Conditions
Bug bites Puerto Rico guide: mosquitoes, no-see-ums, fire ants and centipedes
Most bug bites Puerto Rico visitors and residents get can be cared for at home: wash with soap and water, use ice and try not to scratch. If a bite looks infected, the itching keeps you up, or you get a fever after mosquito bites, our doctor can see you by video. For trouble breathing or swelling of the face or throat, call 911.
Is it an emergency? Call 911.
Pay now, then choose your time right away. Full refund if you cancel 24 hours or more ahead.
See the cancellation policy
You can cancel for a full refund or change the time up to 24 hours before your visit. Within 24 hours you can't cancel and there's no refund. If you don't join in the first 10 minutes, there's no refund.
If you choose a time less than 24 hours away, it can't be cancelled or changed.
If the clinic can't see you, for example because of a technical problem on our side, we refund you in full.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Trouble breathing, wheezing, a tight throat, or swelling of the face, lips or tongue (call 911)
- Dizziness, fainting or hives all over the body after a bite or sting
- A very large number of fire ant stings at once, especially in a child
- Fever with pain behind the eyes or body aches after mosquito bites (possible dengue)
- Spreading redness, pus, warmth or fever around a bite
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At a glance
Bug bites
Common symptoms
- Pain or burning
- Redness and swelling
- Itching
- Numbness or tingling
- Other names
- Insect bites and stings · Mosquito bites · No-see-um bites · Fire ant stings · Centipede bite
- Treatment
- Home care with washing, cold and an antihistamine; other medicine only when the medical evaluation calls for it
- Possible complication
- Skin infection; severe allergic reaction (anaphylaxis)
On this page(10)
Bug bites Puerto Rico: what bites here
On the island, the most common bites come from mosquitoes, no-see-ums (tiny, almost invisible biting insects locals call *mimes*), fire ants (*hormigas bravas*) and, now and then, a centipede or a bee.
According to MedlinePlus, a bite or sting causes pain, redness, swelling, itching, burning, numbness or tingling at the spot. It is almost always a local reaction that clears up on its own in a few days. What matters is a severe allergic reaction (anaphylaxis), infection from scratching, and the diseases mosquitoes carry, such as dengue and Zika, a risk in pregnancy: see Zika and pregnancy.
How we treat bug bites by video
You see Dr. Diana Nieves Castro, a Puerto Rico-licensed general practice physician with several years of emergency-department experience, in English or Spanish. On video the doctor looks at the bites, asks when and where you were bitten and whether you have a fever or allergies, and checks for infection or a more serious reaction.
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you, such as a dengue test if you have a fever. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. If a bite has become infected, read about skin infection (cellulitis). According to the CDC, a staph infection can look like a red, swollen, painful bump full of pus that is sometimes mistaken for a bite: see boil, and don't squeeze it.
We see tourists and residents of all ages; see our care for tourists and visitors. You need to be physically in Puerto Rico during the visit. If the patient is under 21, a parent or legal guardian stays on camera for the whole visit and shows photo ID.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Video doctor visits 24/7 — book online and choose your time right away.
Request your visit.
Book a visit, choose "Doctor visit" and pay by card.
See the doctor.
We send you a secure video link. It works on your phone, tablet or computer. Good light helps the doctor see the bites.
Get your plan.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy; if a test would help, you get a lab order.
What the visit costs
A doctor visit has the same price for every age, with no membership. Your card is charged when you request the visit, and you get a full refund if the clinic can’t see you. We do not bill insurance; on request we give you an itemized receipt (superbill). See all prices.
Bug bite symptoms
According to MedlinePlus, at the bite or sting you may have:
- Pain or burning
- Redness and swelling
- Itching
- Numbness or tingling
What to do for each kind of bite
Mosquitoes and no-see-ums. MedlinePlus advises washing with soap and water, applying ice wrapped in a cloth for 10 minutes at a time and, if needed, an antihistamine. Try not to scratch: broken skin can get infected.
