How Are Bed Bug Bites Treated

US EPA

Bed Bugs

How to Find Bed Bugs

If you have a bed bug infestation, it is best to find it early, before the infestation becomes established or spreads. Treating a minor infestation, while an inconvenience, is far less costly and easier than treating the same infestation after it becomes more widespread.

However, low-level infestations are also much more challenging to find and correctly identify. Other insects, such as carpet beetles, can be easily mistaken for bed bugs. If you misidentify a bed bug infestation, it gives the bugs more time to spread to other areas of the house or hitchhike a ride to someone else’s house to start a new infestation. Learn about identifying bed bugs.

Bites on the skin are a poor indicator of a bed bug infestation. Bed bug bites can look like bites from other insects (such as mosquitoes or chiggers), rashes (such as eczema or fungal infections), or even hives. Some people do not react to bed bug bites at all.

Looking for Signs of Bed Bugs

A more accurate way to identify a possible infestation is to look for physical signs of bed bugs. When cleaning, changing bedding, or staying away from home, look for:

  • Rusty or reddish stains on bed sheets or mattresses caused by bed bugs being crushed.
  • Dark spots (about this size: •), which are bed bug excrement and may bleed on the fabric like a marker would.
  • Eggs and eggshells, which are tiny (about 1mm) and pale yellow skins that nymphs shed as they grow larger.
  • Live bed bugs.

Where Bed Bugs Hide

When not feeding, bed bugs hide in a variety of places. Around the bed, they can be found near the piping, seams and tags of the mattress and box spring, and in cracks on the bed frame and headboard.

If the room is heavily infested, you may find bed bugs:

  • In the seams of chairs and couches, between cushions, in the folds of curtains.
  • In drawer joints.
  • In electrical receptacles and appliances.
  • Under loose wall paper and wall hangings.
  • At the junction where the wall and the ceiling meet.
  • Even in the head of a screw.

Bed Bugs FAQs

What are bed bugs?

Bed bugs (Cimex lectularius) are small, flat, parasitic insects that feed solely on the blood of people and animals while they sleep. Bed bugs are reddish-brown in color, wingless, range from 1mm to 7mm (roughly the size of Lincoln’s head on a penny), and can live several months without a blood meal.

Where are bed bugs found?

Bed bugs are found across the globe from North and South America, to Africa, Asia and Europe. Although the presence of bed bugs has traditionally been seen as a problem in developing countries, it has recently been spreading rapidly in parts of the United States, Canada, the United Kingdom, and other parts of Europe. Bed bugs have been found in five-star hotels and resorts and their presence is not determined by the cleanliness of the living conditions where they are found.

Bed bug infestations usually occur around or near the areas where people sleep. These areas include apartments, shelters, rooming houses, hotels, cruise ships, buses, trains, and dorm rooms. They hide during the day in places such as seams of mattresses, box springs, bed frames, headboards, dresser tables, inside cracks or crevices, behind wallpaper, or any other clutter or objects around a bed. Bed bugs have been shown to be able to travel over 100 feet in a night but tend to live within 8 feet of where people sleep.

Do bed bugs spread disease?

Bed bugs are not known to spread disease. Bed bugs can be an annoyance because their presence may cause itching and loss of sleep. Sometimes the itching can lead to excessive scratching that can sometimes increase the chance of a secondary skin infection.

What health risks do bed bugs pose?

A bed bug bite affects each person differently. Bite responses can range from an absence of any physical signs of the bite, to a small bite mark, to a serious allergic reaction. Bed bugs are not considered to be dangerous; however, an allergic reaction to several bites may need medical attention.

What are the signs and symptoms of a bed bug infestation?

One of the easiest ways to identify a bed bug infestation is by the tell-tale bite marks on the face, neck, arms, hands, or any other body parts while sleeping. However, these bite marks may take as long as 14 days to develop in some people so it is important to look for other clues when determining if bed bugs have infested an area. These signs include:

  • the bed bugs’ exoskeletons after molting,
  • bed bugs in the fold of mattresses and sheets,
  • rusty–colored blood spots due to their blood-filled fecal material that they excrete on the mattress or nearby furniture, and
  • a sweet musty odor.

How do I know if I’ve been bitten by a bed bug?

