This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.
The next sign is that the bites will occur nightly while sleeping and the rashes will increase daily. These rashes will usually be located on the legs, arms, neck, face and back, which are the most common areas. The reason these places are the most common sites is because these areas are usually exposed during the night. Exposed areas of the host are what they prefer.
Bed bug bites typically appear in groups of three, called the "breakfast, lunch, and dinner" pattern. Each victim's reaction to bed bug bites is unique. Some may have a slight reddening of the skin. Others may have a more severe reaction, causing a raised, itchy rash. A raised rash may obscure the individual bites, making it challenging to identify. Sometimes, bites and lesions can throb and become very painful for days after the bugs bit you.
The diagnosis of a bedbug infestation should be based on the clinical history and appearance of bites. A thorough inspection of sleeping quarters by the patient, a family member, or a pest control expert may demonstrate the telltale signs of an infestation15 (i.e., specks of blood-tinged insect feces and exoskeleton casts [Figure 5]). With the aid of a magnifying glass, special attention should be given to cracks and crevices of furniture, baseboards, electrical boxes, curtains, carpet, luggage, bed frames and headboards, picture frames, wall hangings, mattress and box spring seams, peeling wall paper, clothes, and linens.37 Live bedbugs can sometimes be caught by turning on a flashlight just before dawn, when bedbugs are most active, larger in appearance, and slower to scatter because of recent feeding.40
Insect and spider bites and how to deal with them Insect and spider bites can occur almost unnoticed, or they can be painful. Either way, home treatment is usually enough for most symptoms. However, some bites can spread serious disease, such as Lyme disease and malaria. Find out how to protect against bites and what to do if someone has a severe reaction to a bite. Read now

my concern is i am homeless and staying at a mission for now downtown Seattle there are thousands of these things in our city and biting a lot of sick people …”CAN YOU GET AIDS FROM A BED BUG???”i guess this is a major concern for a lot of people and how do we go about eliminating them in our city???..what do we put on the bites or do we just leave it alone???
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).
The bites themselves don't usually pose any major health risk since bedbugs are not known to spread diseases, but an allergic reaction to the bites may require medical attention, CDC officials say. There have also been some strange cases linked to bedbug infestations. Researchers reported in the Canadian Medical Association Journal in 2009 that they treated a 60-year-old man for anemia caused by blood loss from bedbug bites. Another study published in 1991 in the Journal of the Egyptian Society of Parasitology found that people with asthma might be more susceptible to allergic reactions from bedbug bites.
We have bedbugs. They are all over the house. In all of the rooms. My daughter feels that it would be safer to sleep outside than in this house. My son has really sensitive skin and the bedbugs love to attack him. One night he just kept twisting and turning because he must have been itching. We have had to get rid of all of our beds and have had to sleep on the floor. The floor is safer than the beds but not by much. The bedbugs seem to be everywhere. On the walls, on the floor, with you, or in your beds. We have tried many things so if anyone has any advice, it would be very much appreciated.
I need some really serious advice. I’m presently staying in a shelter because of abusive situation. It’s only been two days but I am COVERED in bed bug bites. The shelter refuses to move me to another bed because of limited space they said. I have taken oral and topical medications. The thing is it keeps getting worse and worse because every night I have to sleep in the same bed.
Cracks and crevices of bed frames should also be examined, especially if the frame is wood. (Bed bugs have an affinity for wood and fabric more so than metal or plastic.) Wooden support slats, if present, should be removed and examined since bed bugs often congregate where the ends rest on the frame. Screw holes, knots and other recesses are also common hiding places. Headboards secured to walls should be removed and inspected. In hotels, the area behind the headboard is often the first place that bed bugs become established. Bed bugs also frequently hide within items stored under beds. 
I am having a severe allergic reaction to bed bug bites and I’m 3month pregnant. So bad first they are hives that turn in blisters even on my eye lid, on the top of my hand and on my lower back, I’ve taken benedrel which only gives me about an hr of relief, then it returns and hives last for days. I’m debating going to er, how do they treat this when you’re pregnant?
In addition to the physical manifestations of bedbug bites, patients can experience significant psychological distress. The stigma that bedbugs are related to poor hygiene (however inaccurate) can lead to poor self-esteem, avoidance of family and friends, and suspension from work.37–39 Management of an infestation can be stressful, costly, and disruptive to everyday life. Worry can lead to insomnia, depression, anxiety, and even delusional parasitosis.37
The symptoms of a bedbug bite are usually mild when present, and often individuals will not experience any symptoms at all. Bedbug bites can occur on any exposed part of the body, with the face, neck, arms, and hands being areas commonly affected. The signs and symptoms can appear from minutes to days after the initial bite. Affected individuals will usually complain of localized itching and reddish-colored skin lesions, which may look like a flat welt or a raised bump. Sometimes, the lesions can be found in clusters or in a linear pattern. Typically, these skin lesions will go away after one to two weeks.
If you have been bitten by bedbugs, the good news is that they aren't associated with any disease. You need only to avoid scratching the bites and getting a skin infection. Anti-itch creams may help. Treating your home or possessions to eliminate an infestation is more of a challenge, and you may need both nonchemical and chemical treatments. Learn how to treat your bites and get rid of bedbugs.

Treatment is symptomatic.[2] Eliminating bed bugs from the home is often difficult.[2] Part of this is because bed bugs can live for a year between feeding.[2] Repeated treatments of a home may be required.[2] These treatments may include heating the room to 50 °C (122 °F) for more than 90 minutes, frequent vacuuming, washing clothing at high temperatures, and the use of various pesticides.[2]


Likewise, if I get bitten by a bed bug, I usually get a rather bad rash which is extremely sensitive to touch while they are hardly visible on my husband. If your bites become very itchy, you need to resist the urge to scratch the affected area as this can make the problem worse and cause further inflammation, infection or even bleeding. According to the Center for Disease Control, bed bug bites can even cause insomnia due to the fear of being bitten. This can result in a lack of energy and dramatically increased anxiety levels.


Bedbugs may enter your home undetected through luggage, clothing, used beds and couches, and other items. Their flattened bodies make it possible for them to fit into tiny spaces, about the width of a credit card. Bedbugs do not have nests like ants or bees, but tend to live in groups in hiding places. Their initial hiding places are typically in mattresses, box springs, bed frames, and headboards where they have easy access to people to bite in the night.
×