From the Guidelines
To treat insect bites, first wash the affected area with soap and water, and apply a cold compress for 10 minutes to reduce swelling and pain, as recommended by the most recent guidelines 1. For itching, use over-the-counter hydrocortisone cream (1%) 2-3 times daily for up to a week, or take an oral antihistamine like diphenhydramine (Benadryl) 25-50mg every 4-6 hours or cetirizine (Zyrtec) 10mg once daily, as suggested by the guidelines 1. Calamine lotion can also provide itch relief. Avoid scratching to prevent infection. For pain, take acetaminophen (Tylenol) 325-650mg every 4-6 hours or ibuprofen (Advil) 200-400mg every 6-8 hours as needed. Most insect bites heal within a few days with these treatments. Some key considerations for treatment include:
- Management of acute reactions to stings is symptomatic, with the following considerations:
- Acute systemic reactions to insect stings should be treated like any anaphylactic reaction, with epinephrine injection, supportive therapy, and transport to an emergency department, as stated in the guidelines 1.
- In patients with a history of only cutaneous systemic reactions, initial treatment of cutaneous systemic symptoms might include antihistamines and close observation, as recommended by the guidelines 1.
- Treatment of large local reactions can include antihistamines, cold compresses, and in severe cases a brief course of oral corticosteroids, as suggested by the guidelines 1.
- Antibiotics are usually not necessary, unless there is evidence of secondary infection, as stated in the guidelines 1. Seek medical attention if you develop severe swelling, spreading redness, pus, fever, difficulty breathing, dizziness, or if the bite area continues to worsen after 2-3 days. These treatments work by reducing inflammation, blocking histamine (which causes itching), and addressing pain signals, allowing your body's natural healing process to occur more comfortably. It is also important to note that patients who have experienced a systemic reaction to an insect sting should be referred to an allergist-immunologist for skin testing or occasionally in vitro testing for specific IgE antibodies to insects, as recommended by the guidelines 1. Venom immunotherapy (VIT) is recommended for all patients who have experienced a systemic reaction to an insect sting and who have specific IgE to venom allergens, as stated in the guidelines 1.
From the FDA Drug Label
Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: ... insect bites
- Hydrocortisone (TOP) can be used to temporarily relieve itching associated with insect bites.
- The treatment is intended for minor skin irritations and itching caused by insect bites.
- It is recommended to use the product under the advice and supervision of a doctor for other uses [ 2 ].
From the Research
Insect Bite Treatment Overview
- Insect bites can cause local reactions, immune reactions, and secondary bacterial infections 3
- The consequences of insect bites include anaphylaxis and infections such as impetigo and cellulitis 3
Treatment Options
- Many preparations are available over the counter (OTC) in the UK, including antihistamines and topical corticosteroids 3
- However, there is a lack of evidence for the efficacy of these treatments 3
- Recommendations for treatment are generally based on expert opinion and clinical experience 3