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
So I have had bedbugs before and I had tons of bites everywhere from my feet to my neck! This time im not exactly sure if I have bed bugs.. I came home one evening and notices bites on my inner arm and then on my forearm, the ones on my inner arm are out of place and scattered bites, the ones on my fore arm are 3 diagonal dots. I have checked my bed and box spring seeing as I have had them before but there is nothing there? Am I being paranoid or do I really have bed bugs?
Once an infestation is confirmed, an integrated pest management strategy should be employed. Promoted by the Environmental Protection Agency (EPA) and the Centers for Disease Control and Prevention, an integrated pest management strategy is a multi-faceted, comprehensive strategy that relies on knowledge of bedbug biology and habits, and the most up-to-date pest control methods.3 An integrated pest management strategy minimizes economic, environmental, and health hazards, and is most effective for small bedbug populations.

Bed bugs are active mainly at night. During the daytime, they prefer to hide close to where people sleep. Their flattened bodies enable them to fit into tiny crevices--especially those associated with mattresses, box springs, bed frames and headboards. Bed bugs do not have nests like ants or bees, but do tend to congregate in habitual hiding places. Characteristically, these areas are marked by dark spotting and staining, which is the dried excrement of the bugs. Also present will be hatched and un-hatched eggs, the tannish shed skins of maturing nymphs, and the bugs themselves. Another possible sign are rusty or reddish smears on bed sheets or mattresses from crushed engorged bed bugs. Although it’s often stated that bed bugs have a telltale “buggy” odor, the smell is seldom evident except in extreme infestations and should not be relied upon for detection.
My boyfriend is staying with a man who rents a room out in his house. The last tenants had bed bugs and the living room couch and everything is infested and theyve been gone for a month. The bugs were dormant until a week or two ago. The man has sprayed the house with something that is supposed to kill bed bugs yet my boyfriend is continuously being bitten. We counted around 100 bites. They are swollen and the itching is making him crazy. He is unable to sleep at night. We are trying to convince the man to just throw the couch out. Since he has no carpet we believe the couch is their main breeding ground and the sprays DID NOT WORK.
As bed bugs grow they molt, shedding their skin five times before reaching maturity. A blood meal is needed between each successive molt. Adult females also must feed in order to lay eggs. Under favorable conditions (70-80°F), the bugs can mature fully in as little as a month, producing multiple generations per year. Cooler temperatures or limited access to blood prolong the development time. 
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.
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