Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Bed bugs have five immature nymph life stages and a final sexually mature adult stage.[13] They shed their skins through ecdysis at each stage, discarding their outer exoskeleton.[14] Newly hatched nymphs are translucent, lighter in color, and become browner as they moult and reach maturity. Bed bugs may be mistaken for other insects, such as booklice, small cockroaches, or carpet beetles; however, when warm and active, their movements are more ant-like, and like most other true bugs, they emit a characteristic disagreeable odor when crushed.
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).
Dismantling bed frames in infested areas typically exposes bed bug hiding sites. Having access to these areas during cleaning is important. Stand up the box spring and shine a flashlight through the gauze fabric and look for bed bugs. If the fabric is torn (possible hiding place), remove fabric to prepare for spraying. If the mattress and or box springs are infested, you may want to consider Encasements by Mattress Safe. Once covered with these encasements, bed bugs can not enter or exit. There is no need to treat the mattress or box spring when using these encasements. Keep them on for a year.
Hi been getting bites since March. I have been to three doctors who all say the bites are not bed bug bites due to the pattern of the bites. This weekend I got bit again I have one on my leg and a two on my waistline. One of really big and the other are two small ones that are really red. I woke up in the middle of the night and saw a small bug on pillow and one on wall by bed and took a picture and from looking online looks like pic could be a bed bug or chigger. We have already checked the mattress a bunch and found no signs of bed bugs. Can I send you a pic so you can confirm what the bug might be?
When I discovered bed bugs, at first I thought it was just mosquitoes or something. It wasn’t they his exceptionally well. I cleared any clutter I had, especially near the bed. How to Treat Bed Bug Bites, or bugs in general is you need to first inspect the bed. The black dots are a sign where they dwell. You need to be careful not to alarm them or they’ll just move to another location that’s harder to find.

During the day, bedbugs tend to hide away in furniture, floors, beds, and in wood or paper trash. They typically feed on human or animal blood at night, and most bites occur just before dawn. After taking their meal, which can last as little as three minutes, they drop off the host and crawl to a hiding place. Bedbugs can live for up to 10 months and can go without feeding for weeks.
Is there anything, and I do mean ANYTHING, that I can use when I go to bed at night that will revoke these little critters. Does anyone know of any strong smelling cream or spray I can use on myself so that when I lie down they will not come near me. I don’t really wanna keep complaining to the staff since I just been here two days but I’m so COVERED by these bed bug bites and constantly itching that I cry.
My bites from two weeks ago are still rough. I have used the window cleaner, cortisone and then for the open areas , antibiotic ointment. I slept in my bed last night with no problem. I will spray again and again and again in the event of new generations. They don’t sell Phantom in my area. That is supposed to kill 95% of the eggs. Wish I could find some. These little bastards are something else. Good Luck to all.
Check the mattress throughly, paying close attention to seams and tufts along the edges. Flip the mattress over and inspect the bottom carefully as well. Pay particular attention to any rips in the fabric. View the fabric on the bottom of the box spring and shine a flash light to verify that bed bugs have not penetrated the interior of the box spring.

It was stated in 2012 that no truly effective insecticides were available.[6] Insecticides that have historically been found effective include pyrethroids, dichlorvos, and malathion.[4] Resistance to pesticides has increased significantly over time, and harm to health from their use is of concern.[3] 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.[33] Boric acid, occasionally applied as a safe indoor insecticide, is not effective against bed bugs[34] because they do not groom.[35]
I found something that works. Diatomaceous earth or perma guard. Buy a big bag. About a good 5 pounds and put it around the whole house yard in your bed in every crack the carpet. I mean all over and give it a couple days. They will be gone. I live in an apt I ha e a cat n dog. It isn’t harmful to pets or humans its 100% safe to use around kids and best of all no bed bugs no ants no roaches. I paid about $10 on ebay. Good luck and I’m telling u this worked for me.

