Medscape is available in 5 Language Editions – Choose your Edition here.


Bedbug Bites Medication

  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
Updated: Jun 02, 2016

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.



Class Summary

Corticosteroids have anti-inflammatory properties and cause profound and varied metabolic effects. These agents modify the body's immune response to diverse stimuli.

Triamcinolone topical (Kenalog, Triderm, Zytopic)


Topical triamcinolone (0.1% cream) is an anti-inflammatory that is administered for intense, localized allergic reactions. This agent can be used to treat inflammatory dermatosis that is responsive to steroids.

Topical triamcinolone decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability.

Hydrocortisone (Cortizone, Ala-Cort, Westcort)


Hydrocortisone is an adrenocorticosteroid derivative suitable for application to the skin or external mucous membranes. It decreases inflammation by suppression of the migration of polymorphonuclear leukocytes and reversal of increased capillary permeability.

Clobetasol (Temovate, Clobex)


Clobetasol is a class I superpotent topical steroid; it suppresses mitosis and increases the synthesis of proteins that decrease inflammation and cause vasoconstriction. Clobetasol decreases inflammation by stabilization of lysosomal membranes, inhibition of polymorphonuclear leukocytes, and deregulation of mast cells.



Class Summary

Antihistamines are used to treat minor allergic reactions and anaphylaxis. These agents act by competitive inhibition of histamine at H1 receptor.

Chlorpheniramine (Chlor-Trimeton, Teldrin, Aller-Chlor, Chlor-Hist)


Chlorpheniramine is used to treat intense, localized allergic reactions. This agent competes with histamine or H1-receptor sites on effector cells in blood vessels and the respiratory tract.

Diphenhydramine (Anti-Hist, Allerdryl, Benadryl)


This is a first-generation antihistamine with anticholinergic effects that binds to H1 receptors in the CNS and the body. It competitively blocks histamine from binding to H1 receptors. It is used for symptomatic relief of symptoms caused by the release of histamine in allergic reactions.

Loratadine (Claritin, Alavert)


Loratadine selectively inhibits peripheral histamine H1 receptors. It is tolerated well, with rate of sedation not significantly different from placebo.

Desloratadine (Clarinex)


Desloratadine is a long-acting tricyclic histamine antagonist selective for the H1-receptor. It is a major metabolite of loratadine, which, after ingestion, is extensively metabolized to the active metabolite 3-hydroxydesloratadine.

Cetirizine (Zyrtec)


Cetirizine selectively inhibits histamine H1 receptor sites in blood vessels, the GI tract, and the respiratory tract, which, in turn, inhibits the physiologic effects that histamine normally induces at H1 receptor sites. Once-daily dosing is convenient. Bedtime dosing may be useful if sedation is a problem.

Contributor Information and Disclosures

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Society for Investigative Dermatology, Association of Professors of Dermatology, North American Hair Research Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Craig A Elmets, MD Professor and Chair, Department of Dermatology, Director, Chemoprevention Program Director, Comprehensive Cancer Center, UAB Skin Diseases Research Center, University of Alabama at Birmingham School of Medicine

Craig A Elmets, MD is a member of the following medical societies: American Academy of Dermatology, American Association of Immunologists, American College of Physicians, American Federation for Medical Research, Society for Investigative Dermatology

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: University of Alabama at Birmingham; University of Alabama Health Services Foundation<br/>Serve(d) as a speaker or a member of a speakers bureau for: Ferndale Laboratories<br/>Received research grant from: NIH, Veterans Administration, California Grape Assn<br/>Received consulting fee from Astellas for review panel membership; Received salary from Massachusetts Medical Society for employment; Received salary from UpToDate for employment. for: Astellas.


The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Anna Gorkiewicz-Petkow, MD, PhD, to the development and writing of this article.

  1. Romero A, Potter MF, Potter DA, Haynes KF. Insecticide resistance in the bed bug: a factor in the pest's sudden resurgence?. J Med Entomol. 2007 Mar. 44(2):175-8. [Medline].

  2. Pfiester M, Koehler PG, Pereira RM. Effect of population structure and size on aggregation behavior of Cimex lectularius (Hemiptera: Cimicidae). J Med Entomol. 2009 Sep. 46(5):1015-20. [Medline].

  3. Thomas S, Wrobel MJ, Brown J. Bedbugs: A primer for the health-system pharmacist. Am J Health Syst Pharm. 2013 Jan 1. 70(2):126-30. [Medline].

  4. Patel D, Elston DM. What's eating you? Bedbugs revisited (Cimex lectularius). Cutis. 2012 Oct. 90(4):173-5. [Medline].

