Most settle on their own. The useful skill is telling a normal reaction from infection or true allergy.
Assessed and treated by a GMC-registered GP
Prescriptions, sick notes and referral letters included
A written treatment plan after every appointment
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
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Most insect bites and stings cause a local reaction that looks alarming and is entirely normal. Redness, swelling, heat and itching around the site are the immune system responding to injected saliva or venom — not an infection, and not an allergy.
The genuinely useful skill is distinguishing three things:
The timing is the clue. Reactions that peak and settle over two days are normal. Reactions that start improving and then worsen are infected.
Swelling extending well beyond the bite — sometimes a whole forearm. Dramatic, uncomfortable, and still not an allergy. It settles over several days.
People genuinely differ in how strongly they react, and in how attractive they are to mosquitoes — this is real rather than imagined, and largely down to skin chemistry.
Multiple itchy bumps appearing in crops, especially on a child, may be papular urticaria — an exaggerated reaction to bites that can go on for weeks and is frequently mistaken for repeated new bites or scabies.
Diagnosis is from the appearance and, above all, the timeline — which makes this well suited to assessment from good photographs.
What we ask: when it happened, what bit or stung you, how it has changed day by day, whether you feel unwell, and where you have been — travel and tick exposure change things considerably.
Drawing around the edge of the redness with a pen and noting the time is genuinely useful. It converts "I think it is spreading" into an objective observation, and it is what we will often ask you to do.
Tests are rarely needed. Where infection is spreading, treatment is started on the clinical picture. Allergy testing is for people who have had a systemic reaction to a sting, not for large local swellings.
Most bites and stings need no prescription at all, and we will say so.
We will not prescribe antibiotics for a normal inflammatory reaction, which is what most "infected-looking" bites at 24 hours actually are. A prescription is never guaranteed.
Carry your adrenaline auto-injector at all times, and check the expiry date. Make sure people around you know where it is and how to use it. Venom immunotherapy exists and is highly effective — ask about referral.
Almost everything that helps here is over the counter and inexpensive. Antihistamines, hydrocortisone cream and a cold compress cost a few pounds between them, and a pharmacist can advise without an appointment.
NHS care is free and appropriate for anything infected, and anaphylaxis is a 999 emergency where nothing private has any role.
Where a private consultation genuinely earns its fee:
This page follows NICE Clinical Knowledge Summaries on insect bites and stings and on cellulitis and erysipelas, and NICE NG95 on Lyme disease for tick exposure and erythema migrans.
The distinction between a large local reaction and systemic allergy, and the recommendation for venom immunotherapy referral after a systemic sting reaction, follow BSACI guidance.
DEET is the repellent with the strongest evidence base, and the advice on sunscreen order and on tick removal technique follows UKHSA guidance.
The caution against topical antihistamine preparations reflects their recognised potential to cause contact sensitisation.
The timing tells you. A normal reaction is worst at 24 to 48 hours then improves. Something that starts improving and then gets worse after day two or three is likely infected — particularly with spreading redness, increasing pain or fever.
Almost certainly not. That is a large local reaction — dramatic but not dangerous, and it does not mean the next sting will be worse. True allergy affects the whole body — breathing, throat, widespread rash — within minutes.
Because they genuinely do prefer some people, largely due to skin chemistry and the compounds you give off. It is not imagination, and repellent is the answer rather than diet changes.
Fine-tipped tweezers or a tick tool, gripping as close to the skin as possible, pulling steadily upward. Do not burn it, smother it or twist it. Wash the area afterwards and note the date.
An expanding circular or bull's-eye rash days to weeks after a tick bite needs treating for Lyme disease, whether or not you feel unwell. Do not wait for a blood test to be positive.
Usually not. Most red, swollen, hot bites at 24 hours are inflamed rather than infected. Antibiotics are for genuine spreading infection.
That is often papular urticaria — an exaggerated reaction to bites that appears in crops and can persist for weeks. It is frequently mistaken for new bites or scabies, and it settles with time and antihistamines.
September 8, 2026
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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