Bed bugs are small parasitic insects that eat only one thing鈥攈uman blood鈥攁nd they get it only one way: by biting people.
A bed bug does not eat much or often. If many bed bugs are present, occupants are more likely to see and be bothered by them. Bites may be red, swollen and itchy, and new bites may be seen each morning. Fortunately, bed bugs do not transmit any diseases.
Bed bugs are found worldwide from fancy hotels to ordinary homes. Because bed bugs seem to leave some people alone (even if they sleep in the same bed) and some people have almost no reaction to the bites, it is often difficult for people to accept that their home has bed bugs.
Bed bugs and other biting creatures can cause annoying, itchy bumps on multiple people within a home. Clues that the itchy bumps on your skin are bed bug bites are listed in the Figure.
To confirm that bed bugs are present, look for them (flat, reddish-brown insects about an eighth of an inch long) or their feces (rusty-brown specks and smudges made of dried blood) on bed sheets, mattress seams, box springs, bed frames, and upholstered furniture. Bed bugs are shy; they hide during the day and bite only at night. So if daylight inspection does not work, wait until after midnight when the bedroom is quiet and dark. Switch on a light and then quickly inspect the typical locations.
This requires treating people who have bites and treating the room or house that has bed bugs. Treat the bites by (1) applying over-the-counter cortisone creams to control the itching, (2) using an antibiotic ointment to treat secondary bacterial infections, (3) taking a sedating antihistamine at bedtime to reduce the itch and help you sleep, and (4) not using oral or topical medicines that are used to treat scabies or head lice, as bed bugs do not burrow into anyone鈥檚 skin and do not lay eggs on people (or pets).
To treat the room or house, you may need to engage your landlord or an exterminator. Try to capture a bed bug in a clear zip-close bag to help others decide how to approach the situation. Leave pesticides to a pest control professional. Do not try using them on your own.
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Published Online: July 10, 2024. doi:10.1001/jamadermatol.2024.0099
Conflict of Interest Disclosures: None reported.