The likelihood of bed bugs increases if the affected individual has been traveling, or if they have acquired used beds or furnishings before symptoms started to appear. Bed bugs also are suspect if you wake up with itchy welts you did not have when you went to sleep. It’s important to recognize, however, that not all bite-like reactions are due to bed bugs. Confirmation requires finding and identifying the bed bugs, shed skins, fecal spots, etc., which often requires the help of a professional. (Other possible sources of irritation that may be mistaken for bed bugs are discussed in University of Kentucky entomology fact sheet ENT-58, Invisible Itches: Insect and Non-Insect Causes). 
The symptoms of a bedbug bite are usually mild when present, and often individuals will not experience any symptoms at all. Bedbug bites can occur on any exposed part of the body, with the face, neck, arms, and hands being areas commonly affected. The signs and symptoms can appear from minutes to days after the initial bite. Affected individuals will usually complain of localized itching and reddish-colored skin lesions, which may look like a flat welt or a raised bump. Sometimes, the lesions can be found in clusters or in a linear pattern. Typically, these skin lesions will go away after one to two weeks.

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
After being treated by a dermatologist for nearly 2 mos for red marks all over my body – he stated that I did not have bed bug bites (he even took a biopsy of my skin) and said I had leichen planus. I took pills for 2 weeks and then began ultra violent light treatments – nothing was helping them go away. Finally, I called an exterminator to inspect my home only to find out we have bed bugs and the marks on my body are bed bug bites. I stopped going to the dermatologist and wasted 2 months precious time in getting rid of the bugs. They are driving me crazy – had my first extermination done (2 more needed) and still seeing the bugs and getting bit – can’t sleep a wink – any suggestions to help with the anxiety I’m going through would be greatly appreciated.

Bedbugs are most often found in hotels, hostels, shelters, and apartment complexes where lots of people come and go. Because bedbugs hide in small crevices, they can hitch a ride into your home on luggage, pets, furniture, clothing, boxes, and other objects. Bedbugs are found worldwide, but are most common in developing countries. Once rare in North America, they may be on the rise due, in part, to increases in international travel.
Likewise, if I get bitten by a bed bug, I usually get a rather bad rash which is extremely sensitive to touch while they are hardly visible on my husband. If your bites become very itchy, you need to resist the urge to scratch the affected area as this can make the problem worse and cause further inflammation, infection or even bleeding. According to the Center for Disease Control, bed bug bites can even cause insomnia due to the fear of being bitten. This can result in a lack of energy and dramatically increased anxiety levels.
The size of bed bug bites varies with a number of different factors. Bed bugs inject an anti-coagulant along with their saliva when they pierce the skin to take a blood meal. This anti-coagulant is mostly responsible for how a person reacts to the bite and determines the size of the bug’s bite. Since people will have various sensitivities to the bed bug’s bite, the size of the bite will vary, as well. Another factor that influences the size of a bed bug reaction is the number of times a person is bitten. Bite reactions of people bitten many times are also variable, and their response may be either more or less intense as the number of bites increases.
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