From the Guidelines
Treatment for bug bite blisters involves keeping the area clean and avoiding scratching to prevent infection, with cold compresses and oral antihistamines helping to reduce local pain and swelling, as recommended by the Journal of Allergy and Clinical Immunology 1.
Key Considerations
- Wash the blister gently with mild soap and water to keep the area clean
- Apply an over-the-counter hydrocortisone cream (0.5-1%) up to four times daily for 2-3 days to reduce inflammation and itching
- Use calamine lotion to soothe the area
- Take acetaminophen (Tylenol) 325-650mg every 4-6 hours or ibuprofen (Advil, Motrin) 200-400mg every 6-8 hours as needed for pain relief
- Avoid popping the blister to prevent infection risk
- Cover large or vulnerable blisters with a sterile bandage
- Apply cold compresses for 15-20 minutes several times daily to reduce swelling and discomfort
- Use antihistamines like diphenhydramine (Benadryl) 25-50mg every 4-6 hours or non-sedating options like cetirizine (Zyrtec) 10mg daily to control itching
When to Seek Medical Attention
- Develop signs of infection (increasing redness, warmth, pus, fever)
- Experience severe swelling
- If the blister doesn't improve within a week According to the Journal of Allergy and Clinical Immunology, most insect stings cause transient localized reactions that are of little serious medical consequence, and no treatment usually is required 1. However, some local reactions are more severe and present with extensive erythema and swelling surrounding the sting site, which can persist for several days or more and is accompanied by pruritus, pain, or both 1.
From the FDA Drug Label
Uses For temporary relief of itching associated with minor skin irritations, inflammation and rashes due to: ● eczema ● seborrheic dermatitis ● psoriasis ● insect bites ● poison ivy, oak, sumac ● soaps ● detergents ● cosmetics ● jewelry ● external feminine genital and anal itching Directions Adults and children 2 years of age and older: apply to the affected area not more than 3 to 4 times daily.
The treatment for bug bite blisters is the application of hydrocortisone (TOP) to the affected area, for temporary relief of itching associated with insect bites.
- Application frequency: not more than 3 to 4 times daily for adults and children 2 years of age and older.
- Children under 2 years of age: do not use, consult a doctor 2 2.
From the Research
Treatment of Bug Bite Blisters
- The treatment for bug bite blisters is mainly symptomatic, aiming to alleviate pruritus and control inflammation 3.
- Topical pramoxine and oral antihistamines can be used to relieve pruritus, while topical corticosteroids can be used for significant eruptions to control inflammation and pruritus, and to hasten resolution of the lesions 3.
- In some cases, insect bites may cause exaggerated local reactions, such as vesicles, urticarial wheals, and bullae, which may require more specific treatment 3.
- It is essential to note that reactions to bed bug bites are self-limited, and treatment should focus on relieving symptoms rather than attempting to eradicate the bug itself 3.
- For simple insect bites, many preparations are available over-the-counter, including antihistamines and topical corticosteroids, although there is a lack of evidence for their efficacy, and recommendations are often based on expert opinion and clinical experience 4.
Management of Insect Bites
- Insect bite inflammation may mimic cellulitis, leading to unnecessary antibiotic usage and contributing to antimicrobial resistance in primary care 5.
- A study found that nearly three-quarters of patients with insect bites were prescribed antibiotics, mainly flucloxacillin, highlighting the potential for overuse of antibiotics in insect bite management 5.
- Antihistamines, such as ebastine, have been shown to be effective in reducing the size of bite lesions and pruritus in mosquito bite-sensitive subjects 6.
- Immunotherapy with whole body mosquito extracts has been reported as a viable treatment option for patients with mosquito bite-induced anaphylaxis, although it may also result in severe side effects 7.