1. For comfort, give a SHORT daily lukewarm bath of 5-10 minutes with a mild soap. Aveeno Oatmeal bath treatment is a good choice.
  2. Apply the following medicine to the bites: Hydrocortisone 1% (Over-The-Counter) 2x/day. Use this no longer than 2 weeks.
  3. To keep the bites/rash from becoming infected, apply an antibiotic cream (OTC) (such as Neosporin) to the bites 2x/day. The antibiotic cream can be used at the same time as the hydrocortisone cream.
  4. Keep the fingernails as short as possible. This will reduce injury to the skin from scratching, as well as keep unwanted germs/dirt/debris from being harbored under long nails.
  5. When the child is itchy/scratching apply Sarna Lotion (OTC) (0.5% Camphor + 0.5% Menthol) to the affected area 3-4x/day as needed.  Avoid rubbing on open lesions as this may cause a burning sensation.
  6. When the child is itchy/scratching give Cetirizine (Zyrtec), Loratadine (Claritin), or Fexofenadine (Allegra). See chart for dosing.
  7. If there are signs of an infected skin lesion, please bring the child in a.s.a.p.
    • Tenderness
    • Whitish discharge or pustule formation
    • Fever (temperature >100.4 Fahrenheit)
    • Redness (increasing over time, initially all bites will have some redness)
    • Swelling (increasing over time, initially all bites will have some swelling)
    • Generally looking worse

Children’s Loratadine/Cetirizine/Levocetirizine (Claritin/Zyrtec/Xyzal) Dosing

Age Dose – Liquid (5mg/5mL)
6-12 months 1.25 mL once or twice daily, do not take more than 2.5 mL in 24 hours
1-2 years 2.5 mL once or twice daily, do not take more than 5 mL in 24 hours
2-6 years 5 mL daily, do not take more than 5 mL in 24 hours
6+ years 5 – 10 mL daily, do not take more than 20 mL in 24 hours
Children’s Fexofenadine (Allegra) Dosing

Age Dose – (30mg/5mL)
6 months – 2 years 2.5 mL once or twice daily, do not take more than 5 mL in 24 hours
2 – under 11 years 5 mL once or twice daily, do not take more than 10 mL in 24 hours
12 years and older 10 mL twice daily, do not take more than 20 mL in 24 hours
Children’s Diphenhydramine HCL (Benadryl) Allergy Dosing (1+ Years Old)*

Weight (lbs) Dose – Liquid (12.5mg/5mL) Dose – Chewable (12.5mg) Dose – Capsule (25mg)
20-24 lbs 3.75 mL every 6 hrs, no more than 15 mL in 24 hrs N/A N/A
25-37 lbs 5 mL every 6 hrs, no more than 20 mL in 24 hrs 1 tablet every 6 hrs, no more than 4 tablets in 24 hrs N/A
38-49 lbs 7.5 mL every 6 hrs, no more than 30 mL in 24 hrs 1 1/2 tablets every 6 hrs, no more than 6 tablets in 24 hrs N/A
50-99 lbs 10 mL every 6 hrs, no more than 40 mL in 24 hrs 2 tablets every 6 hrs, no more than 8 tablets in 24 hrs 1 capsule every 6 hrs, no more than 4 caps in 24 hrs
100+ lbs N/A 4 tablets every 6 hrs, no more than 16 tablets in 24 hrs 2 capsules every 6 hrs, no more than 8 caps in 24 hrs

*USE OF DIPHENHYDRAMINE (BENADRYL) IS GENERALLY DISCOURAGED, unless otherwise directed by a physician. Newer allergy medications such as Cetirizine (Zyrtec), Loratadine (Claritin), and Fexofenadine (Allegra) are just as effective, work just as quickly, last longer with less frequent dosing, and are safer with far fewer side effects.

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