They will starve but not die off completely. That’s why you need to sweep, vacuum, and steam the floors daily. If bed bugs don’t feed on you then they can’t lay eggs. Eventually the numbers will diminish. They might even consider relocating. If you share an apt, it would speed up the process if your housemates do the same thing. It may take months to fully get rid of them but at least you won’t be their meal if you follow me bed proofing instructions.

Help!! I have had a long and exhausting experience with these nasty bugs. My mother in law had stayed at my house for a few nights and a few weeks later after returning home she discovered she had a severe infestation of bed bugs.. so of course I took precautions at my home thinking she gave them to me. I threw my mattress away then taped off my entire bed with very sticky tape. No signs or bites at all . Then a few weeks later my son started to sleep in his bed again and sure enough he woke up with 3 bites in the shape of a triangle that were swollen and itchy. I searched his bed and found a casing shell and 3 blood stains under his box spring .I called a exterminator he came out and said we had a mild infestation and there was no signs in my bed but he found one live bug in my son’s bed. He treated the bedrooms and living room. Then my son and i were getting these little bumps on our body that looked nothing like the triangle bites and didn’t itch so the exterminator came again and treated but found no evidence of bed bugs and this cycle happened four times! So he has treated my apartment 4 times and found no signs of bed bugs and even had a dog come out to sniff around .. this was all over the course of about 5 months . The exterminator insists that we do not have bed bugs anymore but my son is still getting these bumps on him, some are reds dots and some are skin colored but no complaining of itching . I’m very overwhelmed and exhausted and havery no idea what to think. I think the tape on my bed prevented them from getting back into my bed after I threw my mattress out but again the exterminator said tape does not work. Are they hiding somewhere else like in the walls to where the exterminator think the problem is gone ?
According to textile experts (Drycleaning & Laundry Institute, Laurel, MD), most garments designated as ‘dry-clean only’ (e.g., cotton, wool, silk, linen, rayon, nylon) will not be harmed provided they are dry before being placed in a clothes dryer at a moderate temperature setting. Dry cleaning procedures also kill bed bugs, but there is a risk of infesting the establishment when buggy items are tagged and sorted. 
The likelihood of bed bugs increases if the affected individual has been traveling, or if they have acquired used beds or furnishings before symptoms started to appear. Bed bugs also are suspect if you wake up with itchy welts you did not have when you went to sleep. It’s important to recognize, however, that not all bite-like reactions are due to bed bugs. Confirmation requires finding and identifying the bed bugs, shed skins, fecal spots, etc., which often requires the help of a professional. (Other possible sources of irritation that may be mistaken for bed bugs are discussed in University of Kentucky entomology fact sheet ENT-58, Invisible Itches: Insect and Non-Insect Causes). 
Went on vacation with my husband, just 3 weeks ago. Stayed at a motel in Daytona. Had a double bed. Slept with my husband the first night, we did not go under the cover. The next night slept in the other bed, went under the cover and low and behold felt something biting me in the middle of the night, so I went on top of the cover for the rest of the night. Told my husband about it when we awoke.
If you know that you have the bugs. Get sealing covers the kind that encloses completely, one for the mattress and one for the box spring. That will trap those critters inside and they will eventually die in there. Next you will need to decide of what combination of treatments you wish to use. Its a job that you will have to keep up with for some time. Do your research online first.
Hi please help me out Natasha! A few days ago I woke up at midnight to find 3 bites in a almost straight line and I was afraid that it was a bed bug my mom said that there was a chance of it being a misquito since I was outside all night long but I’m still getting this weird feeling that it could be bed bugs what do you think it is can you take a guess. Help!
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Have you tried the hot-water cure? It’s old fashioned but works for all kinds of bites (mosquitoes, fleas, BB, sand fleas and poison ivy and oak and also for bee and wasp strings but not spider or venomous bites) . My doctor told me about it when I was pregnant and had got bitten by sand fleas. You take a very hot shower, as you put the water hotter and hotter, the itching increases dramatically. You do this until it starts burning SLIGHTLY, BE CAREFUL NOT TO BURN YOURSELF!
Once an infestation is confirmed, an integrated pest management strategy should be employed. Promoted by the Environmental Protection Agency (EPA) and the Centers for Disease Control and Prevention, an integrated pest management strategy is a multi-faceted, comprehensive strategy that relies on knowledge of bedbug biology and habits, and the most up-to-date pest control methods.3 An integrated pest management strategy minimizes economic, environmental, and health hazards, and is most effective for small bedbug populations.
Vigilant travelers may also want to elevate suitcases off the floor on a stand, tabletop or other hard surface rather than storing them on the floor or another bed. Hyper-vigilant travelers may further opt to keep belongings in sealed plastic pouches and their suitcase in a zippered tote — however each traveler must decide how cautious they wish to be. 
Mix 3 oz per gallon or 0.75 oz per quart and spray with a low pressure sprayer into the areas where the bed bugs are hiding. Typical areas include bed frames, headboards, under beds, baseboards, moldings, behind pictures,etc. Remember to apply in the joints and crevices of furniture. If the crack and crevice is too small, use an aerosol with a crack and crevice tip (recommendations are below.)
Some patients develop blisters filled with blood or bloody fluid, especially on the arms and legs. These blood blisters are extremely rare and can burst, causing bleeding or oozing of the bloody fluid. Healthcare providers are not sure if the cause of these blisters is related to the bug or the human but have found groups of patients that were all bitten by bugs on the same train exhibiting this sign.

