What is the treatment for an insect bite?

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Last updated: May 23, 2025View editorial policy

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From the Guidelines

To treat insect bites, the most effective approach is to wash the affected area with soap and water, apply a cold compress for 10 minutes to reduce swelling and pain, and use over-the-counter antihistamines like diphenhydramine (Benadryl) 25-50mg every 4-6 hours or cetirizine (Zyrtec) 10mg once daily to reduce itching and inflammation, as recommended by the Journal of Allergy and Clinical Immunology 1. When it comes to treating insect bites, it's essential to prioritize reducing the body's inflammatory response to insect saliva or venom.

  • Washing the affected area with soap and water is a crucial first step to prevent infection.
  • Applying a cold compress for 10 minutes can help reduce swelling and pain.
  • Over-the-counter antihistamines like diphenhydramine (Benadryl) 25-50mg every 4-6 hours or cetirizine (Zyrtec) 10mg once daily can help reduce itching and inflammation.
  • Topical treatments such as 1% hydrocortisone cream applied 2-3 times daily for up to a week, or calamine lotion as needed, can provide additional relief.
  • For pain, acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil) 200-400mg every 6 hours can be effective. It's also important to note that patients who have experienced a systemic reaction to an insect sting should carry epinephrine at an appropriate dosage for administration in case of a sting, as recommended by the Journal of Allergy and Clinical Immunology 1. In terms of prevention, venom immunotherapy (VIT) is an extremely effective form of treatment for subjects at risk of insect sting anaphylaxis, reducing the risk of a subsequent systemic sting reaction to as low as 5% compared with the risk of such reactions in untreated patients, as stated in the Journal of Allergy and Clinical Immunology 1. However, the most critical aspect of treating insect bites is to seek medical attention immediately if severe symptoms develop, such as widespread rash, difficulty breathing, swelling of face or throat, dizziness, or if the bite area becomes increasingly red, swollen, or painful, as these may indicate an allergic reaction or infection requiring prescription medication.

From the FDA Drug Label

Emergency treatment of allergic reactions (Type I), including anaphylaxis, which may result from allergic reactions to insect stings, biting insects, foods, drugs, sera, diagnostic testing substances and other allergens, as well as idiopathic anaphylaxis or exercise-induced anaphylaxis. Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: ... insect bites For the treatment of insect bites,

  • Epinephrine (IM) 2 is used for emergency treatment of allergic reactions, including anaphylaxis caused by insect bites.
  • Hydrocortisone (TOP) 3 is used to temporarily relieve itching associated with minor skin irritations and inflammation due to insect bites.

From the Research

Insect Bite Treatment Overview

  • Insect bites can cause local reactions, immune reactions, and secondary bacterial infections 4
  • The consequences of insect bites include anaphylaxis and infections such as impetigo and cellulitis 4

Treatment Options

  • Many preparations are available over the counter (OTC) in the UK, including antihistamines and topical corticosteroids 4
  • However, there is a lack of evidence for the efficacy of these treatments 4
  • Recommendations for treatment are generally based on expert opinion and clinical experience 4

Common Insect Bites

  • The study focuses on simple insect bites, excluding ticks, mites, and lice 4
  • Simple insect bites are those that do not cause anaphylactic shock or systemic infection 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Management of simple insect bites: where's the evidence?

Drug and therapeutics bulletin, 2012

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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