Bedbug Bite
Bedbugs are small, wingless insects that come out at night to feed. They are about the size of an apple seed, and they live in dry, dark crevices such as the seams of mattresses, furniture, floorboards, wallpaper, and suitcases. Their only food source is blood, and they can live for months without a meal. Their bite is painless, so they do not usually wake those who are bitten. They usually feed in the very early morning hours, which is why they are mostly found in and around beds. In the absence of the bedbug’s preferred human host, it will feed on any warm-blooded mammal.
Who's At Risk?
Bedbugs do not discriminate, so anyone can be affected. Additionally, there is usually no relationship between a bedbug infestation and poor hygiene or an unclean home. They are most commonly found in places where there are many people, such as in hotels, dorms, apartment buildings, shelters, and prisons. They are often introduced into a home in used furniture or from suitcases used during travel.
Bedbug infestations have been on the rise. This is thought to be due to recent increases in international travel along with changes in insect pesticides that do not affect the bedbug but do kill the bedbug’s natural predators, the cockroach and red ant.
Signs & Symptoms
The morning after being bitten by a bedbug, you may notice an itchy hive-like papule (a small solid bump) at the site of the bite mark. Other intensely itchy bumps may then develop on the exposed parts of the body (the arms, legs, chest, and sometimes the face) that are red in lighter skin colors or deep red, purple, or dark brown in darker skin colors. There may be a clustered configuration of 3 bites in a line (commonly known as “breakfast, lunch, and dinner”). Resolution of individual lesions takes about 2 weeks and leaves some darkening of the skin (postinflammatory hyperpigmentation).
You may see signs of the bedbug’s presence, such as blood stains on the sheets or flecks of bedbug dung on or around the bed, or you may smell a sweet odor that occurs when there is a large bedbug infestation. You may be able to spot bedbugs by searching cracks and crevices, such as along the seam of the mattress.
Self-Care Guidelines
The management of bedbug bites includes removing the bedbug infestation and controlling the itching.
To help remove the bedbug infestation, wash all linens in hot water and dry them in a hot dryer. You may also need to wash your curtains. Scrub furniture to remove eggs, and fill any cracks that may be in the furniture. Vacuum the room, including the mattress (concentrating on the seams) and any surrounding crevices.
You may want to fill and seal any cracks around the room and paste down any rolling wallpaper seams. Check adjoining rooms for bedbugs as well.
It is best to have a licensed pest control agent inspect and eradicate the bedbugs. Be aware that some insect repellants can be toxic to children, so make sure to find out exactly what chemicals they will be using and what the potential risks are.
Diphenhydramine (eg, Benadryl) can be used to control the itching. A low-strength topical corticosteroid cream or ointment, such as hydrocortisone, can be purchased over the counter to help with itching.
Try to avoid scratching the bite sites because breaks in the skin caused by scratching may result in a skin infection.
When you travel and stay in hotels, keep your suitcase and clothing on tables or dressers and away from the bed or floor. Upon returning home, wash the clothing you took with you, and place your suitcase in an attic, basement, or garage, where there is little chance of the bugs encountering humans for prolonged periods at night.
Treatments
Your medical professional may give you an antihistamine, such as hydroxyzine (eg, Vistaril), and/or prescription topical corticosteroids to help reduce the itching and inflammation. In rare cases of a blistering skin reaction, oral corticosteroids may be necessary. If you have a bacterial infection of the skin from scratching, you may need oral antibiotics. Rarely, anaphylaxis has occurred and is treated with emergency care.
Bedbug bites are difficult to visually diagnose, so if you continue to get lesions, your doctor may need to take a small sample of skin (a skin biopsy) to determine if you have some other skin condition.
Visit Urgency
If self-care measures do not help control the itching, or if there is pus, redness, swelling, fever, or the reactions blister or are otherwise severe, you should see your medical professional. There have been rare cases of severe allergic reaction that affects breathing (anaphylaxis), which requires immediate emergency medical care.
References
Bolognia J, Schaffer JV, Cerroni L. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018.
James WD, Elston D, Treat JR, Rosenbach MA. Andrew’s Diseases of the Skin. 13th ed. Philadelphia, PA: Elsevier; 2019.
Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology. 9th ed. New York, NY: McGraw-Hill Education; 2019.
Paller A, Mancini A. Paller and Mancini: Hurwitz Clinical Pediatric Dermatology. 6th ed. St. Louis, MO: Elsevier; 2022.
Last modified on June 14th, 2024 at 11:11 am
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