In the case of beds, a more economical option is to encase both the mattress and box spring in a protective cover like those used for allergy relief. Encasements specifically designed to help protect against bed bugs are available through retail or pest control firms. Higher quality ones tend to be more durable and comfortable to sleep on. Once the encasement is installed and zipped shut, any bugs which happen to be inside are entombed and eventually will die. Encasements also help protect newly purchased beds, and make it easier to spot and destroy any bugs residing on the outer surface during subsequent examination. Encasements will not, however, keep bed bugs from crawling onto a bed and biting a sleeping person.


Known to be international travelers and expert hitchhikers, bed bugs are everywhere. As you travel, you increase your chances of being bit. However, knowing how to identify the bites and what your treatment options are will help you decide your next course of action. Learn more about where to look for bed bugs and how to avoid them with these great blogs:
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.  
Scabies is very common in shelters. Permethrin. Cream applied head to toe then wages off in the shower the next morning should clear it up. Also ALL bedding must be washed in hot borax and ammonia water the best day. All surfaces must be wipe down with 50% water and 50% rubbing alcohol. Thorough vacuuming of the bedroom washing curtains and miniblinda. All clothes must be washed in hot water. Good luck
The best way to confirm that the bites are from bed bugs is to find other evidence of a bed bug infestation. Common telltale signs can be found on or near your mattress: pull up your sheets and check the seams and folds for thin black fecal streaks or small red blood spots. You might also find bed bugs, living or dead, and their discarded shells in various hiding places, such as the joints of your bed frame.
I am now living in Kuwait far from my family, I was helpless and don’t know what to do, i was chatting w/ my mom and told her about my problem regarding the red spot comes out on my the under arm, i was crying for help coz i though i am sick.. my mother was so worried about me, until i decided search on internet related to my problem that doing facebook… i found this site then now i know it’s bed bug i think i took it from my friend room when i was slept there and I’m not dying as what i thought.. But my problem is i can’t wear backless dress, short pants because of the scar … anyone can help me how to remover this scar? it’s too disaster.

I have been getting a “bites” here and there the last couple weeks. Mostly on legs and a couple on my hip. They don’t itch and sort of look like pimples. I am stressed about bedbugs due to a scare a while back (turned out to be carpet beetles) and think it may be from stress. Anywho there is no evidence (cast,spots, ect) yet but could it be bedbugs if it is new infestation.