  5. Booth W, Balvín O, Vargo EL, Vilímová J, Schal C. Host association drives genetic divergence in the bed bug, Cimex lectularius. Mol Ecol. 2015 Mar. 24(5):980-92. [Medline].

  6. deShazo RD, Feldlaufer MF, Mihm MC Jr, Goddard J. Bullous reactions to bedbug bites reflect cutaneous vasculitis. Am J Med. 2012 Jul. 125(7):688-94. [Medline].

  7. Abdel-Naser MB, Lotfy RA, Al-Sherbiny MM, Sayed Ali NM. Patients with papular urticaria have IgG antibodies to bedbug (Cimex lectularius) antigens. Parasitol Res. 2006 May. 98(6):550-6. [Medline].

  8. Mouchtouri VA, Anagnostopoulou R, Samanidou-Voyadjoglou A, Theodoridou K, Hatzoglou C, Kremastinou J, et al. Surveillance study of vector species on board passenger ships, risk factors related to infestations. BMC Public Health. 2008 Mar 27. 8:100. [Medline].

  9. Gbakima AA, Terry BC, Kanja F, Kortequee S, Dukuley I, Sahr F. High prevalence of bedbugs Cimex hemipterus and Cimex lectularis in camps for internally displaced persons in Freetown, Sierra Leone: a pilot humanitarian investigation. West Afr J Med. 2002 Oct-Dec. 21(4):268-71. [Medline].

  10. Lee IY, Ree HI, An SJ, Linton JA, Yong TS. Reemergence of the bedbug Cimex lectularius in Seoul, Korea. Korean J Parasitol. 2008 Dec. 46(4):269-71. [Medline].

  11. Ogston CW, Wittenstein FS, London WT, Millman I. Persistence of hepatitis B surface antigen in the bedbug Cimex hemipterus (Fabr.). J Infect Dis. 1979 Sep. 140(3):411-4. [Medline].

  12. Pipkin AC Sr. Transmission of Trypanosoma cruzi by arthropod vectors: anterior versus posterior route infection. Int Rev Trop Med. 1969. 3:1-47. [Medline].

  13. Salazar R, Castillo-Neyra R, Tustin AW, Borrini-Mayorí K, Náquira C, Levy MZ. Bed bugs (Cimex lectularius) as vectors of Trypanosoma cruzi. Am J Trop Med Hyg. 2015 Feb. 92(2):331-5. [Medline]. [Full Text].

  14. Iqbal MM. Can we get AIDS from mosquito bites?. J La State Med Soc. 1999 Aug. 151(8):429-33. [Medline].

  15. Webb PA, Happ CM, Maupin GO, Johnson BJ, Ou CY, Monath TP. Potential for insect transmission of HIV: experimental exposure of Cimex hemipterus and Toxorhynchites amboinensis to human immunodeficiency virus. J Infect Dis. 1989 Dec. 160(6):970-7. [Medline].

  16. KINNEAR J. Epidemic of bullous erythema on legs due to bed-bugs. Lancet. 1948 Jul 10. 2(6515):55. [Medline].

  17. Reinhardt K, Kempke D, Naylor RA, Siva-Jothy MT. Sensitivity to bites by the bedbug, Cimex lectularius. Med Vet Entomol. 2009 Mar 9. [Medline].

  18. Crissey JT. Bedbugs: An old problem with a new dimension. Int J Dermatol. 1981 Jul-Aug. 20(6):411-4. [Medline].

  19. Liebold K, Schliemann-Willers S, Wollina U. Disseminated bullous eruption with systemic reaction caused by Cimex lectularius. J Eur Acad Dermatol Venereol. 2003 Jul. 17(4):461-3. [Medline].

  20. Masetti M, Bruschi F. Bedbug infestations recorded in Central Italy. Parasitol Int. 2007 Mar. 56(1):81-3. [Medline].

  21. Melnick L, Samimi S, Elder D, Xu X, Vittorio CC, Rosenbach M, et al. Targetoid lesions in the emergency department. Bed bug bites (Cimex lectularius) with targetoid lesions on initial presentation. JAMA Dermatol. 2013 Jun. 149(6):751-6. [Medline].

  22. Scarupa MD, Economides A. Bedbug bites masquerading as urticaria. J Allergy Clin Immunol. 2006 Jun. 117(6):1508-9. [Medline].

  23. Fletcher MG, Axtell RC. Susceptibility of the bedbug, Cimex lectularius, to selected insecticides and various treated surfaces. Med Vet Entomol. 1993 Jan. 7(1):69-72. [Medline].

  24. Weeks EN, Logan JG, Gezan SA, et al. A bioassay for studying behavioural responses of the common bed bug, Cimex lectularius (Hemiptera: Cimicidae) to bed bug-derived volatiles. Bull Entomol Res. 2010 Jan 27. 1-8. [Medline].