It is hard to tell if you’ve been bitten by a bed bug unless you find bed bugs or signs of infestation. When bed bugs bite, they inject an anesthetic and an anticoagulant that prevents a person from realizing they are being bitten. Most people do not realize they have been bitten until bite marks appear anywhere from one to several days after the initial bite. The bite marks are similar to that of a mosquito or a flea — a slightly swollen and red area that may itch and be irritating. The bite marks may be random or appear in a straight line. Other symptoms of bed bug bites include insomnia, anxiety, and skin problems that arise from profuse scratching of the bites.

Because bed bug bites affect everyone differently, some people may have no reaction and will not develop bite marks or any other visible signs of being bitten. Other people may be allergic to the bed bugs and can react adversely to the bites. These allergic symptoms can include enlarged bite marks, painful swellings at the bite site, and, on rare occasions, anaphylaxis.

How did I get bed bugs?

Bed bugs are experts at hiding. Their slim flat bodies allow them to fit into the smallest of spaces and stay there for long periods of time, even without a blood meal. Bed bugs are usually transported from place to place as people travel. The bed bugs travel in the seams and folds of luggage, overnight bags, folded clothes, bedding, furniture, and anywhere else where they can hide. Most people do not realize they are transporting stow-away bed bugs as they travel from location to location, infecting areas as they travel.

Who is at risk for getting bed bugs?

Everyone is at risk for getting bed bugs when visiting an infected area. However, anyone who travels frequently and shares living and sleeping quarters where other people have previously slept has a higher risk of being bitten and or spreading a bed bug infestation.

How are bed bugs treated and prevented?

Bed bug bites usually do not pose a serious medical threat. The best way to treat a bite is to avoid scratching the area and apply antiseptic creams or lotions and take an antihistamine. Bed bug infestations are commonly treated by insecticide spraying. If you suspect that you have an infestation, contact your landlord or professional pest control company that is experienced with treating bed bugs. The best way to prevent bed bugs is regular inspection for the signs of an infestation.

This information is not meant to be used for self-diagnosis or as a substitute for consultation with a health care provider. If you have any questions about the parasites described above or think that you may have a parasitic infection, consult a health care provider.

Bedbugs

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Bedbugs are small, oval, brownish insects that live on the blood of animals or humans. Adult bedbugs have flat bodies about the size of an apple seed. After feeding, however, their bodies swell and are a reddish color.

Bedbugs do not fly, but they can move quickly over floors, walls, and ceilings. Female bedbugs may lay hundreds of eggs, each of which is about the size of a speck of dust, over a lifetime.

Immature bedbugs, called nymphs, shed their skins five times before reaching maturity and require a meal of blood before each shedding. Under favorable conditions the bugs can develop fully in as little as a month and produce three or more generations per year.

Although they are a nuisance, they are not thought to transmit diseases.

Where Bed Bugs Hide

Bedbugs may enter your home undetected through luggage, clothing, used beds and couches, and other items. Their flattened bodies make it possible for them to fit into tiny spaces, about the width of a credit card. Bedbugs do not have nests like ants or bees, but tend to live in groups in hiding places. Their initial hiding places are typically in mattresses, box springs, bed frames, and headboards where they have easy access to people to bite in the night.

Over time, however, they may scatter through the bedroom, moving into any crevice or protected location. They may also spread to nearby rooms or apartments.

Because bedbugs live solely on blood, having them in your home is not a sign of dirtiness. You are as likely to find them in immaculate homes and hotel rooms as in filthy ones.

When Bedbugs Bite

Bedbugs are active mainly at night and usually bite people while they are sleeping. They feed by piercing the skin and withdrawing blood through an elongated beak. The bugs feed from three to 10 minutes to become engorged and then crawl away unnoticed.

Most bedbug bites are painless at first, but later turn into itchy welts. Unlike flea bites that are mainly around the ankles, bedbug bites are on any area of skin exposed while sleeping. Also, the bites do not have a red spot in the center like flea bites do.

People who don’t realize they have a bedbug infestation may attribute the itching and welts to other causes, such as mosquitoes. To confirm bedbug bites, you must find and identify the bugs themselves.

