How to identify and treat bed bug bites

• Bed bug bites appear as small red marks or dark spots on your skin, often in zig-zag patterns of 3 to 5 bites.
• You can treat bed bug bites with anti-itch cream, antihistamines, or a cold compress.
• It's important to get rid of bed bugs and take steps to prevent infestations if you have bites.

Bed bug bites are itchy, annoying, and just plain creepy. Although the bites are generally harmless, it's important to identify and get rid of bed bugs, otherwise they will keep biting you.

The thing is, it might take a while to realize that you have bed bugs. That's because bed bugs are tiny, and their bites can mimic other insect bites or skin irritations.

Here's everything you should know about bed bug bites and how to get rid of the pesky critters once and for all.

What do bed bugs look like?

Bed bugs are big enough to be seen with the naked eye, says Tanya Nino, MD, a dermatologist with Providence St Joseph Hospital in Orange County, California. They're about the size of a tick (1 to 5 mm long), oval-shaped, flat, and have a reddish-brown color.

Although they're large enough to see, bed bugs can be extremely difficult to find. They're active at night, rather than during the day. When you're away, they're hiding away in the cracks and seams of bedding or upholstered furniture. They're pretty good about staying out of the way when you're looking for them.

Because of that, it's rare to actually spot a bed bug. Instead, it's more likely that you'll notice bed bug bites.

What do bed bug bites look like?

Bed bug bites appear as small red marks on light skin, and could appear as small dark spots on skin that is darker shades, says Sharleen St. Surin-Lord, MD, medical director at Visage Dermatology and Aesthetics Center in Washington D.C.

Usually, they'll appear in clusters of 3 to 5 bites in a zig-zag pattern that reflects where the bug has moved on your body. Although bed bugs can bite anywhere, the bites tend to be concentrated on the abdomen and arms, St. Surin-Lord says.

Bed bug bites tend to be a little smaller than mosquito bites, though it may be difficult to tell them apart from flea bites.

"The difference is that you normally can see the fleas jumping around or the mosquitoes, after they have bitten you," St. Surin-Lord says. "Bed bugs are a little more clandestine."

This comparison table can help you diagnose your type of bug bite:

If your bites are most prominent in the morning and appear in groups of three, that's a good indication that you might be dealing with bed bugs.

"Often, the bites will occur in a line of three, which is sometimes called 'breakfast, lunch, and dinner,' Nino says.

Symptoms

The primary symptom of bed bug bites is welts on your skin. Usually, these welts are very itchy, and appear in groups.

As with other bug bites, some people will have a harsh reaction, including redness and itchiness, while others will barely be bothered by bed bug bites.

Note: Though it's rare, bed bug bites can become infected if you scratch them. If you experience symptoms like fever, significant swelling, or nausea, you should call your doctor. If you have any symptoms that make it difficult to breathe, call 911.

"Bedbugs become dangerous when a large part of the body is affected, causing intense itching and scratching, leading to open, wounded, bleeding skin," St. Surin-Lord says. "This now creates a portal for bacteria and skin infections."

In addition to noticing bed bug bites, you might spot symptoms of a bed bug infestation in your home. These can include:

• Rust-colored spots on your mattress or bedding (this is the bed bugs' excrement)
• Signs of bugs including shed exoskeletons that may look like coffee grounds
• The bugs themselves hiding in the folds and seams of your mattress
• A sweet, musty smell from the bugs

Remember, just because you don't see the bugs doesn't mean they aren't there, especially since the bugs tend to hide during the day and become active at night, Nino says.

How to treat bed bug bites

You can treat bed bug bites by first washing the bite site with soapy water to remove any dirt or debris. Then, you can try these at-home remedies:

• Anti-itch cream. These over-the-counter drugs include steroid ointments, like Cortisone, or antihistamine creams, like Benadryl. Both reduce itching and swelling and can provide relief from bed bug bites when applied topically.
• Oral antihistamine. An over-the-counter oral antihistamine tablet, like Benadryl, counteracts your body's production of histamine, which is what causes bites to itch. However, these oral antihistamines can cause drowsiness - it's best to take Benadryl right before bed to relieve itchiness and help you sleep.
• Cold compress. A cold compress can give temporary itch relief. Apply a cold compress or ice pack wrapped in cloth for not longer than 20 minutes, and wait at least an hour before reapplying.

The itching from bed bug bites can last for up to two weeks, St. Surin-Lord says. That's often prolonged if the infestation hasn't been addressed and the person continues to get new bites. If you're dealing with severe itchiness despite using the remedies above, you can reach out to your doctor for a more powerful prescription anti-itch cream.

In some cases, St. Surin-Lord prescribes oral steroids to people who have severe itching caused by bed bug bites. The oral steroids can reduce inflammation and itchiness in people who don't get relief from topical creams. They can also help prevent further health complications from the overwhelming itchiness.

Prevention

A bed bug infestation can happen to anyone, no matter how clean your home is. That's because most people inadvertently bring bed bugs home after traveling, or occasionally from purchasing used furniture.

During or after travel, you can take these steps to reduce your risk of bringing bed bugs home:

• Check for signs of bed bugs. Examine the hotel room or home that you are staying in for signs of bed bugs, including black or red spots on the bed or upholstered furniture.
• Wash your clothes. When you return home, wash all your clothing in hot water, including items that you didn't wear. This will kill any stowaway bed bugs.
• Vacuum or use a hand steamer. Do this for any furniture, luggage, or other items that are too bulky to be washed. This will also kill bed bugs and prevent you from bringing them into your home.
• Reconsider buying second-hand mattresses or upholstered furniture. Since the bugs can live for up to a year without eating, it can be impossible to determine through a visual inspection whether a piece of furniture has bed bugs.

In general, you should regularly check your home, especially your bedroom, for signs of bed bugs. Pay extra close attention after travel or after sleeping at someone else's home, and remember that it can take up to two weeks for symptoms of an infestation to appear.

How to get rid of bed bugs

Ridding yourself of bed bugs is not a quick or easy task. It can take weeks or months to get rid of bed bugs, so try to be patient and prepare yourself for the long haul.

Here's an overview of how to get rid of bed bugs:

• Contain the infestation by bagging up any sheets and bedding that has been exposed to bed bugs.
• Vacuum your mattress paying close attention to seems and folds, where bed bugs hide.
• Cover your mattress with in bed bug-proof mattress protector, which will keep any lingering bed bugs from escaping.
• Continue to sleep in your room, to reduce risks of spreading bed bugs through your house.
• Methodically break down and clean any furniture in the room that has bed bugs, paying particularly close attention to the mattress, box spring and bed frame.

In most cases, it's a good idea to call a professional exterminator, who is able to use more powerful pesticides and get the infestation under control more quickly.

"Elimination of bed bugs can be a difficult undertaking," Nino says. "You may need a licensed professional."

Insider's takeaway

Although bed bug bites are generally harmless, they can be very uncomfortable. If you're not getting relief from at-home treatments, reach out to your doctor.

In addition, it's important to treat the infestation and get rid of the bed bugs - they will likely keep biting people until they are professionally exterminated.

"No matter what you decide to do, you must rid your home of the bed bugs," St. Surin-Lord says. "If you were at a hotel and feel that you were bitten in their bed and were diagnosed with bed bugs, you should contact that hotel so that they have their rooms treated."