The diagnosis of a bedbug bite can sometimes be difficult, as bedbug bites may appear similar to the bites of other insects. A health care professional will ask detailed questions and perform a physical exam, focusing on the skin. Other organ systems will also be examined to assess for any signs of an allergic reaction or for signs of infection. No blood tests or imaging studies will be necessary. If someone is able to bring in a specimen of the insect that may have bitten them, this can be helpful in making the diagnosis.
You can identify a bedbug infestation by checking bedding, mattress seams, furniture, and wall fixtures for the bugs or their traces. Each bedbug is about the size of an apple seed, about 1/4 inch long. You will often see their droppings instead, which are tiny brown or red specks. You may also see small blood stains on sheets or mattresses when a bedbug has been crushed after feeding. Eggs about the same size as the adults might be seen in seams or cracks and you will also see their molted exoskeletons.
The diagnosis of a bedbug infestation should be based on the clinical history and appearance of bites. A thorough inspection of sleeping quarters by the patient, a family member, or a pest control expert may demonstrate the telltale signs of an infestation15 (i.e., specks of blood-tinged insect feces and exoskeleton casts [Figure 5]). With the aid of a magnifying glass, special attention should be given to cracks and crevices of furniture, baseboards, electrical boxes, curtains, carpet, luggage, bed frames and headboards, picture frames, wall hangings, mattress and box spring seams, peeling wall paper, clothes, and linens.37 Live bedbugs can sometimes be caught by turning on a flashlight just before dawn, when bedbugs are most active, larger in appearance, and slower to scatter because of recent feeding.40
Once you find where they nest. Steam everywhere, you might see them run so be prepared with sticky tape. After you steam and clean your bed, you need to proof it. Get the mattress and pillow covers. Get the wide masking tape and make it into a sticky tape on both sides. Tape around you mattress, around the legs of your bed frame. This will keep them from feeding on you.
If you are experiencing itching, burning, and other forms of pain, there are a couple of treatment methods you could try. The most common recommendation is a topical corticosteroid cream or an anesthetic, which are applied directly to the wound and rubbed in to provide relief from the itching. A possible alternative to corticosteroids is calamine cream, though the FDA isn’t convinced of its effectiveness.
A definitive diagnosis of health effects due to bed bugs requires a search for and finding of the insect in the sleeping environment as symptoms are not sufficiently specific. Bed bugs classically form a line of bites colloquially referred to as "breakfast, lunch, and dinner" and rarely feed in the armpit or behind the knee which may help differentiate it from other biting insects. If the number in a house is large a pungent sweet odor may be described. There are specially trained dogs that can detect this smell.
Excessively scratching the itchy, bitten areas also may increase the chance of a secondary skin infection. Antiseptic creams or lotions can be used to ward off infection and antihistamines can be used to treat the itching. And an infestation can take a psychological toll on those affected: People whose homes have been infested with bedbugs may have trouble sleeping for fear of being bitten in the night. There are also public health, social and economic consequences; office buildings and schools often have to close if they are dealing with a bedbug infestation.
If I go to an infested apartment, then when I leave I check my shoes very carefully for bugs that may have crawled onto them. I also keep a change of clothes in my garage and put them on before entering my house. Once inside, I immediately put the clothes I wore to the infested apartment in the dryer, which is located in a room just off the garage.
They also have the ability to travel beyond the bedroom, so all adjoining rooms should be checked for infestation. Any area that offers a layer of protection, e.g. dark, isolated areas, should be checked. They do leave excrement droppings behind, so even if they are not seen, you can often see where they have been. The best method to find them is to check only at night, and with a red light.
You can develop a skin infection if you scratch the bites. Rarely, a more severe allergic reaction to the bites could produce larger welts, blisters, or anaphylaxis. Bedbugs may also trigger asthma attacks and getting too many repeated bites could lead to anemia. Anxiety, insomnia, and sleep disturbances are common due to the stress of discovering bedbugs.
Bed bugs are obligatory bloodsucking. They have mouth parts that saw through the skin, and inject saliva with anticoagulants and painkillers. Sensitivity of humans varies from extreme allergic reaction to no reaction at all (about 20%). The bite usually produces a swelling with no red spot, but when many bugs feed on a small area, reddish spots may appear after the swelling subsides. Bedbugs prefer exposed skin, preferably the face, neck, and arms of a sleeping person.