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Signs of Infestation

If you wake up with itchy areas you didn’t have when you went to sleep, you may have bedbugs, particularly if you got a used bed or other used furniture around the time the bites started. Other signs that you have bedbugs include:

  • Blood stains on your sheets or pillowcases
  • Dark or rusty spots of bedbug excrement on sheets and mattresses, bed clothes, and walls
  • Bedbug fecal spots, egg shells, or shed skins in areas where bedbugs hide
  • An offensive, musty odor from the bugs’ scent glands

If you suspect an infestation, remove all bedding and check it carefully for signs of the bugs or their excrement. Remove the dust cover over the bottom of the box springs and examine the seams in the wood framing. Peel back the fabric where it is stapled to the wood frame.

Also, check the area around the bed, including inside books, telephones or radios, the edge of the carpet, and even in electrical outlets. Check your closet, because bedbugs can attach to clothing. If you are uncertain about signs of bedbugs, call an exterminator, who will know what to look for.

If you find signs of infestation, begin steps to get rid of the bugs and prevent their return.

Bedbug Treatments

Getting rid of bedbugs begins with cleaning up the places where bedbugs live. This should include the following:

  • Clean bedding, linens, curtains, and clothing in hot water and dry them on the highest dryer setting. Place stuffed animals, shoes, and other items that can’t be washed in the dryer and run on high for 30 minutes.
  • Use a stiff brush to scrub mattress seams to remove bedbugs and their eggs before vacuuming.
  • Vacuum your bed and surrounding area frequently. After vacuuming, immediately place the vacuum cleaner bag in a plastic bag and place in garbage can outdoors.
  • Encase mattress and box springs with a tightly woven, zippered cover to keep bedbugs from entering or escaping. Bedbugs may live up to a year without feeding, so keep the cover on your mattress for at least a year to make sure all bugs in the mattress are dead.
  • Repair cracks in plaster and glue down peeling wallpaper to get rid of places bedbugs can hide.
  • Get rid of clutter around the bed.

If your mattress is infested, you may want to get rid of it and get a new one, but take care to rid the rest of your home of bedbugs or they will infest your new mattress.

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Bedbug Extermination

While cleaning up infested areas will be helpful in controlling bedbugs, getting rid of them usually requires chemical treatments. Because treating your bed and bedroom with insecticides can be harmful, it is important to use products that can be used safely in bedrooms. Do not treat mattresses and bedding unless the label specifically says you can use them on bedding.

Generally it is safest and most effective to hire an experienced pest control professional for bedbug extermination.

Sources

University of Kentucky College of Agriculture: "Bed Bugs."

Ohio State University Extension Fact Sheet: "Bed Bugs."

The New York City Department of Heath and Mental Hygiene: "Stop Bed Bugs Safely."

University of Nebraska–Lincoln Extension Lancaster County: "Managing Bed Bugs."

How Bedbugs Are Treated

Andy Miller, MD, is board-certified in internal medicine and infectious disease. He is an associate professor at Weill Cornell Medicine in New York City.

If you have been bitten by bedbugs, the good news is that they aren’t associated with any disease. You need only to avoid scratching the bites and getting a skin infection. Anti-itch creams may help. Treating your home or possessions to eliminate an infestation is more of a challenge, and you may need both nonchemical and chemical treatments. Learn how to treat your bites and get rid of bedbugs.

Over-the-Counter Therapies

The treatment of bedbug bites depends on the symptoms and their severity. The bites should heal and disappear in two to six weeks whether you treat them or not.   The goal is to prevent scratching the itchy rash, which can lead to a skin infection.

You can use over-the-counter (OTC) anti-itch creams such as calamine lotion or those containing diphenhydramine or cortisone. Be sure to read the product label and don’t use these creams around the eyes, anus, or genitals.  

An OTC antiseptic medication can be used for skin irritation that may then develop into an infection. As a precaution, do not use creams on broken or infected skin. If you have already been scratching, do not use these products on any raw or weeping areas.

If you see signs of a skin infection, such as redness, don’t use these creams in that area, and call your doctor.

Oral Benadryl (diphenhydramine) can also help reduce itchiness.

Prescriptions

Zonalon and Prudoxin (doxepin) are topical creams that can be prescribed for relief from itching.   The active ingredient in these products is a topical tricyclic antidepressant and seems to work against itching by reducing histamine.

Histamines are chemicals your body produces in response to injury or when having an allergic reaction. Prescription-Strength cortisone cream may also help. In some cases, a prescription antihistamine will be given.

