What is the first line treatment for bed bugs?

The primary option for addressing bed bug infestations focuses on managing the symptoms caused by their bites rather than directly treating the infestation itself. Topical corticosteroids and/or antihistamines are commonly recommended to alleviate itching and discomfort associated with the bites, helping to prevent secondary infections and enhance patient comfort.

Using topical corticosteroids can reduce inflammation and itching, which is crucial since scratching can lead to secondary skin infections. Antihistamines help minimize allergic reactions, offering further relief from itching and facilitating sleep, which can be disrupted by the discomfort. While other options like warm compresses with incision and drainage could be relevant in cases where secondary infections arise from excessive scratching, they are not typically considered first-line treatments for the initial reaction to bed bug bites.

Cool compresses may provide soothing relief for itching but are generally less effective than corticosteroids or antihistamines for managing inflammation and severe reactions. Similarly, oral antibiotics like Cephalexin would only be indicated if there were signs of bacterial infection due to scratching and would not address the bite reactions directly. Therefore, focusing on itching relief through topical corticosteroids and antihistamines is the most appropriate first-line treatment strategy in this context.