Data Sources: A PubMed search was completed in Clinical Queries using the key terms bedbug, rash, bites, and infestation. The search included meta-analyses, randomized controlled trials, clinical trials, case reports, and reviews. We also searched the online databases of the Environmental Protection Agency, Centers for Disease Control and Prevention, and Jefferson Clinical Images. Lastly, we used Essential Evidence Plus. Search dates: February through June 2011.
Bed bugs usually bite people at night while they are sleeping. Hungry bed bugs may also feed during the daytime, especially if this is when the occupant normally sleeps. They feed by piercing the skin with an elongated beak through which they withdraw blood. Engorgement of the bed bug takes roughly three to 10 minutes, but because the bite is painless, the person seldom realizes they are being bitten. Bed bugs normally do not reside on people like head or body lice do; instead, immediately after feeding, bed bugs crawl to a secluded location to digest their meal. Symptoms after being bitten by bed bugs vary from person to person. Many develop an itchy red welt within a day or so of the bite. Others have little or no reaction. Sometimes the reaction is delayed days or even weeks after the actual bite occurs, which can make it difficult to determine where or when bites actually occurred. Studies conducted in bed bug-infested apartments suggest about 30 percent of people do not react even when bitten repeatedly over time, and there is still higher incidence of non-reactivity among the elderly. Unlike flea bites, which occur mainly around the lower legs and ankles, bed bugs feed on any skin exposed while sleeping (face, neck, shoulders, back, arms, legs, etc.). The welts and itching are often wrongly attributed to other causes, such as mosquitoes. For these reasons, infestations may go a long time unnoticed, and can become quite large before being detected.
A number of other symptoms may occur from either the bite of the bed bugs or from their exposure. Anaphylaxis from the injection of serum and other nonspecific proteins has been rarely documented. Due to each bite taking a tiny amount of blood, chronic or severe infestation may lead to anemia. Bacterial skin infection may occur due to skin break down from scratching. Systemic poisoning may occur if the bites are numerous. Exposure to bed bugs may trigger an asthma attack via the effects of airborne allergens although evidence of this association is limited. There is no evidence that bed bugs transmit infectious diseases even though they appear physically capable of carrying pathogens and this possibility has been investigated. The bite itself may be painful thus resulting in poor sleep and worse work performance.
Bed bugs can result in a number of health effects including skin rashes, psychological effects and allergic symptoms. Bed bug bites may lead to skin changes ranging from non visible to prominent blisters. Symptoms may take between minutes to days to appear. Itchiness is common, while some may feel tired or have a fever. Typically uncovered areas of the body are affected. Classically three bites occur in a row. Bed bugs bites are not known to transmit any infectious disease.
An OTC antiseptic medication can be used for skin irritation that may then develop into an infection. As a precaution, do not use creams on broken or infected skin. If you have already been scratching, do not use these products on any raw or weeping areas. If you see signs of a skin infection, such as redness, don't use these creams in that area, and call your doctor.
While cleaning up infested areas will be helpful in controlling bedbugs, getting rid of them usually requires chemical treatments. Because treating your bed and bedroom with insecticides can be harmful, it is important to use products that can be used safely in bedrooms. Do not treat mattresses and bedding unless the label specifically says you can use them on bedding.