June 6, 2022/Primary Care

Bed Bug Bites: What They Look Like and How To Get Rid of Them

Bed bug bites often occur on the exposed parts of your skin while you sleep

Close-up of red bed bug bites on a person's back

Even the smallest thought of bed bugs will likely make your skin crawl. These tiny pests, while not dangerous, tend to create panic wherever they turn up. By the time you spot bed bugs, they’ve likely been there for a while, and serious infestations can be overwhelming.

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Fortunately, you can protect yourself and your family with a little bit of knowledge and some common-sense precautions.

Family practitioner Sarah Pickering Beers, MD, offers some pointers on how to identify, treat and prevent these tiny annoying invaders. She provides answers to common questions — from what bed bug bites look like and how to treat them, to what to do if you have a bed bug infestation in your house.

What are bed bugs?

Bed bugs are usually flat, reddish-brown and about the size and shape of an apple seed. They often look brown before they eat and take on a more reddish hue afterward. Gross, but true.

Bed bugs typically only jump onto people only when they’re feeding. The rest of the time, they hide. They tend to hang out in cracks and crevices of your furniture and blankets, such as between the cushions of a couch or chair, or between a mattress and box spring.

“You’ll often see evidence of bed bugs without actually seeing the bugs themselves,” Dr. Pickering Beers says. “For example, you may see small blood stains on your sheets or your pajamas. Also, look for black or rust-colored spots — these are bed bug droppings — on your clothes and bed linens. These are the most likely signs of an infestation.”

Often, people will assume bed bugs are a result of uncleanliness or issues with hygiene, but this is most certainly not the case.

“People can get bed bugs from hotels, movie theaters or traveling. If someone has an outbreak in an apartment building, you could even experience your own infestation from that,” says Dr. Pickering Beers. “Bed bugs are going to infest where they want to infest.”

What do bed bug bites look like?

It’s sometimes hard to tell the difference between a bed bug bite and another bug bite.

“They can look like any other insect bite, but the position of them on your body will be a little bit of a giveaway,” explains Dr. Pickering Beers. “If the bites appear only on the ankles or lower legs it’s more than likely fleas, as they’re often found in carpets and can only jump so high. Bed bug bites on the other hand can occur anywhere on exposed body parts and often appear in a linear pattern, as a series of multiple bites in a row.”

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Bed bugs are typically nocturnal. They’ll most likely get you while you’re sitting or lying down, which is how the bites can happen anywhere on your body. If you sleep naked, you can get bed bug bites anywhere on your body.

Bed bug bites often have a little bloody spot or reddish bruise in the middle. They’re typically slightly larger than flea bites, but a lot of that can depend on an individual person’s reaction to a bite and how much inflammation occurs around the bite’s center.

“Some people don’t show any symptoms at all in terms of the itch and you just have these little red bumps that don’t itch,” notes Dr. Pickering Beers. “Sometimes, bed bug bites can mimic hives, so not everyone is affected exactly in the same way.”

It’s even possible to have an allergic reaction to bed bug bites — but only in the rarest cases and major infestation has anyone experienced true anaphylaxis.

How to treat bed bug bites

Start by keeping the bite clean. Wash it with soap and water every day to prevent infection and help it heal.

“The most important thing we worry about with all the itching and scratching is you could introduce bacteria into the skin and cause a secondary infection,” says Dr. Pickering Beers.

“If the bite starts to get more red or swollen, starts to have discharge coming from it or becomes tender, you should see a doctor.”

Over-the-counter hydrocortisone cream or other anti-itch creams can help stop your need to itch. If left alone, bed bug bites usually heal on their own within a week, but if you truly want to get rid of those 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.

Wash and change your sheets, including your comforter or duvet cover, and vacuum your mattresses and furniture cushions so they don’t repopulate or re-infest.

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What to do about bed bugs

You want to clean everything immediately. Start by vacuuming the areas where bed bugs tend to hide, and washing fabrics and surfaces with hot water and baking soda. Use a steam cleaner or other deep cleaning tools that both clean on contact and suck up and remove the bugs and any eggs.

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

An exterminator might use insecticides, a heat treatment or a mixture of both to kill the bed bugs and stop them from spreading. In the meantime, again, you’ll want to wash your sheets, bedding, clothes and any other fabrics that might have come into contact with bed bugs with the hottest setting and dry them on the hottest setting, too. Doing this will kill off any remaining bugs and eggs.

If you don’t have an infestation, but you’re worried about the possibility of bed bugs, there are ways you can reduce your chances of getting them. When you travel, make sure you do a visual inspection of your hotel room when you first arrive. Make it a habit to pull the sheets back and check for bugs, blood spots or brown spots on the comforter, sheets and mattress.

It’s also a good idea to put your luggage on a luggage rack, or somewhere else away from the bed. Don’t put your suitcase on the bed or a chair because if there’s a problem with bed bugs, they might get into your luggage and come home with you.

Put your dirty clothes in a plastic bag and store them up high, like on a closet shelf, rather than on furniture or the floor. As soon as you return home from traveling, wash all of your travel clothes immediately in hot soapy water and dry on high heat.

You should also be careful buying used items from garage sales or resale shops — like used clothing, furniture, linens and fabric-made toys. If you purchase these items, wash and dry them immediately upon bringing them into your home.

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