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
"In the past, bedbugs have repeatedly shown the ability to develop resistance to products overly relied upon for their control. The findings of the current study also show similar trends in regard to chlorfenapyr and bifenthrin resistance development in bedbugs," study researcher Ameya Gondhalekar, research assistant professor at Purdue's Center for Urban and Industrial Pest Management, said in the Entomology Today statement. "With these findings in mind and from an insecticide resistance management perspective, both bifenthrin and chlorfenapyr should be integrated with other methods used for bed bug elimination in order to preserve their efficacy in the long term."
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Bed bugs will also succumb to cold temperatures below 32°F, but the freezing temperatures must be maintained for a longer period (e.g., one to two weeks). Consequently, heating tends to be a better option throughout much of the country. Efforts to rid entire dwellings of bed bugs by raising or lowering the thermostat will be unsuccessful, although pest control firms are able to achieve lethal temperatures with supplemental heaters (see the subsequent section entitled "Heat Treatments" for more details). 
Adult bedbugs are reddish brown in color, flat, oval-shaped, wingless and approximately 4-5 millimeters in length. Immature bedbugs (nymphs) may be translucent or light tan in color and therefore very difficult to see. Bedbugs are often more red in color after feeding. Bedbugs are attracted by warmth, and they generally feed during the night, often just before dawn. They tend to feed every five to 10 days, though they can survive without feeding for several months. Bedbugs pierce the skin and inject saliva that contains anesthetics and anticoagulants into the host, which often make their bites painless initially. After feeding on the host's blood for several minutes, bedbugs will crawl back to their hiding place. They will generally try to hide and remain within close range of their warm-blooded host. Affected individuals may feel and see the consequences of the bedbug bite afterward, though many individuals will not develop any physical signs of a bite. Bedbugs do not transmit or spread human disease.
As mentioned earlier, applying insect repellent at bedtime will probably not deter bed bugs from biting. When working in severely infested dwellings, there may be some benefit to spraying tops and bottoms of shoes with DEET-based repellents. Those working in bed bug-infested environments may also want to hot wash or run clothing, etc. through a dryer upon returning home or to the office.    
Just wondering if it is unusual for bed bugs to bite where you are clothed? I have 3 bites, in a diagonal line on one side and in a triangle shape on the other side of my pelvic area both which are covered by underwear at night. Then I have a random spot here and there on my legs. We have a plastic mattress cover on our bed but use dark sheets. As best I can tell there is no evidence of bed bugs. What do you think? Thanks!
I too feel hopeless about the bed bugs, I clean scrub and now have noticed them on the mattress, walls, picture frames and just the other day on my laptop!! I’ve tried so hard to get rid of these animals and haven’t been able too, my arms and hands feel like I have small pox these things can get really annoying the itching never stops I’ve tried aloe and calamine and it’s just getting worse. I’ve spent sleepless nights looking for them and I haven’t been able to get rid of them
thank you natasha! i’ve reached out to both locations i’ve traveled to and they confirmed their pest control vendors have found nothing. and i had a visual/dog inspection from a reputable pest control company to check my entire house and they’ve found nothing as well. so hopefully this is just a one off and / or mosquito bites that just like biting in a line…can’t help but still be paranoid and sleep bundled up with socks
Bed bug bites are caused primarily by two species of insects: Cimex lectularius (the common bed bug) and Cimex hemipterus.[3] They are about 1 to 7 mm in size.[7] Spread is by the bugs walking between nearby locations or being carried within personal items.[2] Infestation is rarely due to a lack of hygiene but is more common in high density areas.[8][2] Diagnosis involves both finding the bugs and the occurrence of compatible symptoms.[5] Bed bugs spend much of their time in dark locations like mattress seams or cracks in the wall.[2]
I personally did not know about bedbugs or how to treat bites. I and my family have suffered the trauma of dealing with this problem. I have little knowledge of bedbugs. It has been a very bad experience to my family. I have had to throw away many items that was precious to me. Giving up all the mattress in my home. Sleeping on the floor with jackets, socks, long pants, and long shirts. My son is has asthma. I have a major concern with his health. My family is my major concern.

