What is the treatment for chigger bites?

Treatment of Chigger Bites

The treatment of chigger bites primarily consists of symptomatic relief through antipruritics, antihistamines, and topical corticosteroids, as most chigger bites are self-healing within a couple of weeks. 1, 2

Immediate Management

• Apply cold compresses to the affected area to reduce inflammation and provide immediate relief 3, 4
• Wash the affected area thoroughly with soap and water to remove any remaining chiggers 2
• Avoid scratching the bites to prevent secondary infection 2

Pharmacological Treatment

• Topical treatments:

  • Apply topical antipruritics containing polidocanol to relieve itching 4
  • Use topical corticosteroids (e.g., hydrocortisone cream) to reduce inflammation and itching 1, 2
  • Consider topical lidocaine cream or gel for pain relief if needed 3
  • Zinc lotions or alcohol compresses may provide additional relief 4

• Oral medications:

  • Administer oral antihistamines (e.g., diphenhydramine, cetirizine) to control itching 1, 2
  • Over-the-counter acetaminophen or nonsteroidal anti-inflammatory drugs can be used for pain management 3

• For severe cases:

  • Consider intralesional triamcinolone acetonide injection for intense, localized reactions 2
  • Short courses of oral corticosteroids may be beneficial for extensive reactions 1

When to Seek Medical Attention

• If symptoms extend beyond the bite site or become severe 3
• If pain is not controlled with over-the-counter medications 3
• If an open wound develops or signs of secondary infection appear (increasing redness, warmth, swelling, pus) 3
• If systemic symptoms develop such as fever, difficulty breathing, or widespread rash 3

Prevention Strategies

• Wear protective clothing that completely covers the skin when in chigger-infested areas 2, 5
• Apply insect repellents containing DEET to both skin and clothing 1, 2
• Avoid sitting directly on the ground in grassy or wooded areas 5
• Take a hot shower and wash clothes in hot water immediately after potential exposure 2
• Consider treating outdoor clothing with permethrin for additional protection 5

Special Considerations

• For children with penile involvement (summer penile syndrome), treatment follows the same principles with cold compresses and oral antihistamines, with expected resolution within 3-4 days on average 6
• In areas where scrub typhus is endemic, monitor for signs of systemic illness as some chigger species can transmit Orientia bacteria 5