Bees and wasps. If a stinger is left in, scrape it out sideways with the edge of a credit card rather than tweezers, per MedlinePlus. Then wash and apply ice.
Fire ants. According to the Merck Manual, the sting causes immediate pain and a red, swollen area that fades within about 45 minutes; then a small blister forms, breaks in 2 to 3 days and often becomes infected. Don't pop it, and keep it clean.
Centipedes. According to the Merck Manual, larger centipedes can give a painful bite with swelling and redness that rarely lasts more than 48 hours. An ice cube wrapped in plastic and a thin cloth usually eases the pain.
If itching or swelling keeps you up at night, or a bite looks infected, the doctor can evaluate you and, if appropriate, prescribe.
Fever after mosquito bites
The Aedes aegypti mosquito spreads dengue in Puerto Rico. If you get a fever in the days after being on the island, especially with pain behind the eyes, body aches or a rash, read about dengue in Puerto Rico and get checked. Don't take aspirin or ibuprofen until you have been evaluated.
How to prevent mosquito bites
The CDC recommends:
- An EPA-registered repellent with DEET, picaridin, IR3535, oil of lemon eucalyptus (OLE), PMD or 2-undecanone. For Puerto Rico, the CDC advises 20% DEET or more.
- Sunscreen first, repellent second.
- Long sleeves and long pants, ideally treated with permethrin.
- Screens on windows and doors, and emptying standing water weekly from tires, buckets, flowerpot saucers and toys.
- For children: no OLE or PMD under age 3, and apply repellent with your own hands, never to their hands, eyes or mouth.
Severe allergic reaction: when to call 911
According to MedlinePlus, anaphylaxis starts within seconds or minutes: trouble breathing, wheezing, a tight throat, swelling of the face, eyes or tongue, hives, dizziness or fainting. Call [911](tel:911) right away. If the person has an epinephrine auto-injector, use it immediately.
According to the Merck Manual, people who know they are allergic to stings should always carry their prescribed epinephrine. See also when to go to the ER.
Why a video visit
| Comparison | By video | Emergency room |
|---|---|---|
| Getting there | From home: join from your phone, tablet or computer. | Drive and find parking. |
| Hours and time | Every day, any time (Puerto Rico time). Video doctor visits 24/7 — book online and choose your time right away. | In Puerto Rico, a median of 4 h 52 min from arrival to departure for patients sent home (US: 2 h 42 min; Oct 2024–Sep 2025).1,2 |
| Price | $79 visit · $49 follow-up · $35 forms. You see it before you pay; no insurance needed. | Depends on your insurance and on what is done. |
For problems that are not emergencies. In an emergency, call 911.
Table sources
- 1. CMS Care Compare, “Timely and Effective Care – State”, measure OP-18b: median time in the emergency department, arrival to departure, for patients sent home (opens in a new tab), data for Oct 2024–Sep 2025 (accessed 2026-10-02)
- 2. CMS Care Compare, “Timely and Effective Care – National”, measure OP-18b (US figure) (opens in a new tab), data for Oct 2024–Sep 2025 (accessed 2026-10-02)
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
What should I do for a fire ant sting?
Is a centipede bite dangerous?
What insect repellent should I use in Puerto Rico?
When is a bug bite an emergency?
Related topics
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-02 · Updated: 2026-10-11
Sources (9)
- Insect bites and stings (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Anaphylaxis (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Bee, Wasp, Hornet, and Ant Stings (Merck Manual) (opens in a new tab) (accessed 2026-10-02)
- Centipede and Millipede Bites (Merck Manual) (opens in a new tab) (accessed 2026-10-02)
- Dengue: Treatment (CDC) (opens in a new tab) (accessed 2026-10-02)
- Preventing Mosquito Bites (CDC) (opens in a new tab) (accessed 2026-10-02)
- Puerto Rico: traveler information (CDC) (opens in a new tab) (accessed 2026-10-02)
- About Zika (CDC) (opens in a new tab) (accessed 2026-10-02)
- About MRSA (CDC) (opens in a new tab) (accessed 2026-10-09)