Allergy to bedbug bites: how to treat it? - briefly
Management includes topical corticosteroids to reduce inflammation and oral antihistamines for systemic itching, with short courses of systemic steroids reserved for severe reactions. Preventive actions involve thorough cleaning, heat treatment of infested items, and professional pest control to avoid re‑exposure.
Allergy to bedbug bites: how to treat it? - in detail
Bed‑bug (Cimex lectularius) bites can trigger IgE‑mediated hypersensitivity, manifesting as erythematous, pruritic papules that may develop into vesicles or bullae in sensitized individuals. The reaction typically appears within 24 hours of exposure and can persist for several days, occasionally accompanied by systemic symptoms such as urticaria or angio‑edema.
Accurate assessment begins with a thorough history of recent infestations and a physical examination that distinguishes bed‑bug lesions from those caused by other arthropods. Dermoscopy may reveal a central punctum surrounded by a halo, supporting the diagnosis. In ambiguous cases, skin‑prick testing with bed‑bug extract can confirm sensitization.
Therapeutic management focuses on symptom control and prevention of secondary infection. First‑line measures include:
- Oral nonsedating antihistamines (e.g., cetirizine, loratadine) to reduce pruritus and histamine‑driven inflammation.
- Topical corticosteroids (medium‑potency creams such as triamcinolone acetonide) applied twice daily for 5–7 days to diminish local edema and erythema.
- Cool compresses or calamine lotion to provide immediate relief of itching.
If lesions are extensive, rapidly evolving, or accompanied by systemic involvement, short courses of oral corticosteroids (prednisone 0.5 mg/kg/day for 5 days) are indicated. Persistent excoriation or signs of bacterial superinfection warrant topical antibiotics (mupirocin) or oral agents (dicloxacillin) based on culture results.
Long‑term strategies aim to eradicate the infestation and reduce re‑exposure. Effective control measures comprise:
- Professional heat‑treatment or steam‑cleaning of infested furniture and bedding.
- Encapsulation of mattresses and box springs with certified bed‑bug‑proof covers.
- Regular laundering of linens at ≥ 60 °C and thorough vacuuming of cracks, crevices, and baseboards.
- Application of residual insecticides by certified pest‑management operators, adhering to label instructions.
Patients with a documented severe allergy should carry an epinephrine autoinjector and receive education on recognizing anaphylaxis. Follow‑up evaluation after initial therapy confirms resolution of cutaneous lesions and assesses the need for additional interventions.