite followed by a circular rash that expands over days, particularly if you have been hiking in northern Spain — possible Lyme disease, needs assessment and treatment
  • Fever, joint pain, or feeling generally unwell days after a bite, with or without rash — possible insect-borne infection
  • You are immunocompromised, diabetic, or have any condition that affects skin healing

For any of these, the right route is a Centro de Salud or Urgencias for proper examination.

What a Spanish pharmacy can do without a prescription

Spanish pharmacies are well stocked for bites and stings.

  • Cool compresses or after-bite gels for immediate relief of itch and swelling.
  • Mild hydrocortisone cream (1%) is over the counter in Spain and helps reduce redness and itch on a larger local reaction.
  • Oral antihistamines — loratadine, cetirizine, fexofenadine, bilastine — all OTC and useful for itch, particularly at night.
  • Antiseptic solutions (chlorhexidine, povidone-iodine) for cleaning a bite that has been scratched open.
  • Insect repellent for the rest of the trip — DEET, picaridin, or icaridin are all available in concentrations strong enough for the Spanish summer.

For most bites, this is enough. Stronger topical steroids, oral steroids, and antibiotics all require a prescription in Spain.

When prescription treatment is appropriate

Step up to a prescription consultation when:

  • A larger local reaction is not settling with OTC antihistamines and hydrocortisone over 48 hours.
  • An infected bite is developing — increasing redness, warmth, pain, and pus — and you need a course of antibiotics.
  • You have multiple bites with significant generalised itch disrupting sleep, and stronger antihistamine treatment would help.
  • A bite or sting is on a part of the body where swelling is causing real functional problems (the face, hands, around a joint).

What gets prescribed depends on what the bite looks like, where it is, what has already been tried, and your personal history. That decision sits inside the consultation, not on a web page.

How to get a Spanish prescription the same day

Public route: Centro de Salud

With an EHIC, a UK GHIC, or a Spanish tarjeta sanitaria, any Centro de Salud will see you for a bite reaction. The right route if there is any suggestion of significant infection.

Private in-person GP

A private GP appointment costs EUR 50 to 120 with same-day availability. Useful if you want a definitive examination of a bite that might be infected.

Online private consultation

For a clear large local reaction in someone otherwise well — no fever, no signs of spreading infection, no systemic symptoms — an online consultation can collect the relevant history and a photograph if helpful, and a prescription can be issued the same day if appropriate.

Not settling with pharmacy treatment?
Submit a consultation with a photograph if useful. Free initial assessment. EUR 50 only if our doctor approves and issues a prescription.
Start a consultation

The Holiday Doctor flow: complete the form (about five minutes), our doctor reviews it the same day within consultation hours, often with a short call or email to confirm a clinical detail. If a prescription is appropriate, it is issued through REMPe and collectable at any Spanish pharmacy.

Practical advice for the rest of the trip

  • Don't scratch. It feels good for ten seconds and turns most non-infected bites into infected bites within two days. Keep fingernails short.
  • Use insect repellent. A DEET or picaridin product applied to exposed skin in the late afternoon and evening will dramatically reduce mosquito and sand fly bites.
  • Cover up at dusk. Long sleeves and long trousers at sundown stop most bites before they happen.
  • Check beds and curtains for bedbugs if you are getting clusters of bites overnight — pharmacy treatment is the same, but your accommodation may have a separate problem to solve.
  • Watch the bites you have. Photograph anything that looks unusual on day one; if it is still expanding or looks different on day three or four, that is when an infected bite becomes obvious.
  • If you have started antibiotics, finish the full course even if the bite looks better.
Important. The Holiday Doctor does not assess anaphylaxis, severe systemic reactions, suspected Lyme disease, or any of the situations listed above. For severe allergic reactions, call 112 immediately.
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Most consultations are decided the same day. Free unless our doctor approves and issues a prescription.
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