From the Guidelines
For most bug bites, treatment involves managing symptoms until the bite heals naturally, with the most recent guidelines from 2024 recommending over-the-counter oral antihistamines and topical corticosteroids for local itching and pain relief 1. Start by washing the affected area with soap and water to prevent infection. Apply a cold compress for 15-20 minutes to reduce swelling and numb the area. Some key considerations for treatment include:
- Over-the-counter antihistamines like diphenhydramine (Benadryl) 25-50mg every 4-6 hours or cetirizine (Zyrtec) 10mg daily can help reduce itching and inflammation.
- Topical treatments such as calamine lotion, hydrocortisone cream (0.5-1%), or lidocaine gel provide additional relief when applied 2-3 times daily.
- For pain, acetaminophen (Tylenol) 325-650mg every 4-6 hours or ibuprofen (Advil) 200-400mg every 6-8 hours can be effective.
- Avoid scratching to prevent secondary infection. If the bite shows signs of infection (increasing redness, warmth, swelling, pus), or if you experience severe symptoms like difficulty breathing, dizziness, or widespread rash, seek immediate medical attention as these could indicate a severe allergic reaction or infected bite requiring antibiotics or emergency treatment, as highlighted in guidelines for stinging insect hypersensitivity 1. These treatments work by reducing the inflammatory response to the proteins in bug saliva that cause itching and swelling. In cases of anaphylaxis due to a bee, wasp, or hornet sting, the 2024 American Heart Association and American Red Cross guidelines recommend self-administration of an epinephrine autoinjector and activation of the emergency response system 1. For large local reactions, treatment may include antihistamines, cold compresses, and in severe cases, a short course of oral corticosteroids, with antibiotics usually not necessary unless there is evidence of secondary infection 1.
From the FDA Drug Label
Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: ... insect bites Emergency treatment of allergic reactions (Type I), including anaphylaxis, which may result from allergic reactions to insect stings, biting insects, ...
Treatments for bug bites may entail:
- Topical hydrocortisone to relieve itching associated with minor skin irritations and inflammation due to insect bites 2
- Epinephrine for emergency treatment of allergic reactions, including anaphylaxis, resulting from insect stings or bites 3
From the Research
Treatments for Bug Bites
- Local reactions to bug bites can be treated with measures to reduce symptoms such as sharp, localized pain and reddening at the site, which usually resolve themselves in 24 hours 4.
- For toxic reactions, which may include gastrointestinal symptoms, fever, headache, dizziness, or convulsions, treatment depends on the severity of the symptoms 4.
- Anaphylactic reactions, which can be mild (hives, itching) or severe (systemic reactions including airway and cardiovascular symptoms), require immediate medical attention and may involve the use of epinephrine and other emergency measures 4.
- Simple insect bites can be treated with over-the-counter preparations such as antihistamines and topical corticosteroids, although there is a lack of evidence for the efficacy of these treatments 5.
- The use of concentrated heat after insect bites/stings has been shown to reduce swelling, pain, and pruritus, with significant improvements in symptoms within 10 minutes of treatment 6.
- For mammalian bites, treatment may involve antibiotic prophylaxis, antibiotics, debridement, decontamination, irrigation, primary wound closure, and tetanus vaccination, depending on the severity of the bite and the risk of infection 7.
- Infections of bite wounds can be caused by a variety of bacteria, including Pasteurella multocida, Staphylococcus aureus, and anaerobic bacteria, and treatment may involve antibiotics and other measures to manage the infection 8.