Bring a little flashlight—hotel room lighting is always pretty poor and the dimmer the lighting, the harder it is to see small bed bugs or their fecal spots. I would pull back the bed covers and look all around the head of the bed. Pull back the sheets, too, and look at mattress seams and edges that are exposed. bed bugs love to hide under mattress tags. Look all around the box springs, too. If there's a dust ruffle, pull it up and look under it as much as possible. Look for moving bugs and stationary, hiding bugs.
Individuals who experience repeated bites over time may have more pronounced symptoms. Some people may also develop scarring or a skin infection from intense scratching of the skin. Rarely, a more severe systemic allergic reaction to a bedbug bite may develop. Some individuals may develop insomnia and anxiety from serious or repeated bedbug infestations.
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.
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.