Bed Bugs and Bed Bug Bites

What are bed bugs?

Bed bugs (Cimex lectularius) are tiny insects that bite people and animals to get blood for food. They are parasites, meaning they need human hosts to supply them with food. Most bites happen while you’re asleep.

What do bed bugs look like?

Bed bugs are flat, brown or reddish-brown insects with six legs. Adult bed bugs are about the size of an apple seed (5-7 mm). Young bed bugs are white-to-yellow in color or appear translucent if they haven't been fed. Bed bug eggs are very small, about the size of a pinhead, and are a pearly white color. If an egg is more than five days old, it’s marked with a black dot on a white egg. A female bed bug lays 200 to 500 eggs during its lifetime, so even a few bed bugs in your home can quickly turn into an infestation.

Where do bed bugs live?

Bed bugs are found in all types of locations, from five-star hotels to homes and apartments, dormitories and shelters. They’re found in buses and trains and ships. Bed bugs are found in all corners of the globe.

Usually, bed bugs live within eight feet of where you sleep and are mostly active at night.

During the day, bed bugs hide in the areas in and around your bed including:

• Along the seams of your mattress.
• In your box spring, bed frame and headboard.
• Between and along the seams of cushions of bedroom chairs or couches.
• In the joints of drawers of bedroom furniture.
• In any cracks, crevices or folds of objects in your bedroom or near your bed.
• Along corners of walls, inside the edges of loose wallpaper and around electrical outlets.

On average, bed bugs live from six to 24 months. Bed bugs usually feed every three to seven days but can survive several months to a year without feeding.

How do I know if I have bed bugs?

Your first obvious sign might be a bed bug bite. If you have a bite and want to verify if you have bed bugs, check for signs of an infestation including:

• A sweet, musty odor.
• Reddish or rust-colored stains on bed sheets, sleepwear or nearby objects. This is what bed bugs excrete after eating, essential bed bug poop.
• Bed bug exoskeletons (the skeleton they shed after molting).
• Live bed bugs in the folds of bedsheets and mattresses.

Bed bugs move slower than other small bugs, so pay attention to the speed of the bug you find to help with identification.

Who do bed bug bites affect?

Anyone can get bed bugs. Unfortunately, bed bugs infestations are possible even if you keep your living space spotless. Bed bugs are excellent hitchhikers. They can come into your home on luggage, folded clothing, bedding including used mattresses and other used furniture items and boxes. If you live with a lot of people or with people who travel a lot, you are at greater risk of bringing home these unwanted pests.

How common are bed bugs?

An estimated 1 in every 5 Americans has either had a bed bug infestation in their home or knows someone who encountered bed bugs in their home or at a hotel. Most pest control professionals report infestations occurring during the summer when travel increases. Often, bed bugs are confused as other pests, like fleas or cockroaches, before being diagnosed by a pest control professional.

Where do bed bugs bite?

Bed bugs can bite anywhere on your skin. They specifically target areas of your skin that make contact with your bed, including your:

• Arms.
• Back.
• Face.
• Neck.
• Legs.

What are the symptoms of bed bug bites?

Symptoms of bed bug bites include:

• Itchiness.
• Raised skin that resembles a pimple or a rash (inflammation).
• Burning sensation.
• Mild pain and discomfort.

Just as you probably don’t feel a spider bite while you’re sleeping, you won’t feel a bed bug bite either. Bed bugs have another defense system that prevents you from feeling you’ve been bitten. They inject an anesthetic (numbing) and an anticoagulant (stops bleeding) into your skin when they bite. You may not notice you’ve been bitten until the bite marks appear, which can take from one to a couple of days after the bites.

In rare cases, bed bug bites can cause serious reactions. Signs of a serious, even life-threatening reaction (called anaphylaxis) to bed bug bites include:

• Difficulty breathing.
• Swollen tongue.
• Blisters.
• Fever.
• Irregular heartbeat.
• Feeling extremely sick.

If you experience any severe symptoms as a reaction to a bed bug bite, visit your healthcare provider immediately.

What do bed bug bites look like?

Bed bugs bite each person differently, but the most common appearances of bed bug bites include:

• Raised bumps in a line, zigzag or random pattern.
• Pimple-like bump with a dark red center and skin tone lighter than normal surrounding it.
• Round bump on your skin containing a clear fluid (blister).
• Raised area of your skin with several small bumps, often red or purple in color (hives).

Some people may not develop any marks from a bite. Most people develop marks similar to mosquito or flea bites — slightly swollen bumps with a reddish bruise in the middle that itch.

What causes bed bug infestations and bites?

Bed bugs are nature’s hitchhikers. They travel from other infested areas by attaching themselves to your clothing, bags and luggage or any surface that's soft or upholstered. Once they’re inside your home, bed bugs travel between rooms to find more surfaces to live, breed and feed.

Bed bugs bite because they are hungry. They feed on your blood by inserting a beak that resembles a straw into your skin. The bugs drink your blood for a few minutes before becoming full, then detach and crawl away from your body to digest their meal.

What are the side effects of bed bug bites?

In most people, bed bug bites don’t cause any serious health problems and the bite marks disappear within a few weeks. In others, bite marks may be enlarged or swollen welts and are more painful and itchy.

Other health problems from bed bug bites include:

• Insomnia.
• Anxiety.
• Possible skin infections from tears in your skin caused by vigorous itching.

How are bed bug bites diagnosed?