Antibiotics usually will be prescribed if you develop a skin infection from scratching.

Topical Bactroban (mupirocin) may be prescribed or you may be given oral antibiotics. A severe allergic reaction or anaphylaxis may be treated with an injection of antihistamine, corticosteroids, or epinephrine.

Home Remedies and Lifestyle

The only way to stop getting bedbug bites is to eradicate them, but it will be difficult and time-consuming. You can try to address the problem yourself, but It is best to enlist a professional pest control service that can use nonchemical and chemical measures.

If you are renting, notify your landlord as other units should be inspected and the landlord may be required to assist in the eradication.

Preparing a Room for Treatment

First, there should be a thorough inspection of areas that may be infested to identify bedbugs. Once a room is identified as infested, don’t remove anything from the room unless it is sealed in a plastic bag.  

Furniture and items that you want to discard rather than treat should be bagged and destroyed so other people don’t use them. Call your trash collection agency to arrange for an immediate pickup.

Reduce the clutter in the room and discard any cardboard boxes as they can harbor bedbugs. Vacuum the area and seal the vacuum bag in a plastic bag and discard it.

Nonchemical Treatment

Nonchemical treatment means include:

  • Heat treatment:Heat of 120 F for two hours will kill bedbugs.   Wash items in hot water (120 F or above). This may not be enough, though, so it’s recommended that you place items in a clothes dryer on hot heat for at least 30 minutes. In a hot climate, you can bag items in a black plastic bag and leave them in direct sunlight for 24 hours. For travel or home use, there are portable heating units that can be used for clothing and luggage. A garment steamer can also be used on some items, such as luggage.
  • Cold treatment:Bag items in plastic and freeze (below 0 F) for four days or at 20 F for seven days.   Ensure your freezer is set cold enough. If leaving items outdoors to freeze, ensure they are in a dry, shaded area.
  • Barriers:You can purchase bedbug-proof encasement covers for mattresses, box springs, and pillows. Also get bedbug interceptors to place under each leg of the bed or furniture items. These also allow you to see if there are any remaining bedbugs as they get trapped in the double rings of the interceptor disks. Ensure the bed is at least 6 inches from the wall and the bedding doesn’t touch the floor.

Chemical Treatment

Chemical treatments are available for consumers as well as professionals. Some sources say the consumer products are not very effective and it is best to use a professional service.

Effective eradication may require more than one chemical, as each works on bedbugs in a different way.

The chemicals that may be used include:

  • Pyrethrins and pyrethroids: These are the most common compounds used.   However, some bedbugs are resistant and using a fogger often doesn’t reach bed bugs in crevices.
  • Desiccants: These include diatomaceous earth and boric acid. Because they can be an inhalant risk, they are best used only in crevices. You should only use those that are registered by the EPA and labeled for use against bedbugs.
  • Cold pressed neem oil is registered for use as a biochemical pesticide.  
  • Chlorfenapyr is used as a pro-insecticide that disrupts the bug’s cells.
  • Neonicotinoids activate nicotine receptors in the bug’s nervous system and overstimulate them.
  • Insect growth regulators mimic insect hormones and disrupt their growth.

Prevention

Wearing an insect repellent is not completely effective, although you might try oil of lemon eucalyptus or DEET to prevent bites. Avoid bringing home second-hand items such as used furniture, mattresses, or any item that someone has kept in a bedroom.

Launder all used clothing before storing or wearing it. Use mattress, box spring, and pillow encasements on your bed. Fill in any cracks and crevices in your bedroom.

Bedbugs can linger without feeding for several months in most environments.

When traveling, inspect the bedding prior to exposing yourself or your belongings. Seal your dirty clothes in plastic bags. You may even consider encasing your luggage in a plastic bag while you are in a hotel room. Launder your clothing as soon as you get home.

You can treat your suitcase by vacuuming, using a clothes steamer, or handwashing it with hot water and soap. You might also consider encasing luggage in a plastic bag between trips.

Coping

Being bitten by bedbugs, whether while traveling or at home, can be distressing. Many people report anxiety, depression, and loss of sleep.   Although bedbugs are not associated with poor hygiene, you might be afraid of the stigma. Be sure to take time for stress relief as you deal with a bedbug infestation.

