Bed bugs are small parasitic insects that feed on human blood by biting the skin. They do not live on or under human skin, but rather in the furniture or structures that are in a home or hotel.

They commonly feed during the night and so tend to live in your bed or the surrounding furniture. You may not be able to tell if you have bed bugs in your home as they are small, hard to see and are nocturnal (active at night). A bed bug is around 4-7 mm long – about the size of an apple seed.

Bites of bed bugs are small, red, itchy bites that are usually on areas of skin that are exposed when you are sleeping (head, neck, arms and shoulders). Bed bugs are found all over the world. Generally, bed bugs do not pose serious health threats and are more of a nuisance to get rid of than a major health issue.

Where do bed bugs live?

They live in houses, hotels and shelters and are often found in bed mattresses, headboards, in between cracks in furniture, behind wallpaper, in the walls of houses and in clothes. They can even be found in movie theatres and on aeroplanes. Bed bugs usually bite humans when they are sleeping or resting (most commonly at night time). They can also bite other warm-blooded animals such as dogs but prefer humans. Bed bugs can spread quickly, causing new infestations to form. They can survive for months without a blood meal.

What do bed bug bites look like?

Bed bug bites don’t really have any distinguishing signs or symptoms from other insect bites. You may not notice straight away after being bitten by a bed bug. Most people don’t feel it, as bed bugs inject an anaesthetic when they bite (as well as an anticoagulant). The bites may not show up on your skin immediately. In some people, the bites are only obvious up to 9 days after being bitten.

The bites look like red, small areas of skin that are swollen. They can be in a row or line and are often very itchy. They can be on the face, neck, arms and hands or other body parts that are not covered when sleeping. New bites are often noticed in the morning.

Some people have an allergic reaction to the bites and suffer from intense itching and hives (urticaria). The bites usually go away between 1 and 2 weeks after you’ve been bitten.

How do I know if I have bed bugs in my home?

Bed bugs are reddish-brown and are oval in shape, roughly 4-6mm in length. After biting a human and having a blood meal, they may turn a black colour. Bed bugs are hard to spot as they are less active during the day time.

Signs of a bed bug infestation in your home include:

  • Live bed bugs
  • Shedding of the skin of the nymph phase (immature bed bugs)
  • Bed bug eggs (which look white or semi-transparent in colour and are 1mm in length)
  • Blood spots on the bed sheets
  • Rust-coloured marks or spots of bed bug excrement on bedding
  • A sweet smell may accompany heavy infestations.

 

bed bug shedding skin

Risk factors

Anyone can get bed bugs, but there are a few factors that make you more likely to get a bed bug infestation, these include:

  • Living in short-term accommodation or other places where people come and go regularly, such as backpacker hostels, trains, hotels, motels, boats and homeless shelters
  • Having travelled recently
  • Having second-hand furniture, especially mattresses, in the home.

Bed bugs are transported from place to place in people’s luggage, bedding and furniture and start new infestations as they travel. They don’t fly, but once they have been spread to a new building they can crawl about fairly easily, sometimes moving between floors or rooms.

 

Complications

Although bed bugs can be frustrating and cause problems, they rarely transmit any diseases. If the bites are causing a lot of irritation and discomfort, they may lead to a loss of sleep. If the bites are severe and you scratch them too much, it may cause your skin to become infected. If this happens, you should see a doctor, and they will help you to treat the skin infection. If you have asthma, bed bugs may be a trigger for worsening symptoms.

 

Can you test for bed bug bites?

There is no test to specifically identify if an insect bite on the skin was from a bed bug. Bed bug bites may look like the bites from other types of insects, bugs and other diseases. From a detailed history and inspection of your skin, your doctor may suggest the likely cause as bed bug bites. However, if you collect some evidence of bed bugs, such as eggs or live or dead adults, a laboratory can identify the bugs by looking at them under a microscope.

 

Treatment

To control bed bugs, your doctor will treat the symptoms of bed bug bites and also advise you to clear the infestation to avoid recontamination.

Treatment of the bed bug bites is usually with an anti-pruritic (an anti-itching) agent. Anti-histamines may also be recommended to help reduce the itch. If your bites become severe, a steroid cream can be used in the short term to reduce the itching further and speed up the resolution of the rash. If the rash becomes infected, then your doctor will prescribe you an antibiotic to clear the secondary skin infection.

Clearing the infestation in the house can be a serious challenge. Generally, the first measures are cleaning the entire home, including washing clothes and bedding, vacuuming furniture and examining and potentially disposing of any contaminated mattresses. Often professional cleaning and pest control/extermination is necessary. Following extermination, to ensure the bed bugs are eradicated you must treat all bedding and cloth items (e.g. blinds, clothing, towels) in water greater than 55 degrees C or put items in a hot air drier for longer than 30 minutes. If clothes are heat sensitive, you can freeze them below -20 degrees C in the freezer to ensure the bed bugs are gone.

 

What type of doctor should I see about bed bugs?

Usually, your general practitioner (GP) will be the one to help you with bed bug bites. They may advise you on pest control companies that specifically deal with bed bugs to help you clear the infestation.

Support, where to get help

You can contact your landlord or local council for advice on treating bed bug infestations or a licensed pest control service for help with eradication of the bed bug infestation. Many bed bugs are now resistant to the insecticides used to treat them, so it’s essential to use a reputable service.

Outlook

Keeping your living space clean and tidy and minimising cracks and spaces where bed bugs can hide can prevent further infestations. For a heavy infestation, it may be difficult to totally clear the house of bed bugs on the first treatment. However, with regular follow up and further extermination treatments, eradication can be achieved.

 

Prevention

To prevent getting bitten by bed bugs, you must get rid of the bed bugs living in your home. You should also avoid sleeping or staying over at places that you know have bed bugs.

There are a few things that you can do to help prevent getting a bed bug infestation in your house and to prevent getting bed bug bites.

If you are having guests stay at your home/accommodation, you can:

  • Ask if they have had bed bugs bites or other unidentified insect bites. If they have, kindly ask them to inspect their belongings for any signs of bed bugs and treat them.

To control infestations, you can:

  • Look in hiding places for bed bugs, e.g. in cracks and crevices, in walls, in between bed mattresses and in the coils
  • Reduce the number of cracks and crevices in your house by sealing them up
  • Clean all areas of your home by thoroughly vacuuming and removing unnecessary clutter
  • Wash all bed sheets regularly in hot water and dry in a heated dryer
  • Dispose of all bed bug-infested contents in a sealed bag to prevent spread.

When travelling, you can:

  • Check your hotel room or other new places where you are staying for any signs of bed bugs
  • Avoid placing your luggage close to the bed, on the bed, or on the floor, when travelling and store it away in a high spot, such as on a luggage rack
  • Regularly inspect your luggage for signs of bed bugs.

Last Reviewed: 14/11/2019

myDr



References

1. Trevino J J, Dundon SL. Bed Bugs. BMJ Best Practice. https://bestpractice.bmj.com/topics/en-gb/851 Last reviewed October 2019. Updated January 2018.
2. Doggett S L, Russell R. Bed bugs. Australian Family Physician 2009: 38(11): 880-884. https://www.racgp.org.au/afp/2009/november/bed-bugs/
3. CDC. Bed bugs FAQs. https://www.cdc.gov/parasites/bedbugs/faqs.html Reviewed Jan 2017.
4. Institute of Clinical Pathology and Medical Research (ICPMR). Medical entomology. Bed bugs factsheet. http://medent.usyd.edu.au/bedbug/bed_bugs_factsheet.pdf