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Insect bites and stings - Management
What treatments are not recommended?
- The following treatments are not recommended for the treatment of insect bites or stings:
- Topical combination products containing a topical corticosteroid plus crotamiton
- Topical antihistamines
- Calamine lotion
- Vinegar
- Bicarbonate of soda
Basis for recommendation
- It is best to prescribe the components of topical combination products containing corticosteroids separately rather than as a combined preparation, as this minimizes exposure to topical corticosteroids and their potential adverse effects.
- Topical antihistamines are of limited efficacy and may cause sensitization [BNF 52, 2006].
- Calamine lotion generally soothes itch, although the dried residue can exacerbate itch in some people. Calamine preparations are of little value for the treatment of insect bites and stings [BNF 52, 2006].
- Vinegar has traditionally been used to treat wasp stings as their venom is alkaline. Bicarbonate of soda has also been used to treat bee stings as their sting venom is acidic. Neutralizing a bee sting or wasp sting is unlikely to be effective or practically possible as:
- The venom from wasps and bees (5–50 micrograms of fluid) is injected under the skin and after a few minutes spreads deep into the tissues. The applications of an unknown strength of vinegar or bicarbonate of soda onto the skin surface is unlikely to neutralize the venom [Glaser, 2007].
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