Images of Bedbug Bite (4)
Bedbugs are very small insects (Cimex lectularius) that come out to feed at night on the blood of humans and other warm-blooded animals. They live in dry, dark crevices such as the seams of mattresses, furniture, floorboards, wallpaper, carpets, and suitcases. The amount of blood they take from a human or other animal is very small, and the bite itself is painless, but the act of taking the blood causes an intense allergic reaction in most people. They usually feed in the very early morning hours, which is why they are mostly found in and around beds. A bedbug egg is about the size of a large grain of salt, and an adult bedbug is about the size of a small apple seed. They do not have wings, but they can move very fast. They can live for up to a year without a meal.
Who's At Risk?
Anyone can be affected by bedbugs. Their only food source is blood, so they are often found in places where there are many humans living in over-crowded conditions, such as dorms, shelters, and hotels. They do not feed on trash or dirt, so poor hygiene and untidiness do not contribute to bedbug infestations; however, teens who spend the night in multiple environments may be more likely to get bedbug bites only because they are exposed to more potential bedbug habitats. It is probably not possible to look at someone’s bed or couch and know if bedbugs are present. Bedbug infestations are becoming more common, perhaps because international travel is on the rise and because some insect pesticides do not kill bedbugs but do kill their natural predators, cockroaches and red ants.
Signs & Symptoms
The morning after being bitten by a bedbug, you may notice an itchy hive-like bump at the site of the bite, which will go away through the course of the day. There may or may not be a visible bite mark in the center of the lesion. After that, what start as small bruise-like areas turn into red bumps on the exposed parts of the body (arms, legs, chest, and sometimes the face). These areas are intensely itchy. There may be a clustered configuration of 3 bites in a line (known as “breakfast, lunch, and dinner”). Resolution takes about 2 weeks and leaves some darkening of the skin (post-inflammatory hyperpigmentation).
You may see tell-tale signs such as blood stains on the sheets, flecks of bedbug dung on or around your bed, or smell a sweet odor that occurs with large numbers of bedbugs. You may be able to spot a moving bedbug if you are searching at night.
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Management of bedbug bites includes removing the bedbugs and controlling the itching.
Wash all linens in hot water and dry in a hot dryer. You may also need to wash your curtains. Scrub furniture to remove eggs, and fix any cracks that may be in the furniture; you may need to take the furniture apart to properly do this. 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 the adjoining rooms for bugs as well, even if the occupants do not complain of itching.
Sometimes, in cases of severe infestation, it may be best to have a licensed pest control agent inspect and eradicate the bedbugs. Remember that some insect repellants can be toxic, so make sure to find out exactly what chemicals the agent will be using and what the chemical’s risk profile is.
Diphenhydramine (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.
When you stay with friends or travel, keep your overnight bag and clothing away from the bed or other furniture. When you return home, wash the clothing you took with you, and place your bag in an attic, basement, or garage, where there is little chance of the bugs encountering humans for prolonged periods.
Your doctor may give you an antihistamine, like Benadryl, and/or 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 are continuing to get lesions, your doctor may need to take a small sample of skin (biopsy) to determine if you have some other skin condition.
You may need a prescription-strength topical corticosteroid to help very itchy bites. Sometimes, scratching may cause infection. If there is pus, redness, swelling, fever, or if the reactions blister or are otherwise severe, you should see your doctor. There have been rare cases of severe allergic reaction that have affected breathing (anaphylaxis), which requires immediate emergency medical care.
Ter Poorten, M, et al. The Return of the Common Bedbug. Pediatric Dermatology 22 (3), 183–187, 2005 May.