From the Guidelines
To treat insect bites, first wash the affected area with soap and water, and apply a cold compress for 10 minutes to reduce swelling and pain, as most insect stings cause transient localized reactions that are of little serious medical consequence 1.
Insect Bite Treatment
The primary goal of treating insect bites is to alleviate symptoms and prevent complications.
- Wash the affected area with soap and water to prevent infection.
- Apply a cold compress for 10 minutes to 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 1.
- 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.
- Avoid scratching to prevent infection.
- For pain, acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil) 200-400mg every 6 hours can be effective.
Special Considerations
- Fire ant stings typically cause a sterile pseudopustule within 24 hours after a sting, which should be left intact and kept clean to prevent secondary infection 1.
- Patients who have experienced a systemic reaction to an insect sting should be educated in avoidance of stinging insects, carry epinephrine for emergency self-administration, and undergo testing for specific IgE antibodies to stinging insects 1.
- Venom immunotherapy (VIT) is recommended for all patients who have experienced a systemic reaction to an insect sting and who have specific IgE to venom allergens 1.
When to Seek Medical Attention
- Seek medical attention if you develop severe swelling, spreading redness, fever, difficulty breathing, or if symptoms worsen after 24-48 hours, as these may indicate an allergic reaction or infection requiring prescription medication 1.
From the FDA Drug Label
Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: ... insect bites
- Hydrocortisone (TOP) can be used to temporarily relieve itching associated with insect bites.
- The treatment is intended for minor skin irritations and itching caused by insect bites.
- It is recommended to use the product under the advice and supervision of a doctor for other uses [ 2 ].
From the Research
Insect Bite Treatment Overview
- Insect bites can cause local reactions, immune reactions, and secondary bacterial infections [ 3 ]
- The consequences of insect bites include anaphylaxis and infections such as impetigo and cellulitis [ 3 ]
Treatment of Simple Insect Bites
- Simple insect bites are those that do not cause anaphylactic shock or systemic infection [ 3 ]
- Various over-the-counter (OTC) preparations are available for treatment, including antihistamines and topical corticosteroids [ 3 ]
- However, there is a lack of evidence for the efficacy of these treatments, with recommendations often based on expert opinion and clinical experience [ 3 ]