Bed bug bites: What you need to know
There are several ways of reducing the chances of getting bites, while the treatment options include good hygiene and antihistamines.
This article explores bed bug bite treatment and prevention methods in detail.
Bed bugs are small parasitic insects that feed on human blood.
While they are a public health concern, bed bugs are not known to transmit disease through their bites.
Bed bugs use a small tube-like structure called a proboscis to pierce the skin and drink a person's blood. The pests are most active when humans are asleep, during the night and early morning.
An estimated one in five Americans have personally dealt with a bed bug infestation or knows someone who has encountered the pests.
The bed bug bites may form a line or be in a zigzag pattern.
Bed bugs can bite anywhere on the body where there is skin. Typically, bites tend to occur on areas exposed during sleeping, such as:
Many people do not feel the bite itself or develop clear symptoms other than the dots where the bug bit and some minor, surrounding inflammation and irritation. Others are considered hypersensitive to bites and develop more severe symptoms.
In most cases symptoms occur more or less immediately after the bite, but they can develop or progress over the following days as well. Without further irritation, symptoms typically resolve after a week or so.
Almost all bed bug bites will produce some degree of discomfort, typically itchiness and inflammation. Other signs and symptoms of bed bug bites include:
- a burning painful sensation
- a raised itchy bump with a clear center
- a red itchy bump with a dark center and lighter swollen surrounding area
- small red bumps or welts in a zigzag pattern or a line
- small red bumps surrounded by blisters or hives
- papular eruptions or areas of skin with raised or flat patches that may be inflamed
- small spots of blood from bites often dried or stained onto sheets or bed clothing
- reddish or reddish-brown dried stains on fabrics due to bed bug droppings
- white or clear skins, shed by the nymphs as they mature
Individual characteristics of the bug's bite and the person who is bitten also influence the resulting sore.
While fairly rare, some people have or develop severe reactions and symptoms from bed bug bites. Serious symptoms that require medical attention include:
- difficulty breathing
- feeling nauseous or flu-like
- swollen tongue
- irregular heartbeat
Living with bed bugs can cause additional health complications:
- Increased likelihood of infection: Due to the skin's surface being compromised.
- Sleep deprivation: The idea of being fed on can be extremely stressful. Given that the bugs only feed at night, some people will avoid sleep or will only get fitful or restless sleep.
- Decreased wellbeing: A continual lack of sleep has been linked to feelings of depression, anxiety, general fatigue, and lowered immune function. The misconceptions surrounding bed bugs, especially the mistaken association with lack of cleanliness, can add to feelings of depression and low self-esteem.
Bed bug bites should heal on their own, but may be itchy and swollen in the meantime.
Image credit: James Heilman MD, 2013
There are relatively few treatments options when it comes to uncomplicated bed bug bites.
The first recommended line of treatment involves cleaning the wound, ideally with soap and water.
For itchy bites, the following may relieve minor symptoms:
- over-the-counter hydrocortisone, which can be purchased online.
- anti-itch creams
Most wounds heal on their own within a week, sometimes two.
If severe swelling, inflammation, or itchiness occurs or persists, a person should seek medical attention.
A dramatic immune response may be a sign of an allergic reaction. If this is the case, one of the following may need to be administered:
- an injectable corticosteroid
- epinephrine medication
If infection occurs, antibiotics may be prescribed.
Severe itchiness may result in further complications, such as infection or scarring. If severe itching is experienced, people may be prescribed corticosteroid creams and antihistamine pills or liquid.
Older bed bugs are about the size of an apple seed and are brown in color.
One way to help prevent exposure and potential infestations by bed bugs is to be able to recognize bed bugs and distinguish them from other pests.
In a 2017 study, some 35 percent of polled American business travellers and 28 percent of leisure travellers were unable to tell a bed bug apart from other household pests.
Common characteristics of nymphs (young bed bugs) include:
- being less than than 5 mm in length
- whitish-yellow and or clear-colored
- invisible without a microscope or magnifying glass
The nymphs are easier to see if they have just feed when the blood fills their abdomen, giving it a reddish brown color.
Adult bed bugs are typically far easier to spot than nymphs. Identifiable characteristics of most adult bed bugs include:
- an oval-shaped body
- apple seed in size
- a body that is fairly flat unless recently fed and inflated
- reddish-brown to light-brown or tan color of shell, depending on how recently it fed
- a length of 5-7 millimeters (mm)
- three segments, an antenna with four parts, short yellow hairs, and unusable wings
- a musty or stale-sweet scent released by glands on the underbelly
Controlling bed bugs needs the identification and complete removal or destruction of the pest's eggs.
On average, one female can produce at least 345 eggs over her lifetime. Egg-laying females often increase the volume and frequency of feeding to support their brood.
Common characteristics and signs of bed bug eggs include:
- they are often laid in the same places where the female choses to rest
- they resemble tiny barrel-shaped, pearl-colored specks, no bigger than the head of a pin
- they develop a noticeable eye spot after a few days
The key to preventing bed bug bites is to stop the insects entering, feeding, and breeding in human environments.
In the daytime, bed bugs often seek refuge in the cracks and crevices of furniture, flooring, walls, and mattresses.
The seams and folds of upholstered furniture can also offer an ideal hiding place. Bed bugs have been known to persist in vacuum canisters or units.
The insects tend to pick hiding spots near human sleeping quarters, including bedrooms. Bed bugs found in other rooms are usually a sign of a severe infestation.
Areas where bed bug infestations commonly occur include:
Searching for bed bugs includes looking for reddish-brown stains caused by their droppings and the clear skins shed by nymphs as they mature.
- apartment or condominium buildings
- large office spaces
- vacation rentals
- cruise ships
- nursing homes
- college dormitories or housing units
- public transportation, including airplanes
- shopping malls
- furniture or second hand stores
- urban areas
- rented homes
Items commonly responsible for spreading bed bugs include:
- used or secondhand furniture
- new furniture or textiles exposed to bed bugs during transit
- items of luggage
- chairs or loungers where people fall asleep
- bedding or bed clothes
- moving or storage boxes
- shipped items, especially if held at several locations or warehouses
Bed bugs do not have a preference between sanitary, messy, or unsanitary conditions.
They can, however, be found at higher rates in places, such as hotels, if infestations are not properly cleared.
Control of bed bugs
Home tips for preventing, controlling, and clearing bed bug infestations include:
- Avoid furniture or items from infested areas or environments commonly impacted by bed bugs, such as apartment buildings.
- Pick furniture or items made out of materials that do not typically contain cracks, crevices or seams, including plastic, stone, metal, plaster, and high-weave textiles.
Washing bedding at high temperatures and checking for signs of bed bugs in hotel rooms can help prevent bed bug bites.
- Fill or seal cracks, crevices, and seams with products, such as glue or calking.
- Clean bedding and bed clothing regularly.
- Wash and dry bedding at high heat.
- Vacuum upholstered items regularly and thoroughly, including mattresses, pillows, etc.
- Clean heavier bedding items, including mattresses, pillows, comforters, and duvet covers, using high heat, ideally the "dry steam" setting available on modern washing machines.
- Use a hand steamer to kill eggs and bugs in luggage or upholstered items.
- When traveling, keep luggage on racks and away from floors, beds, and furniture.
- Check for signs of bed bugs upon entering hotel rooms or other pest hot spots.
- Remember, where there is one bed bug there are usually many, often in the areas surrounding or adjacent to the infected room or item.
- Cover as much of the skin as possible while sleeping.
In severe or persistent cases, furniture or infected items may need to be destroyed, ideally by burning.
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