Bedbugs: Bites, Infestation Signs and Treatment

What bedbugs are

The common bedbug (Cimex lectularius) lives wherever people sleep: homes, hotels, dormitories, shelters, trains and buses. Adults are oval, flat and brown, swelling and turning redder after feeding. Young bedbugs (nymphs) are smaller and pale. They cannot fly or jump but crawl quickly and spread by hitching rides in luggage, clothing, used furniture and bags.

They hide in cracks within a few meters of a bed: mattress seams, box springs, headboards, bed frames, behind wallpaper and electrical outlets. They come out at night, attracted by body heat and carbon dioxide, feed for 3 to 10 minutes, and retreat. Adults can survive months without a meal.

Bedbugs are not a sign of dirt. Clean homes and upscale hotels can have them.

Bedbug bite symptoms

• small, raised, red, very itchy bumps, sometimes with a darker center
• bites in a line, zigzag or cluster
• on skin exposed during sleep: face, neck, arms, hands, shoulders and legs
• itching often worse in the morning
• in sensitive people, larger welts, blisters or hives

Bites are painless at the time because bedbugs inject an anesthetic. Reactions may take hours to several days to appear, and some people, especially older adults, have no reaction at all, so one person in a bed may react while another does not. See also bed bug bites.

Bedbug bites vs other bites and rashes

See flea bites and scabies for comparison.

Signs of a bedbug infestation

Look closely at mattress seams and tags, box springs, bed frames, headboards and nearby furniture, using a flashlight:

• live bugs in seams and crevices
• dark spots like ink dots or marker dots (bedbug droppings) that may bleed into fabric
• rusty or reddish stains on sheets from crushed bugs
• shed skins and tiny pale eggs (about 1 mm) in clusters
• a musty, sweet odor in heavy infestations

Bedbug interceptor cups under bed legs can catch bugs climbing up. If you are unsure, a pest control professional or a trained detection dog can confirm.

Health effects

• Itching and scratching, which can lead to bacterial skin infection (impetigo or cellulitis)
• Allergic reactions, rarely severe
• Sleep loss, anxiety and distress: infestation can cause significant psychological effects
• Disease: bedbugs are not known to transmit infections to people

Treating bedbug bites

Bites usually heal on their own in 1 to 2 weeks.

• Wash bites with soap and water.
• Apply a cold compress to reduce itching and swelling.
• Use hydrocortisone 1% cream or calamine lotion. Follow the label.
• Take an oral antihistamine for itching, especially at night. Follow the label dose.
• Keep fingernails short and avoid scratching.
• See a doctor for signs of infection; antibiotics may be needed.

Getting rid of bedbugs

Bedbugs are hard to eliminate on your own. Integrated pest management combines several methods:

1. Confirm the infestation before treating.
2. Reduce clutter where bugs can hide.
3. Wash and dry: wash bedding, curtains and clothing in hot water and dry on the highest heat setting for at least 30 minutes. Heat kills all life stages.
4. Vacuum mattresses, seams, carpets and furniture thoroughly, then seal and discard the vacuum bag outside.
5. Encase mattresses and box springs in bedbug-proof covers for at least a year.
6. Heat treatment: professionals heat rooms to temperatures lethal to bedbugs.
7. Insecticides: applied by licensed professionals. Many bedbugs are resistant to common pyrethroids, so over-the-counter foggers ("bug bombs") rarely work and can spread bugs.
8. Follow up: several visits are usually needed over weeks.

Do not move to another room or home to escape them without treating belongings, as this can spread the infestation. In rental properties, inform your landlord promptly.

Preventing bedbugs

• When traveling: inspect hotel mattresses and headboards, keep luggage on racks away from the bed, and on return wash clothes in hot water and dry on high heat.
• Second-hand furniture: inspect carefully; avoid bringing home discarded mattresses.
• Shared laundry: transport items in sealed bags.
• Seal cracks around baseboards and outlets.

Frequently asked questions

What do bedbug bites look like?

Bedbug bites are small, raised, red, itchy bumps, often in a line or cluster of 3 to 5 on skin exposed during sleep, such as the arms, neck and face. Some people develop larger welts or blisters. Others have no reaction at all.

How do I know if I have bedbugs?

Look for live bugs, tiny dark spots of droppings, rusty stains on sheets, shed skins and eggs along mattress seams, bed frames and headboards. New itchy bites appearing overnight are a clue, but bites alone cannot confirm bedbugs.

How long do bedbug bites last?

Most bedbug bites heal within 1 to 2 weeks. Anti-itch creams and antihistamines help with itching. Bites that become painful, hot or ooze pus may be infected and should be seen by a doctor.

Can bedbugs spread disease?

No. Bedbugs are not known to transmit diseases to humans. The main health problems are itching, skin infections from scratching, allergic reactions, poor sleep and anxiety.

Can I get rid of bedbugs myself?

Small infestations can sometimes be controlled with hot washing and drying, vacuuming, mattress encasements and careful monitoring. Most infestations need professional pest control, because bedbugs hide well and many are resistant to common insecticides.