Bed Bug Bites
Itchy bumps from tiny blood-feeding insects
Quick Facts
- Type: Insect bite skin reaction
- Cause: Bed bugs feeding on blood
- Typical pattern: Lines or clusters of itchy bumps
- Disease risk: Bed bugs are not known to spread disease
Overview
Bed bugs are small, flat, reddish-brown insects that feed on the blood of people and animals, usually at night. Their bites cause small, itchy welts on the skin. Bed bugs hide in mattresses, bed frames, furniture, and cracks during the day, which is why bites often appear after sleeping.
While the bites are uncomfortable and the infestation distressing, bed bugs are not known to spread disease to humans. Most bites heal on their own within a week or two. The bigger challenge is usually eliminating the bugs from the home, which often requires thorough cleaning and sometimes professional pest control.
Symptoms
Reactions to bed bug bites vary from person to person, and some people have no visible reaction at all.
- Small, red, raised bumps that are often very itchy
- Bites arranged in a line, cluster, or zigzag pattern
- A small dark center or surrounding red area on each bite
- Bites commonly on exposed skin such as the face, neck, arms, and hands
- Sometimes blisters or hives in people who react strongly
Bites may not appear until hours or days after feeding, and scratching can lead to broken skin and secondary infection.
Causes
The bites are caused by bed bugs feeding on blood. The itch and bumps come from the body's reaction to substances in the bug's saliva.
- Feeding at night: Bed bugs are most active while people sleep and are drawn to body heat and exhaled carbon dioxide.
- Hiding nearby: They live in mattresses, bed frames, baseboards, and furniture close to where people rest.
- Spread: Bed bugs travel in luggage, used furniture, clothing, and between connected living spaces, so an infestation is not a sign of poor hygiene.
Risk Factors
- Recent travel and staying in hotels or shared lodging
- Living in apartments or buildings where bugs can move between units
- Buying or acquiring used furniture or mattresses
- Having recent guests or staying with others who have an infestation
- Reactions can be stronger in people with sensitive skin
Diagnosis
Bed bug bites are usually identified by their appearance and pattern, along with evidence of bugs in the home.
- Examining the bites: The line or cluster pattern on exposed skin is suggestive but not unique to bed bugs.
- Finding the bugs: Confirmation often comes from spotting live bugs, shed skins, tiny dark fecal spots, or small blood stains on bedding.
- Ruling out other causes: A clinician may consider other insect bites, hives, or skin conditions that look similar.
Treatment
Treatment focuses on relieving itching and preventing scratching-related infection, while the home is treated for the bugs.
- Wash the bites: Clean the area with soap and water.
- Soothe the itch: Over-the-counter anti-itch creams, such as those containing hydrocortisone, and cool compresses can help.
- Oral antihistamines: May reduce itching and any allergic reaction.
- Avoid scratching: To prevent broken skin and secondary infection.
- Treat infection if it develops: Spreading redness, warmth, or pus may need a doctor's care.
Most bites clear within one to two weeks. Getting rid of the bed bugs themselves usually requires thorough cleaning, laundering bedding in hot water, and often professional pest control.
Prevention
Preventing bites largely means avoiding and eliminating bed bugs:
- Inspect hotel beds and headboards when traveling, and keep luggage off the floor and bed
- Wash and heat-dry clothing after trips
- Examine used furniture and mattresses before bringing them home
- Use protective mattress and box-spring covers
- Reduce clutter where bugs can hide
- Act quickly at the first sign of an infestation, often with professional help
When to See a Doctor
See a doctor if bites become very swollen, intensely itchy, or show signs of infection such as increasing redness, warmth, pus, or pain. A clinician can also help if itching is severe enough to disrupt sleep or daily life.
Seek emergency care for any signs of a severe allergic reaction, which is rare with bed bug bites, including difficulty breathing, swelling of the face, lips, or throat, or feeling faint. Call emergency services right away if these occur.
Frequently Asked Questions
How do I know if bites are from bed bugs?
Bed bug bites are usually small, itchy red bumps that appear in a line or cluster on exposed skin after sleeping. Finding live bugs, shed skins, dark fecal spots, or blood stains on bedding helps confirm them, since the bites alone can look like other insect bites.
Do bed bugs spread disease?
Bed bugs are not known to transmit disease to people. The main problems are itching, discomfort, and the stress of an infestation. Scratching can occasionally cause a skin infection, which is the main complication to watch for.
How do I stop the itching?
Wash the bites, apply a cool compress, and use over-the-counter anti-itch creams such as hydrocortisone. Oral antihistamines can also help. Try not to scratch, as broken skin can become infected.
Does having bed bugs mean my home is dirty?
No. Bed bugs spread through travel, used furniture, and movement between living spaces, and they infest clean and messy homes alike. An infestation is not a reflection of hygiene.
When should bites prompt a doctor visit?
See a doctor if bites become very swollen, intensely itchy, or show signs of infection like spreading redness, warmth, or pus. Seek emergency care for any rare severe allergic reaction, such as trouble breathing or facial swelling.
References
- Centers for Disease Control and Prevention (CDC). Bed Bugs.
- Environmental Protection Agency (EPA). Bed Bugs.
- American Academy of Dermatology Association. Bed bugs: Diagnosis and treatment.
- MedlinePlus, U.S. National Library of Medicine. Bedbugs.