One trick to make this disposal easier involves using the cut-off end of a nylon stocking (or a knee-high nylon stocking) and a rubber band. Insert the stocking (toe first) into the end of the vacuum suction wand/tube, leaving the opening of the stocking protruding out of the end of the suction wand. Then fold the stocking opening back over the end of the wand and use the rubber band to secure it there. When the vacuum is turned on and the bed bugs are sucked into the tube, they will be trapped in the stocking. Afterwards, carefully remove the rubber band and retrieve the bug-filled stocking. Then secure the end of the stocking with the rubber band and dispose of it. 
If all other options have been exhausted, you may need to seek a professional PMP (Pest Management Professional). There are pesticides that are approved for professionals to use during a infestation. These pesticides, however, are not always effective, and typically not as effective as steam cleaning, excessive heat, or excessive cold. The exterminator may opt to treat the area with carbon dioxide.
Our apartment is clean, but apparently this has little to do with it. We were told to put our dry clothes in the clothes dryer for 30 minutes at a high heat and bag them tightly, spray rubbing alchoha l92% to repel them from the bed , couch covers and seat cushions, as well as to dry our bedding, curtains, towels etc., and to remove the light covers from the plugs. They were reasonable (about$400 divided into monthly payments.)They will come twice, a month apart beginning two days from now, We’ve been vacuuming daily, and tightly securing debris. We were told that rubbing alcohol, sprayed in cushions and the bottom of shoes will repel them (92%). I was told that the most common place to pick them up is hospital and doctor’s waiting rooms. I write, and have a lot of boxed papers. I’ve emptied my drawers. I’m also not sure of what to do about my hanging paintings. I have enough problems right now, and just want this to end.
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.
Your replies to these questions are great! I have a question for you. I’ve recently returned home after spending a week in a hotel and the day after I returned I noticed 4 red dots which could be bites on my waist line. They don’t itch or hurt but I’ve never had anything like this before. I can send you a picture if you tell me how. I’m worried that they may be bed bug bites.
Many news reports in recent years have focused on the discovery of bedbugs and their health effects (even in upscale five-star hotels), and a number of lawsuits have been filed by guests of fashionable hotels who awoke to find hundreds of bedbug bites covering their skin. Searching on travel-review web sites regularly reveals information and even photos confirming the presence of bedbugs in numerous hotels.

When it comes to controlling bed bugs, "do it yourself" should not be anyone's motto. Bed bugs are notoriously difficult to eradicate - 76 percent of pest professionals say they are the most difficult pest to control.  As such, people who suspect a bed bug infestation should turn to a qualified pest professional with expertise in treating these pests. The pest professional will evaluate the extent of an infestation and recommend the best course of treatment.  In fact, the Centers for Disease Control and Prevention endorses that appropriate control of a bed bug infestation requires an experienced pest management professional and recommends that victims be advised against attempting to control measures themselves.
Very helpful article, plus everyone’s comments. I wish you all the best of luck with bedbug problems. We went to a cabin near Yosemite before Christmas and I saw bugs on the bed. Luckily we didn’t sleep there and left right away. However I’m afraid some came home with us. About 3 weeks after our trip, I got a rash on my neck, but it’s not very itchy. Haven’t seen any bugs at home, but am worried. Will try the tips in the article–any suggestions how to heat a bedroom to 120 degrees?

Have you tried the hot-water cure? It’s old fashioned but works for all kinds of bites (mosquitoes, fleas, BB, sand fleas and poison ivy and oak and also for bee and wasp strings but not spider or venomous bites) . My doctor told me about it when I was pregnant and had got bitten by sand fleas. You take a very hot shower, as you put the water hotter and hotter, the itching increases dramatically. You do this until it starts burning SLIGHTLY, BE CAREFUL NOT TO BURN YOURSELF!

