I have various skin lesions which might or might not be bed-bug bites–small, raised, sometimes red, sometimes itchy. The problem is I live right next door to a large park and get all kinds of insects in summer, may small enough to get through my window-screen. Also, I have Parkinson’s disease, and the meds I take for it can produce hives and itching as a side-effect. And, my bedding and mattress are all dark colored, so I likely would not see fecal stains or shed bed-bug skins.
Encasing mattresses is one of many good parts of a solution, but it doesn't get rid of the infestation. There are going to be other bugs away from the mattress, hiding nearby. What mattress covers are good at is entombing the sometimes large number of bed bugs that can live on a mattress. And because the covers tend to be uniform in color and don't have a lot of seams that the bugs can hide in, it's easier to see the insects.
This pair of bed bug bite photos below show the immediate (left) and next day (right) reaction after feeding a colony of bedbugs from a container in the lab. (That's why they are contained in a small circular area).  The hive-like immediate symptoms are replace by dark red rash type reaction the following day with inflammation and less severe redness radiating out to a larger area.  
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.
The prognosis for bedbug bites is excellent. The vast majority of people who experience bedbug bites will recover without any long-term problems, and many individuals who are bitten may not exhibit any physical signs at all. However, the recent resurgence in bedbug infestations will require increasing public education and awareness, instituting effective preventive and control measures, and continuing research into the development of more effective, safe insecticides.

Some people have no reaction whatsoever to bed bugs. In addition to not having much of an effect on the elderly, some are just not allergic. Since the irritation and welting appears as the result of an allergic reaction, it is possible to not even know that you were bitten at all. It is entirely possible for several people to live in the same house, and have one person not be affected.
Nightstands and dressers may need to be emptied and examined inside and out, and tipped over to inspect the woodwork underneath. Oftentimes the bugs will be hiding in cracks, corners, and recesses. Other common bed bug hiding places include: along and under the edge of wall-to-wall carpeting, especially behind beds and sofas; cracks in wood molding; ceiling-wall junctures; behind wall-mounted pictures, mirrors, outlets and switch plates; under loose wallpaper; clothing and clutter within closets; and inside clocks, phones, televisions and smoke detectors.
Bed bug bites typically appear in groups of three, called the "breakfast, lunch, and dinner" pattern. Each victim's reaction to bed bug bites is unique. Some may have a slight reddening of the skin. Others may have a more severe reaction, causing a raised, itchy rash. A raised rash may obscure the individual bites, making it challenging to identify. Sometimes, bites and lesions can throb and become very painful for days after the bugs bit you.
I dealt with these creatures for over 7 months. thought I was going crazy. 3 doctors- allergist-GP, dermatoligist. was treated for scabies as well. every day 2-3 new bites. some days none. i did the diaclamateous earth- alcohol- website bed bug kikkers. Finally, I actually saw 3 in a box. then i called an exterminator- for bedbugs. showed him the box he came 4 times – every sat for a month. something to do with how they reproduce. luckily this was a good man and he charged 300.00 and guaranteed it. i ripped out the carpet- the baseboards- everything in my room. only saw maybe 20 bugs in total. he said i had been treating them so that was why there were so few. Finally they are gone- 2 months now. I was the only one getting bitten- my husband did not until the very end and not nearly like me. The drs do not know for sure what the bites are when we go. and when we traet ourselves we kill them… but they hatch and are not gone. Had I known i would have gladly paid the 300 in the 1st place as these things nearly made me crazy. Just my story
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.
Bring in only what is needed, and avoid sitting or placing coats and other items on beds, floors and sofas where the bugs commonly reside. Essential items can be placed on a tabletop or other hard surface, preferably away from bedrooms and sleeping areas. Better to sit on a hard (non-upholstered) chair than on sofas and recliners. Also try to avoid leaning or brushing against beds and upholstered furniture. If such items are carried out of infested dwellings (e.g., by sanitation workers or firefighters), it’s best to wrap them in plastic or at least not hold them against your body during transport. Emergency Medical (EMS) personnel may need to take additional precautions, such as removing a patient’s bed bug-infested shoes or clothing, or installing plastic sheeting before transporting them in the emergency vehicle.    
Bed bug infestations are primarily the result of two species of insects from genus Cimex: Cimex lectularius (the common bed bug) and Cimex hemipterus.[3] These insects feed exclusively on blood and may survive a year without eating.[3] Adult Cimex are light brown to reddish-brown, flat, oval, and have no hind wings. The front wings are vestigial and reduced to pad-like structures. Adults grow to 4–5 mm (0.16–0.20 in) long and 1.5–3 mm (0.059–0.118 in) wide.
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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