  25. Singh N, Wang C, Cooper R. Posttreatment Feeding Affects Mortality of Bed Bugs (Hemiptera: Cimicidae) Exposed to Insecticides. J Econ Entomol. 2016 Feb. 109 (1):273-83. [Medline].

  26. Lindsay SW, Snow RW, Armstrong JR, Greenwood BM. Permethrin-impregnated bednets reduce nuisance arthropods in Gambian houses. Med Vet Entomol. 1989 Oct. 3(4):377-83. [Medline].

  27. Pereira RM, Koehler PG, Pfiester M, Walker W. Lethal effects of heat and use of localized heat treatment for control of bed bug infestations. J Econ Entomol. 2009 Jun. 102(3):1182-8. [Medline].

  28. Wang C, Gibb T, Bennett GW, McKnight S. Bed bug (Heteroptera: Cimicidae) attraction to pitfall traps baited with carbon dioxide, heat, and chemical lure. J Econ Entomol. 2009 Aug. 102(4):1580-5. [Medline].

  29. Ho D, Lai O, Glick S, Jagdeo J. Lack of evidence that bedbugs transmit pathogens to humans. J Am Acad Dermatol. 2016 Jun. 74 (6):1261. [Medline].

  30. Wang C, Lü L, Zhang A, Liu C. Repellency of selected chemicals against the bed bug (Hemiptera: Cimicidae). J Econ Entomol. 2013 Dec. 106(6):2522-9. [Medline].

The bedbug is a flat, oval, reddish brown insect that turns violaceous after feeding. Courtesy of Colonel Dirk M. Elston, MD (from Elston, 2000).
Bedbugs feeding on a human host. Courtesy of Colonel Dirk M. Elston, MD (from Elston, 2000).
Human infestation with bedbugs, lice, and mites are common causes of dermatologic symptoms. Although these organisms thrive in conditions of overcrowding and decreased sanitation, Americans of all socioeconomic backgrounds may be at risk for infestation. Clinicians must maintain high suspicion in the appropriate set of clinical circumstances to identify and treat infestations, as they can cause substantial dermatologic and psychological discomfort for patients. Images courtesy of the US Centers for Disease Control and Prevention.
Bedbugs are parasitic arthropods from the family Cimicidae. They are typically less than 1 cm in length and reddish brown in color. Bedbugs can be found in furniture, floorboards, peeling paint, or other small spaces, most commonly in areas of clutter. These insects come out at night in search of prey upon which to feed, with peak feeding times just before dawn. Bedbugs are typically attracted to body heat, carbon dioxide, vibration, sweat, and odor. The image of a Cimex lectularius is shown courtesy of the US Centers for Disease Control and Prevention (CDC).
After bedbugs find a food source, they bite down with their mouths and inject anticoagulant and anesthetic compounds into the skin. Depending on the species, these parasites feed on the host blood via 1 of 2 mechanisms. Vessel feeders directly insert their mouthparts into superficial capillaries, whereas pool feeders damage the superficial tissue and feed on the accumulated blood. As bedbugs feed, their color may change as they swell with the host blood, as shown in this picture of a larval bedbug feeding on a volunteer host. Image courtesy of the US Centers for Disease Control and Prevention (CDC).
Bedbug bites themselves are typically painless. However, the subsequent allergic reaction that may develop can cause intense pruritus. While feeding, bedbugs may inject one of several pharmacologically active substances, including hyaluronidase, proteases, and kinins. These compounds may induce different skin reactions, such as erythema, wheals, vesicles, or hemorrhagic nodules. Repeated bites may sensitize individuals, leading to more pronounced cutaneous manifestations or systemic hypersensitivity reactions. The local trauma from bedbug bites can lead to secondary bacterial infection, causing ecthyma, cellulitis, or lymphangitis. There is some evidence that bedbugs may also be a vector for hepatitis B and Chagas disease. Histologic findings from bite-site biopsy specimens typically show eosinophilic infiltrates, which are indicative of the allergic nature of the reaction. The image shown is papular urticaria, which may develop from bedbug bites.
Treatment for bedbug bites is typically supportive. Local antiseptic lotions or antibiotic creams can be applied for secondary infections, whereas corticosteroid creams and oral antihistamines can be used for allergic reactions. Bedbugs can be eliminated through the use of permethrin insecticides, baited traps, special bedbug-free beds, and bed nets. Homemade methods, such as wrapping duct tape around bed legs as shown, may be effective, but bedbugs have been known to climb other objects and then fall down onto a bed. Image courtesy of Wikimedia Commons.
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.