when i was a young kid and got the chicken pox my mom had bathed me in warm water and oat meal, when my children developed chicken pox i did the same for them, this helps with the itching for several hours. You can buy packets of oat meal at a drug store for purposes suck as chicken pox, poison ivy, poison oak, etc. The packets sold at stores contain oat meal and other ingredients to ease itching and burning. I hope this is helpful for anyone who is willing to try it, it works for my family.
Hi, I’ve been in my apartment for over 8 years. We just had new neighbors move into our building. Now me and my children are getting bit at night by something. So, this morning, I was sitting on the couch in my bedroom and a bug crawled up my pants’ leg. I captured it in a plastic bag. I believe it’s a bed bug but is there a way to submit a picture to you, so you can take a look? Thank you!
Thank you so much for all the information. I just found a bed bug in my room at 5:00 AM in the morning. I have been getting these red itchy rashes for more than 2weeks . It’s extremely annoying and in spite of looking every where , I couldn’t find anything. These Biggs are so difficult to find. Now after reading this I feel they are even more difficult to eradicate.
Hey Randy! Based on your description of the situation, it does sound like bed bugs. Since you have had the similar experience for 5 years, I highly recommend getting someone to take a look at your bed for bed bugs. Something that you can try in the meantime is a close inspection of your linen. If you find any tiny blood marks on the sheets, that’s a tell tale sign of the presence of bed bugs. If you like you can send me a picture and I can take a closer look
Reactions to bed bug bites differ from person to person from none to a full-blown allergic reaction. A mild reaction may reveal flat, red bumps at the bite sites. A more severe reaction may include an irritating itch (as in my case), or swelling. Resisting the itch is incredibly difficult, but giving in to it can cause severe irritation to the skin, increasing your risk for an infection. It’s the chemicals in the bed bug’s saliva that trigger such reactions, some lasting more than two weeks.
Our place is pretty cluttered so I was freaking out. Luckily we have hardwood floors and not carpet. We tried different things. It gets really hot here, so I loaded up any nearby sheets, pillows, comforters, clothes, etc into trash bags and tied them off so nothing could get out. I put those in the car so the sun could beat heat into them all day. Never thought I’d be so thankful for Texas summers… Still got bites. We bought a mattress cover. Still got bites. We thought, okay, maybe they’re coming from the wall socket from a neighbors or something. We couldn’t close it so we kept the bed away from furniture and walls and put sticky traps on the legs. Caught NO bed bugs but STILL GOT BITES. I was losing my mind.

Bed bugs infestations can be treated by pesticides (make sure it specifically treats for bed bugs) or call a professional. Clean laundry and bedding by washing in hot water and drying with high heat. Steam cleaning can be effective, but be sure to check for bugs in a week or two. Concentrate in the areas they like to hide such as the seams. Bed bugs are sensitive to heat, so putting your mattress in a tight plastic bag and leaving it in the heat for several days can kill adults and the eggs. Vacuum your mattress and the areas around it. Be sure to immediately empty the vacuum cleaner and throw it out. If your mattress is infested, you may also consider getting a new mattress, but be sure to take care of the rest of your home so that your new mattress doesn’t get infested.
We have bedbugs. They are all over the house. In all of the rooms. My daughter feels that it would be safer to sleep outside than in this house. My son has really sensitive skin and the bedbugs love to attack him. One night he just kept twisting and turning because he must have been itching. We have had to get rid of all of our beds and have had to sleep on the floor. The floor is safer than the beds but not by much. The bedbugs seem to be everywhere. On the walls, on the floor, with you, or in your beds. We have tried many things so if anyone has any advice, it would be very much appreciated.

Hi Natasha !! I recently saw a bed bug crawling on my bed. So, I immediately cleaned all clothes in my room with hot water and put in high heat in the drier. I also sprayed the whole house with bed bug spray. Now on closer look of the mattress I found some bug remaining like its cover/shell, 2-3 blood stains but I did not find a colony/cluster of the bugs (which I was sort of expecting). So I bought a steamer and steamed my mattress and box spring. I also bought covers for the mattress and the box spring so that in case I missed any, they might get suffocated (at least I hope so). After all this, the next morning I woke up and found some sort of bite marks on my face. Also since I could not find any cluster of bugs, could they still be somewhere in my room ? where should I look for them ?

recently i have gotten an infestation of bed bugs.. i noticed it not long after i got an exterminator to come spray for ants and other outside bugs.. after he sprayed i noticed an increase of spiders(especially black widows) and a lot more bugs coming inside.. i have a fairly new home(5yrs old) and i shouldn’t have this problem… make sure you get a real professional company to come and do the work. ask what they are spraying/laying down, and what they are treating for and research it to be sure.. i think my house was baited rather than treated
Pay attention to when the bites occur. Consider, for example, if you notice the bites after waking up when previously you hadn't noticed them. However, this can also be difficult to determine because each person's reaction time can vary significantly. Symptoms that result from the bite can manifest at any point from a couple of hours to more than a week after the bite occurred.
Some people develop allergic reactions to bedbug bites, which can include a fever, difficulty breathing, hives, or a swollen tongue. Others may develop an infection where the bite starts oozing pus. If you experience either of these reactions or you develop blisters where the bites occurred, it’s a good idea to make an appointment with a dermatologist.
×