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It was stated in 2012 that no truly effective insecticides were available. Insecticides that have historically been found effective include pyrethroids, dichlorvos, and malathion. Resistance to pesticides has increased significantly over time, and harm to health from their use is of concern. The carbamate insecticide propoxur is highly toxic to bed bugs, but it has potential toxicity to children exposed to it, and the US Environmental Protection Agency has been reluctant to approve it for indoor use. Boric acid, occasionally applied as a safe indoor insecticide, is not effective against bed bugs because they do not groom.
Some preparation is still required (e.g. removal of heat-sensitive items such as aerosol cans, indoor plants and medications), but it is seldom necessary to bag, launder and/or hot dry bedding and clothing since these items will be heated along with other furnishings. Another advantage of heat treatment is that infestations can often be eliminated in one day, rather than over multiple days or weeks. Conversely, heat treatment alone has no lasting (residual) effect should bed bugs be reintroduced into the dwelling. Consequently, some companies recommend concurrently applying residual insecticides. To further minimize reintroduction, occupants are advised to take as few belongings as possible with them while the heat treatment is in progress.
One bed bug will usually take more than one bite. Once a bed bug inserts its mouthparts and finds a suitable blood vessel, it will begin feeding. However, finding the right blood vessel may take more than one injection into the skin. In addition, bed bugs are very sensitive to movement by the host they are feeding on. Therefore, if a sleeping person moves, a feeding bed bug will probably withdraw its mouthparts and begin its search for a blood meal on another part of the body. It’s important to remember that the number of bites a person receives is not indicative of the number of bed bugs that feed on that person.