From the Guidelines
To treat a 7-year-old with likely bed bug bites on the groin area, first address the itching with over-the-counter 1% hydrocortisone cream applied thinly to the affected areas twice daily for up to one week. For more severe itching, children's diphenhydramine (Benadryl) can be given orally following the age-appropriate dosing on the package. Keep the area clean by washing gently with mild soap and water, and trim the child's fingernails to prevent scratching that could lead to infection. While treating the symptoms, it's crucial to eliminate the bed bugs from your home. Wash all bedding, clothing, and stuffed animals in hot water (at least 130°F) and dry on high heat. Vacuum mattresses, furniture, and floors thoroughly, and consider using bed bug-proof mattress and pillow encasements. Professional pest control may be necessary for effective elimination. Bed bug bites cause itching because the bugs inject saliva containing anticoagulants and anesthetic compounds that trigger an immune response in humans. If the bites become increasingly red, swollen, or show signs of infection (pus, increased pain), or if the child develops a fever, seek medical attention promptly. The provided evidence on treating sexually transmitted diseases 1 and stinging insect hypersensitivity 1 does not directly apply to the treatment of bed bug bites, but the general principles of managing itching and preventing infection are relevant. However, the most relevant treatment for bed bug bites is not explicitly mentioned in the provided studies, so the recommended approach is based on general medical knowledge and principles of managing similar skin reactions. It's essential to note that permethrin 1% cream rinse or pyrethrins with piperonyl butoxide, as recommended for other conditions 1, are not typically used for treating bed bug bites on the skin, but rather for treating lice or scabies infestations. Therefore, the focus should be on relieving symptoms and eliminating the bed bug infestation.
From the FDA Drug Label
Directions for itching of skin irritation, inflammation, and rashes: adults and children 2 years of age and older: apply to affected area not more than 3 to 4 times daily children under 12 years of age: ask a doctor Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: ... insect bites ... temporarily relieves external anal and genital itching
For a 7-year-old with itchy skin on the groin likely due to bed bugs, hydrocortisone (TOP) can be used to relieve itching associated with minor skin irritations and insect bites, including bed bugs.
- The child is over 2 years of age, so the product can be applied to the affected area not more than 3 to 4 times daily.
- However, since the child is under 12 years of age and the itching is on the genital area, it is recommended to ask a doctor before applying the product 2.
- The product is indicated for temporary relief of external anal and genital itching 2.
From the Research
Treatment of Bed Bug Bites
- The treatment of bed bug bites typically involves symptomatic control, with options including:
- It is essential to note that there is limited evidence for the efficacy of these treatments, and recommendations are often based on expert opinion and clinical experience 4
Management of Bed Bug Infestations
- Effective management of bed bug infestations is crucial to prevent further bites and reduce the risk of associated health consequences 5, 3, 6
- A multidisciplinary approach to control, including nonchemical means and the judicious use of insecticides, is recommended 6
- Accommodation providers should implement risk management procedures to reduce the potential of bed bug infestations 6