Insect Bites Treatment Overview
First steps to consider
- Most bug bites can be treated at home with OTC anti-itch cream like calamine lotion or hydrocortisone cream.
- An antihistamine, like Zyrtec or Claritin, can also help with itching or mild allergic reactions.
- Applying cold packs to the bite or sting site can help.
When you may need a provider
- You have tried home treatments for more than 3 days and they are not helping.
- You develop a rash with intense itching, or a rash that has a bullseye.
- You find a tick that you think has been on you for more than 36 hours
- The area around the bite has become painful, swollen, red, and warm to the touch.
Go to the ER if you have any of these symptoms:
- Trouble breathing
- Swelling of your mouth or throat
- Vomiting or abdominal pain
- Fever or chills, body aches, joint pain, fatigue, and headaches
- Intense pain where you were bitten
- You think you may have been bitten by a widow or recluse spider.
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When to see a healthcare provider
If your insect bite has redness and swelling that does not go away or worsens after 3–4 days, it is a good idea to see a healthcare provider to make sure you don’t have an infection.
Also, if there is a chance you were bitten by a poisonous insect, like a widow spider, you should go to the ER for monitoring and further treatment.
You should also see your provider if you think you’ve been bitten by a tick or have an infestation like scabies.
Your doctor will most likely examine your skin for any rashes and signs of a bug bite. They will also ask you questions to make sure you don’t have another condition. In most cases, no additional tests will be needed.
What to expect from your visit
- The provider will probably examine the area where you were bitten.
- If there is still an insect attached or a stinger, they will remove it.
- If you are having a severe allergic reaction, they will give you medications like epinephrine.
- Certain types of insect bites might need a prescription medication. For example, scabies from mites is treated with a special lotion, called Permethrin cream. If a tick was attached to you for more than 36 hours, your provider may prescribe an antibiotic within the first 72 hours to prevent Lyme disease. A rash in the shape of a bullseye could be a sign of early Lyme disease and you will need to take antibiotics.
Prescription medications for insect bites
- Permethrin 5% cream (for scabies)
- Hydrocortisone lotion (for itching)
- Epinephrine (Epipen for anaphylaxis)
Types of providers who treat insect bites
- A primary care provider can treat most reactions to bug bite.
- A dermatologist is a skin doctor who can help identify complex rashes that are difficult to diagnose.
- A toxicology specialist can help with treatment for poisonous insect bites.
How to treat insect bites at home
Try to clean the bite right away by washing the area with soap and water. You can also apply an ice pack or cold compress to the area to reduce the swelling. If you have a lot of pain after the bite, ibuprofen (Advil, Motrin) can help.
To help it heal, try to avoid scratching the area. The itching, swelling, or redness should go away after a few days. To stop yourself from scratching:
- Wear loose clothing that covers the area.
- Apply anti-itch creams like calamine lotion (Caladryl) or hydrocortisone cream
- Take an antihistamine once or twice a day to help with the itching. Zyrtec, Allegra, or Claritin are good choices since they are less likely to make you sleepy.
- Calamine lotion (Caladryl)
- Sarna Anti-Itch Lotion
- Hydrocortisone lotion
- Antihistamines: cetirizine (Zyrtec), fexofenadine (Allegra), or loratadine (Claritin)
- Ibuprofen (Advil, Motrin)
Tips for removing stingers and ticks
- If you have been stung and the stinger is still in your skin, you should remove it as quickly as possible to prevent more venom from being released. First stretch your skin flat. Then use either your fingernail or a hard surface, like a credit card, to scrape the stinger out. Using a tweezer or anything else to pinch the stinger is not recommended as it could squeeze more venom into you.
- If you find a tick attached to you, it should be carefully removed right away. With a tweezer, grasp the tick close to the skin and pull it out of the skin with a gentle, steady motion. If you can, save the tick in a sealed bag. Your doctor may want to see it or even have it tested.