A visual examination of the bites on your skin gives your healthcare provider proof of a bite, but the bites may look similar to other bug bites. You can confirm the diagnosis by locating and identifying a bed bug in your sleeping environment.

How are bed bug bites treated?

Fortunately, bed bug bites don’t usually present a serious threat to your health. The best way to treat bed bug bites includes:

1. Washing the bites gently with soap and water.
2. Applying an anti-itch cream or lotion (look for hydrocortisone 1%) to your skin.
3. Repeating daily or twice daily if itching continues.

If your itching is severe and causes you extreme discomfort, your healthcare provider may prescribe a stronger steroid cream or recommend that you take an over-the-counter or prescription antihistamine medication.

It’s important to avoid scratching bed bug bites as much as possible. Scratching the bites can lead to skin tears and infections.

What medications are used to treat bed bug bites?

To treat the symptoms of the bed bug bite, the following medications can help:

• Anti-itch cream.
• Antihistamines.
• Steroid cream.
• Antibiotics.

Do bed bug bites spread if I itch my skin?

No, bed bug bites don’t multiply if you itch them. Bed bugs also don’t carry or spread disease, so the bite is not contagious.

How do I get rid of bed bugs?

If you have a bed bug infestation, you can get rid of bed bugs by:

• Washing your clothing, sheets and blankets with hot, soapy water and then drying them on high heat for 20 minutes.
• Freeze clothing and/or fabric where bed bugs lived at temperatures under 32°F (0°C) in a sealed bag for at least four days.
• Brushing your mattress, box spring and/or furniture seams with a stiff brush, followed by vacuuming the room.
• Using a steam cleaner at a temperature above 130°F (55°C) to treat carpets, mattresses and furniture.
• Hiring an exterminator who uses insecticide spray to kill bed bugs and their eggs. If you rent, you should contact your landlord for information.

How soon after I treat a bed bug infestation will it go away?

Depending on the severity of the bed bug infestation, it could take weeks to months to eliminate the pests. Often, the first attempt to eliminate an infestation is not 100% successful, so keep a watchful eye on the infected area each week to monitor the situation and re-treat as needed.

How can I prevent bed bug bites?

You can best prevent bed bug bites by frequently inspecting your home for signs of the presence of bed bugs. You can also lower your risk of bringing home bed bugs by following these simple steps:

• Encase mattresses and box springs in protective plastic covers.
• Vacuum frequently, especially in areas near where you sleep.
• Cut down on clutter in your home, which will eliminate some hiding places for bed bugs.
• If you live in an apartment or other shared housing, try to close off your unit. Seal cracks around baseboards, light sockets and doors to prevent bed bugs from coming into your home.
• If you're traveling, inspect your room for signs of bed bugs. Be sure to check the bed (pull back the sheets/check the mattress) and all upholstered furniture in your hotel room/stay space. Inspect your luggage before packing for your return trip home.
• Upon returning home from traveling, wash all clothing immediately using hot, soapy water and dry on high heat for 20 minutes.
• Check all used furniture and mattresses you purchase before bringing them into your home.
• Carefully inspect all used clothing and fabric items before you buy. Immediately wash these items in hot, soapy water and dry on high heat for 20 minutes.

What can I expect if I have bed bug bites?

Bed bug bites irritate your skin and can be a discomfort to your daily routine. Bites can cause infection if you scratch too much. Bed bug bites often lead to sleep deprivation due to itching, stress and anxiety inside of your bedroom after finding an infestation. Exterminating the bed bugs leads to more peace of mind.

How long do bed bug bites last?

Bed bug bites usually heal within a week but could last longer depending on how your body reacts to the bite. If you don’t kill the bed bugs, you might get more bed bug bites until the bugs have been exterminated.

When should I see my healthcare provider?

You should visit your healthcare provider if you experience severe itching that prevents you from going about your day. If you scratch a lot and the site of the bite turns into sores that are puffy, red and oozing, that may be a sign of infection. Your healthcare provider will help you treat the infection.

What questions should I ask my doctor?

• How can I tell whether this is a bed bug bite?
• How often can I apply anti-itch cream to treat my itching?
• Am I allergic to bed bugs?

What is the difference between bed bug bites and other bug bites?

While the symptoms for many bug bites include itching, the bite pattern and location help separate each bug to better treat the bite.

• Bed bug bites: Bed bug bites form raised bumps that can show up in a zigzag pattern on skin that makes contact with your bed, including your arms, legs and back.
• Flea bites: Flea bites are most similar to bed bug bites, which are small raised bumps that form in a zigzag pattern on your skin, most often targeting your legs and waist.
• Mosquito bites: A mosquito will leave a single bite, which is a small, raised bump, on an area of your body not covered by clothing, including your arms and legs.
• Scabies: Scabies are mites that burrow into your skin, causing small red bumps to appear often in folds or narrow cracks of your skin, like between fingers and toes.
• Spider bites: Most spider bites aren't a problem, but some may leave a single bite that turns into a wound and causes muscle pain, headaches and trouble breathing. Spider bites should be immediately treated by your healthcare provider.
• Tick bites: Ticks most commonly bite on the back of your neck, scalp and legs. Ticks burrow their head in your skin, which causes a rash or small red, elevated spots on your skin.

A note from Cleveland Clinic

Bed bugs are traveling pests whose bite causes itching and discomfort. Take steps to prevent bed bugs from getting comfortable in your home by encasing your mattress in a protective cover and washing your clothing with hot, soapy water immediately when returning from vacation.