No one tactic alone will be effective. A good pest control operator will develop a strategy to deal with the bed bugs that takes the particulars of the setting into account, and will return several times to check on progress. Dry ice sprays that freeze bed bugs have limited potential to reach hidden bugs. Steam has somewhat better penetrating ability. The downside of steam is that it leaves moisture behind. Dry ice doesn't leave any residue at all. Vacuuming has a role, but it has limitations, too. Some insecticides leave behind deposits that are slow to act but are effective in the long-term. Other insecticides kill on contact, but only reach insects that are in view. Insecticide resistance makes the choice of tactics more difficult.
Unlike those of other insects, bed bug bites may sometimes appear in tight lines of multiple, small, red marks where multiple bed bugs have fed along an exposed area. Bed bug bites can cause itchiness. Initially, a victim may detect a slight burning sensation. The burning area then develops red bumps, known as papules or wheals (rash). In extreme cases, bites may swell dramatically or turn into blister-like skin inflammations.