Cutaneous reactions to bedbug bites can vary widely and are easily confused with other conditions (Table 1).15–19 A typical lesion is a 2- to 20-mm, pruritic, erythematous maculopapule with a central hemorrhagic crust or vesicle.5,8 Macules, papules, wheals (Figure 3), vesicles, bullae, and nodules have all been reported,20 as have asymptomatic lesions with a barely visible punctum as the only evidence of a bite.8 Bites vary in number and are preferentially distributed in unclothed areas (e.g., face, neck, extremities). Unlike many other arthropod and insect bites, bedbug bites are rarely located in the popliteal fossae or axillae.21 Lesions can be noticeable immediately when waking up or several days later, with the reaction often progressing from delayed to immediate with subsequent exposures22–26 (Table 2). The classic bedbug rash is referred to as “breakfast, lunch, and dinner” because it commonly presents as several bites in a row or cluster 20 (Figure 4).
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.
Bed bugs have flat oval bodies, six legs, are reddish-brown in color and are similar in size to a dog tick - many have described the adults as resembling a flat apple seed. Adult bed bugs are approximately 1/4 inch long, while nymphs (juveniles) may be as small 1/16 of an inch. With feeding, they enlarge or engorge with blood. The adults turn from a brownish to reddish color, while the translucent nymphs may become bright red during the feeding process.
The exact causes of this resurgence remain unclear; it is variously ascribed to greater foreign travel, increased immigration from the developing world to the developed world, more frequent exchange of second-hand furnishings among homes, a greater focus on control of other pests, resulting in neglect of bed bug countermeasures, and increasing resistance to pesticides. Declines in household cockroach populations that have resulted from the use of insecticides effective against this major bed bug predator have aided the bed bugs' resurgence, as have bans on DDT and other potent pesticides.[medical citation needed]
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.