From the Guidelines
For a horse fly bite causing a tender, hot, swollen elbow, you should first clean the area with mild soap and water, then apply a cold compress for 10-15 minutes several times daily to reduce swelling and pain, as recommended by the most recent guidelines 1. The management of acute reactions to insect bites is primarily symptomatic, focusing on alleviating the discomfort and reducing the risk of infection.
- Cleaning the area with mild soap and water is essential to prevent infection, as emphasized in the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
- Applying a cold compress can help reduce swelling and pain, which is a common recommendation for managing local reactions to insect bites, including those from horse flies 1.
- Over-the-counter antihistamines like diphenhydramine (Benadryl) 25-50mg every 6 hours or cetirizine (Zyrtec) 10mg once daily can help reduce itching and inflammation, as suggested by various studies on insect bite management 1.
- For pain relief, using acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil) 400-600mg every 6 hours with food is recommended, aligning with general guidelines for managing pain associated with insect bites.
- Applying a thin layer of 1% hydrocortisone cream to the bite area 2-3 times daily can help reduce inflammation, which is a common practice for managing local skin reactions. It's crucial to watch for signs of infection, such as increasing redness, warmth, swelling, pus, or red streaks extending from the bite, which would require medical attention, as infection can lead to more severe complications if not properly managed 1. Horse fly bites can cause significant local reactions due to the anticoagulants and other irritating compounds in their saliva, which trigger inflammation, but most reactions improve within 3-7 days with appropriate measures, and medical care should be sought if symptoms worsen or if fever, extensive swelling, or severe pain develops.
From the Research
Symptoms and Reactions
- A horse fly bite can cause a tender, hot, swollen elbow, as well as other symptoms such as pain, erythema, and pruritus at the site of the bite 2, 3, 4.
- In some cases, horse fly bites can cause systemic reactions, including anaphylaxis, which can be life-threatening 5, 3.
Treatment and Management
- Topical corticosteroids can be effective in treating the symptoms of a horse fly bite, such as pain and inflammation 2, 4.
- Antihistamines can also be used to relieve symptoms such as pruritus and erythema 2, 4.
- In cases of anaphylaxis or severe systemic reactions, treatment with adrenaline, intravenous antihistamines, and corticosteroids may be necessary 5, 3.
- It is essential to monitor for signs of infection, such as sepsis, and to use antibiotics judiciously to avoid unnecessary use 4.