Hello, I am Dr. Neal Schultz and welcome to DermTV.

A few weeks ago I discussed how to apply insect repellent so you could get the maximum protection against insect bites but the reality is, whether you’re using insect repellent or not some people are going to get insect bites. So what’s the best way to treat them? Well the only reason we really need to treat insect bites is because they itch and when we itch we scratch and that’s the problem. Scratching causes three different issues. The first problem with scratching is that while it sure feels good and helps to stop the uncomfortable itching it actually causes more itching. You get a rebound flare of the itching, so you’re sort of getting into an itch-scratch cycle. The more you itch the more you scratch, the more you scratch the more you itch.

Secondly, scratching insect bites can actually cause dark staining of the skin, just the way picking pimples can cause a dark staining and those dark stains are very difficult to treat. And third and perhaps most important, scratching can cause infections in your skin and obviously that’s something we’d like to avoid. So the best way to treat insect bites is first of all, with an oral, non-sedating, antihistamine. You can get Allegra by prescription or Claritin over the counter without a prescription. Second, we want to use mentholated lotions or creams to help stop the itching.

When menthol touches our skin it causes a cooling sensation and that cooling sensation erases the itching and it feels much better. If you’re at home you can take an ice-cube and touch it with an ice-cube. Ice will stop the itching without causing any increase in itching. Lastly, whatever you do, don’t use topical antihistamines like topical Benadryl because they can cause delayed allergic reactions. For the redness and the bumps, topical cortisone creams or ointments are helpful, 1% hydrocortisone is usually available without a prescription such as the Cortisone-10. If after three or four days of these measures your insect bites and your itching aren’t getting better it’s time to see your dermatologist for stronger treatment.

Please join me again at DermTV.com. If you have a question please send it to me by visiting DermTV.com/question. I'm Dr. Neal Schultz and thank you for watching today.