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).

No one tactic alone will be effective. A good pest control operator will develop a strategy to deal with the bed bugs that takes the particulars of the setting into account, and will return several times to check on progress. Dry ice sprays that freeze bed bugs have limited potential to reach hidden bugs. Steam has somewhat better penetrating ability. The downside of steam is that it leaves moisture behind. Dry ice doesn't leave any residue at all. Vacuuming has a role, but it has limitations, too. Some insecticides leave behind deposits that are slow to act but are effective in the long-term. Other insecticides kill on contact, but only reach insects that are in view. Insecticide resistance makes the choice of tactics more difficult.
Bed bugs are very resilient. Nymphs and adults can persist months without feeding which is unusual for most insects. The ability to survive without a blood meal is longer at cooler temperatures ― potentially up to a year or longer at 55°F or less. In temperature-controlled buildings, a more typical duration is about 2 to 6 months. Consequently, it is usually impractical to leave buildings unoccupied in hopes of ‘starving out’ an infestation. When infested dwellings such as apartments are vacated, bed bugs often disperse to nearby units, or reduce their activity until the unit is reoccupied. 
Amazingly, these sneaky little bloodsuckers dine on you without waking you. You don't feel their stealthy bite because they inject a numbing agent into your body, along with an anticoagulant to keep your blood flowing as they suck. The first sign of bedbugs may be itchy, red bites on the skin, usually on the arms or shoulders. Bedbugs tend to leave straight rows of bites.
Some pest control firms utilize specialized heating equipment to de-infest furnishings, rooms, and entire dwellings. The procedure involves heating up the infested item or area to temperatures lethal to bed bugs. Portable heaters and fans are used to gradually heat the air to about 120 - 130°F while monitoring with strategically placed sensors. By carefully controlling the temperature, bugs and eggs are killed wherever they may be without damaging household items. 
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. 
To avoid light, bedbugs hide in the seams of mattresses and crevices of bed frames, walls, and furniture during the day.5,7 They are attracted to human hosts by warmth and carbon dioxide; these hosts generally sleep within 3 to 7 feet (1 to 2 meters) of the bedbugs’ hiding places.8,9 Feeding usually takes place just before dawn.10 Bedbug saliva contains several anesthetic, vasodilatory, anticoagulant, and proteolytic compounds that allow the insects to feed undetected for five to 10 minutes. Three of these compounds have been identified as instigators of the subsequent hypersensitivity reactions that may be noticed when the host awakens.11–14
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???
Data Sources: A PubMed search was completed in Clinical Queries using the key terms bedbug, rash, bites, and infestation. The search included meta-analyses, randomized controlled trials, clinical trials, case reports, and reviews. We also searched the online databases of the Environmental Protection Agency, Centers for Disease Control and Prevention, and Jefferson Clinical Images. Lastly, we used Essential Evidence Plus. Search dates: February through June 2011.
Some bed bug species are parasites of bats or birds, and may bite people if the wild hosts are no longer available. Although similar in overall appearance, the species of bed bugs that normally feed on bats, swallows, chimney swifts, pigeons or other wild hosts can be differentiated from those that prefer humans. Entomologists and knowledgeable pest managers can make this determination. If bat bugs or bird bugs are present, roosting and nesting sites should be the primary focus, and the animals should be removed and excluded from the building. 

Great stuff to use. My former girlfriend gave me a parting gift of bedbugs she got while staying at her parents house. She was good enough to leave me some cortisone though which I needed for the first time this morning. I had being seeing bedbugs and routinely treating them for about 2 months and I had laid diatomaceaous earth around my bed and didn’t have any itching or real issues. The layer had been wearing thin and I was too lazy to respreads. Last night I slept in the nude and woke up with the worst itching and now a rash all over my body. I had been seeing bedbugs and killing them for a month or two on and off and thought what’s the big deal. Now if know!!! This is the worst case of itching I’ve ever experienced!! Luckily I have the cortisone but it’s not helping too much. I’m blasting off a bed bug bomb my brother gave me 2 months ago that I never used and respreading the diamo earth. I checked my mattress and found literally only 2 bugs a very small nymph and an adult but they must be somewhere else because my body is covered in a rash. Maybe I finally reacted to bites I had been getting in the past or more are hiding elsewhere but I’m going to rid myself of these pests. Wish I could rid the world of them!!! This itching is the worst!!
Heat treatment: Heat of 120 F for two hours will kill bedbugs. Wash items in hot water (120 F or above). This may not be enough, though, so it's recommended that you place items in a clothes dryer on hot heat for at least 30 minutes. In a hot climate, you can bag items in a black plastic bag and leave them in direct sunlight for 24 hours. For travel or home use, there are portable heating units that can be used for clothing and luggage. A garment steamer can also be used on some items, such as luggage.
Bed bug bites occur most frequently while you’re asleep. As bed bugs bite they inject their victims with an anesthetic (as well as an anticoagulant), numbing the area and making it very rare for someone to wake up when bitten. Bites normally take a day or two to appear, although depending on your individual reaction they may be more visible sooner.
In the lab we handle all the bed bugs in a specific room that we steam clean once a week, and we have double-stick tape barriers that they can't walk through (as long as the adhesive remains dust-free). And the bed bugs themselves are enclosed in containers that they can't get out of. We actually feed them inside those containers—we lay a blood reservoir against the cloth "lid" and the bed bugs have to push their mouthparts through the cloth into the reservoir to eat.
I’ve found that the locoid lipocream he gave me to be the most effective. He also gave a sample of foaming medication in a small can which didn’t seem to work. The swollen areas were much worse that you would imagine, I experienced flat out pain by nighttime. I treated my arm 3x that day with the lipocream and by morning it was 100x better with significantly reduced redness and swelling.
Each of the following pictures of bed bug bites shows typical skin reactions to the insect's saliva. Most people  are not hypersensitive to the bites and will show no reaction at all with the exception of two small dots where the bedbug punctured the skin. Other people can develop red papular eruptions (raised inflamed areas) or in severe cases, blisters.
We kept feeling something crawling on us when we sat on tge couch. Then tiny bites Started appearing. After months of trying various cleaning approaches, we contacted Terminex. Their inspector found two bedbugs in the seams of a chair in the bedroom , but nothing on the sofa. They charged me a thousand dollars and steam cleaned both the bed, chair and sofa. About 10 days later, we started getting bites again. Terminex came and “dusted” the areas thus time. This continued for a a few months and them the “inspector” from Terminex said they could fund no signs of the bugs rhe last few times and he thought misquitoes were probably biting us. It has been months now and the problem has worsened. Now I get horrible welts when bitten and we constantly look for tangible signs: excrement, bugs in tape, anything before we call a different extermination company but life has become unbearable. We can’t have guests over because we fear they’ll become infected. It has been and is a truly awful experience.
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.
It is also recommended to put infested items, such as a mattress, in a sauna that reaches temperatures of upwards of 170° Fahrenheit. Similarly, they also perish in extremely cold temperatures so mattresses and other items can be cleansed of these bugs with the use of plastic wrap and dry ice. Cover the items with large plastic tarps and carefully insert dry ice, and then secure. The extreme temperature will naturally fumigate the pests.
To treat an allergic reaction, the doctor may prescribe an antihistamine, corticosteroid, or epinephrine injection. If the area is infected, he or she might prescribe an antibiotic or recommend an over-the-counter antiseptic. Finally, if it’s severe itchiness that you’re dealing with, applying corticosteroid or taking an antihistamine in pill or liquid form may be able to help.
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