“Good night, sleep tight, don’t let the bed bugs bite.” This horrific nighttime creature is a member of the Hemiptera order of insects that feast solely on blood. Because of the way they mate, they multiply in size while breeding. A Department of Health report claimed that if forty are placed in a room with a mild temperature, within six months their population would exceed 5,900.
Kept replacing the sticky traps just in case but never caught anything other than the occasional spider. Always cycled the sheets and such using the car+sun. They were still getting to us. Bed bugs cannot fly or jump. They had to be in the bed frame. I check it over and notice rusty spotting, which is apparently bed bug fecal matter. Luckily ours was from IKEA so it was easy to take apart – and sure enough – there they were. The way my bed works is a metal frame with holes, rubber end caps fit into those holes, and wooden slats run across the frame in the end caps. So every few days I’d mix up a 50/50 mix of bleach and water in a bucket and soak the wooden slats and end caps for ten minutes. The bed bugs were gone a couple of weeks and came back. I started soaking the things longer and scraping them with a disposable spoon, which was hard to do on the end caps. It warped the wood a little but nothing too bad. After a couple of weeks or so, I stopped finding bed bugs in the frame. I was worried they were in the metal too, but I completely stopped getting bites. I think the added time and scraping got rid of eggs. Not a lot can survive a 30 minute bleach bath.
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I am now living in Kuwait far from my family, I was helpless and don’t know what to do, i was chatting w/ my mom and told her about my problem regarding the red spot comes out on my the under arm, i was crying for help coz i though i am sick.. my mother was so worried about me, until i decided search on internet related to my problem that doing facebook… i found this site then now i know it’s bed bug i think i took it from my friend room when i was slept there and I’m not dying as what i thought.. But my problem is i can’t wear backless dress, short pants because of the scar … anyone can help me how to remover this scar? it’s too disaster.
Probably chiggers -- they are very small, red mites that usually cannot be seen with the naked eye. They are about as small as the period at the end of this sentence. To stop the itching, use OraJel (usually sold for teething babies), which contains benzocaine (an anesthetic). Also, rub in hydrocortisone cream. To prevent chigger bites, wear long pants and stuff the cuffs into your socks.
Adult bedbugs are reddish brown in color, flat, oval-shaped, wingless and approximately 4-5 millimeters in length. Immature bedbugs (nymphs) may be translucent or light tan in color and therefore very difficult to see. Bedbugs are often more red in color after feeding. Bedbugs are attracted by warmth, and they generally feed during the night, often just before dawn. They tend to feed every five to 10 days, though they can survive without feeding for several months. Bedbugs pierce the skin and inject saliva that contains anesthetics and anticoagulants into the host, which often make their bites painless initially. After feeding on the host's blood for several minutes, bedbugs will crawl back to their hiding place. They will generally try to hide and remain within close range of their warm-blooded host. Affected individuals may feel and see the consequences of the bedbug bite afterward, though many individuals will not develop any physical signs of a bite. Bedbugs do not transmit or spread human disease.
CrossFire Bed Bug Concentrate has two different active ingredients for dual modes of action (both a quick kill and residual activity). Mix 3 oz of CrossFire Insecticide with one gallon of water or 0.75 oz per quart (Remember to use what you mix-within 24 hours.) Adjust the spray pattern to a mist by turning the nozzle. A low fine mist is best for most spraying, but you may need to use a stream to get into some cracks and crevices. If you can't get into the cracks and crevices use one of the aerosols described below with it's crack and crevice tips to reach into these areas.
Bedbug bites usually do not require any treatment. If you develop itching of the skin around the site of the bite, you can use an over-the-counter antihistamine pill or cream such as diphenhydramine (Benadryl). Some individuals may also experience relief from the itching by applying a hot washcloth directly to the affected area. Try to avoid scratching the skin, as this can cause skin breakdown and a subsequent secondary bacterial skin infection.

Many news reports in recent years have focused on the discovery of bedbugs and their health effects (even in upscale five-star hotels), and a number of lawsuits have been filed by guests of fashionable hotels who awoke to find hundreds of bedbug bites covering their skin. Searching on travel-review web sites regularly reveals information and even photos confirming the presence of bedbugs in numerous hotels.
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