Bed Bug Facts & Statistics

Read our Bugs Without Borders Survey below for more bed bug statistics.

The following bed bug facts and statistics are compiled from the 2018 Bugs Without Borders survey conducted by the National Pest Management Association:

  • Almost all (97 percent) pest professionals have treated bed bugs in the past year.A majority of them say that overall bed bug service work (69 percent) and the prevalence of these pests (66 percent) are increasing.
  • Bed bugs may be easily confused with other pests, as 84 percent of pest control professionals were initially contacted about a different type of pest before identifying them as bed bugs. The majority of these contacts (71 percent) were about fleas, followed by cockroaches (28 percent).
  • More than half of pest control professionals noted that they receive the most bed bug complaints during the summer, as increased travel during this time of the year may help spread bed bugs from vacation destinations to homes or even college lodgings to homes as students go on summer break.
  • The top three places where pest professionals report finding bed bugs are single-family homes (91 percent), apartments/condominiums (89 percent), and hotels/motels (68 percent). Past bed bug statistics have shown these environments to consistently be the top three where bed bugs have been encountered.
  • Bed bugs are also found seemingly everywhere else and in higher numbers, such as nursing homes (59 percent), schools and daycare centers (47 percent), offices (46 percent), college dorms (45 percent), hospitals (36 percent) and public transportation (19 percent).
  • Bites are the most commonly reported sign of an infestation (92 percent) and more than half of people reach out for treatment after discovering bites and welts on their bodies.Although some people immediately develop a skin reaction to bites, others may take two to three days before showing obvious symptoms or any symptoms at all, meaning that people could be unaware of a bed bug problem until a full-blown infestation has taken root.
  • Typically found in couches and bed frames, bed bugs can also be found in some of the most unexpected places, including stuffed animals, wheelchairs, airplanes, school buses, purses and even inside bedside lamps.

Previous Bed Bugs in America Survey

The following bed bug statistics and facts are compiled from the NPMA’s 2011 Bed Bugs in America Survey:

  • One out of five Americans has had a bed bug infestation in their home or knows someone who has encountered bed bugs at home or in a hotel
  • Americans who have encountered bed bugs tend to be younger, live in urban areas and rent their homes. The incidence of bed bugs is three times higher in urban areas than in rural areas due to factors such as larger population size, apartment living and increased mobility, which are conducive to the rapid spread and breeding of bed bugs.
  • Bed bugs are found in all 50 states. Specifically, the pests were encountered by 17 percent of respondents in the Northeast; 20 percent in the Midwest; 20 percent in the South; and 19 percent in the West.
  • Most Americans are concerned about bed bugs and believe that infestations in the United States are increasing. Nearly 80 percent are most concerned about encountering bed bugs at hotels; 52 percent on public transportation; 49 percent in movie theaters; 44 percent in retail stores; 40 percent in medical facilities; 36 percent in their own homes; and 32 percent equally pointed to places of employment and friends’ homes. The fear of getting bitten topped the list of concerns.
  • As the public’s awareness of the bed bug resurgence grows, many Americans are modifying their behaviors to minimize their risk of an infestation: 27 percent have inspected or washed clothing upon returning from a trip; 25 percent have checked a hotel room for bed bugs; 17 percent have inspected or vacuumed a suitcase upon returning from a trip and 12 percent have altered or canceled travel plans because of concern about bed bugs.
  • Sixteen percent of survey respondents inspected second-hand furniture they have brought into their homes; 15 percent have checked dressing rooms when trying on clothing and 29 percent have washed new clothing immediately upon bringing it home from a store.
  • Of the 13 percent of respondents who said they knew someone who had a bed bug infestation in their home, 40 percent said they avoided entering the infested home and 33 percent discouraged those who had the infestation from entering their own home.
  • Despite the availability of information, most Americans still have misconceptions about bed bugs. Nearly half of respondents incorrectly believe that bed bugs transmit disease. However, research conducted to date has shown that bed bugs do not transmit disease to their human victims, although some people may experience itchy, red welts; 29 percent inaccurately believe bed bugs are more common among lower income households, and 37 percent believe bed bugs are attracted to dirty homes. Bed bugs do not discriminate in regard to household income and are found in both sanitary and unsanitary conditions.

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