Are Those Bed Bug Bites? How To Tell

Bed bugs, while not dangerous, tend to create panic wherever they turn up. By the time you spot these tiny pests, they’ve likely been there for a while, and serious infestations can be overwhelming — and itchy.

Family practitioner Sarah Pickering Beers, MD, offers pointers on how to identify, treat and prevent bed bug bites.

How do you tell if bites are from bed bugs?

It can be tough to tell the difference between bed bug bites and other types of bug bites. So, what do bed bug bites look like that sets them apart?

“Bed bug bites can look like any other insect bite, but their positioning on your body will be the main giveaway,” Dr. Pickering Beers says. Flea bites, in particular, look very similar to bed bug bites. But there are a few ways to tell the difference.

• Pattern: Bed bug bites may appear in a linear pattern, as a series of multiple bites in a row or a zigzag. Flea bites often show up in clusters of three (sometimes also in a straight line).
• Appearance: Bed bug bites may have a small, bloody spot or reddish bruise in the middle. They’re typically a bit larger, too.
• Location: The main differentiator between bed bug bites and flea bites is their location on your body. “Bed bug bites can crop up anywhere the bugs have come into contact with your bare skin,” Dr. Pickering Beers explains. “But if the bites appear only on your ankles or lower legs, it’s more than likely fleas, as they’re often found in carpets and can only jump so high.”

Here’s how bed bug bites typically differ from other types of insect bites.

• Mosquito bites: These small, raised bumps often appear as single bites in areas of your body not covered by clothing, like your arms and legs.
• Scabies: These mites burrow into your skin and cause small red bumps, often in folds or cracks of your skin, like between fingers and toes.
• Tick bites: Ticks burrow their head in your skin, causing a rash or small, red, elevated spots on your skin. They commonly crop up on the scalp, legs and back of the neck.
• Spider bites: Though most spider bites aren’t a problem, some leave a single bite that turns into a wound and causes muscle pain, headaches and trouble breathing. They should be immediately treated by a healthcare provider.

Where do bed bug bites appear?

Bed bug bites form raised bumps that can show up in a line or zigzag that may resemble a rash. The bugs can’t bite through clothes or sheets, so you’ll see their bites in places where your bare skin has been in contact with your bed, like your:

• Arms
• Legs
• Back
• Face
• Neck

If you sleep naked, you can get bed bug bites anywhere on your body.

“Bed bugs are typically nocturnal,” Dr. Pickering Beers says. “They most often get you while you’re sitting or lying down, which is how the bites can happen anywhere on your body.”

How do bed bug bites feel?

Bed bug bites are typically itchy. They can also bring a little bit of pain, discomfort and even a mild burning sensation … but not always.

“Not everyone is affected exactly in the same way,” Dr. Pickering Beers notes. “Sometimes, bed bug bites can mimic hives. And other people don’t show any itchiness symptoms at all, so they just have these little red bumps that don’t itch.”

It’s even possible to have a severe allergic reaction (anaphylaxis) to bed bug bites, but it’s rare and only in cases of a major infestation.

How to confirm it’s a bed bug bite

In addition to the way bed bug bites look and where on your body they appear, you may also spot these telltale signs of bed bug activity on your pajamas and bed linens:

• Small blood stains
• Black or rust-colored spots (bed bug droppings)
• Teeny-tiny, pinhead-sized eggs or eggshells

“Bed bugs typically only jump onto people when they’re feeding, and the rest of the time, they hide,” Dr. Pickering Beers points out. “So, you’ll often see evidence of them without actually seeing the bugs themselves.”

But adult bed bugs are about the size of an apple seed, so you can spot them with the naked eye — if you know where to find them. They tend to hang out in cracks and crevices of furniture and blankets, like between the cushions of a couch or chair, or between a mattress and box spring.

“You can even get bed bugs from hotels, movie theaters and secondhand items from garage sales and resale shops, like clothing, furniture, linens and fabric-made toys,” she warns. “If there’s an outbreak someplace else in your apartment building, you could even experience an infestation from that.”

Treating bed bug bites

If left alone, bed bug bites usually heal on their own within a week. But it’s important to take care of them in the meantime.

1. Keep the bites clean. Wash them with soap and water every day to prevent infection and promote healing.
2. Use over-the-counter products. Hydrocortisone cream or other anti-itch creams can help stop your need to itch. “The most important thing we worry about with all the itching and scratching is that you could introduce bacteria into the skin and cause a secondary infection,” says Dr. Pickering Beers.
3. Stay vigilant. If the bites start to get redder, swollen, tender or start to have discharge coming from them, it’s time to see a healthcare provider for an assist.

To truly get rid of bed bug bites, you’ll have to get rid of the pests that caused them. Otherwise, new bites will pop up as the old ones heal. Start cleaning immediately, vacuuming any place bed bugs might hide and washing your bedding in the hottest water possible. Then, call in reinforcements.

“More than likely, you’ll need to contact a qualified exterminator who can, of course, tell you definitively whether you have bed bugs and discuss your treatment options,” Dr. Pickering Beers says.