How to Treat Bed Bug Bites

Bed bugs. The mere mention of them might make your skin crawl.

These little critters are all too common, with one out of five people in the U.S. reporting a previous infestation or knowing of someone who encountered them at home or while traveling, according to a survey from the National Pest Management Association. Unless they get infected, bed bug bites are almost always harmless. Still, that doesn’t make them any more pleasant.

If you suspect that you have bed bug bites, what’s the best way to treat them? When do you need to see a doctor for bed bug bites? Here’s some more information.

[READ:First Aid for Insect and Spider Bites and Stings.]

Bed Bug Bite Signs and Symptoms

There are a few signs that may lead you to think you have bed bug bites, including the following:

Bites that appear after sleeping. Bed bugs are most active in the dark, says Dr. Adam Friedman, professor and chair of dermatology at the George Washington University School of Medicine and Health Sciences in Washington, D.C.

Reddish bites on skin that’s exposed at night, such as your arms, hands, neck or torso, says Dr. Annie Gonzalez, a board-certified dermatologist with Riverchase Dermatology in Miami.

Itchiness.

Three bites that appear in a row. Friedman calls this a “breakfast, lunch, dinner” pattern. This is because the bed bug will bite in one area and then move to the other areas to feast a little more on blood. Without this pattern, it can be hard to distinguish bed bug bites from other insect bites, such as mosquito and spider bites, Gonzalez says.

Appearance of specks of “black pepper” on your sheets or mattress, says New York City-based Dr. Tania Elliott, a board-certified allergist and internist and a national spokesperson for the American College of Allergy, Asthma and Immunology. These are what the bugs look like to the naked eye.

Small droplets of blood on your sheets from where you’ve been bitten.

Don’t rule out bed bugs if you sleep with a partner and only one of you is bitten. Bed bugs are attracted to carbon dioxide, which we exhale when breathing. You and others in your home may have different levels of carbon dioxide, Friedman says. That may lead them to prefer to bite one person over the other.

Although mattresses are the main place where you can find bed bugs, they can live on other types of furniture, including upholstered furniture in a home or office. If a place is deeply infested, they can even be found in sneaky areas, like loose wallpaper and in electrical outlets. They can’t fly, but they’ll travel 5 to 20 feet from a hiding place to bite a host, Gonzalez says. Don’t rule out furniture in public places, such as movie theaters or public transportation, as a source of bed bug bites.

[READ: First Aid for Insect and Spider Bites and Stings.]

At-Home and OTC Treatments for Bed Bugs

If you suspect you have bed bug bites, you’ll want to do your best to confirm the presence of the bugs. Look for some of the signs described above. Also, Friedman recommends turning off the lights at night and waiting 10 minutes. Then, use a flashlight to inspect your mattress to see if they have emerged.

If you find bed bugs, strip your bed of its sheets and wash and dry them at the hottest temperatures possible, perhaps even more than once. The heat will kill the bugs. Get in touch with an exterminator as well, and follow any guidance they give. If you live in an apartment, let the landlord know.

Bed bugs don’t spread diseases to humans. Of course, the bites are annoying and could get infected, and you don’t want them to multiply and lead to an infestation.

For the bed bug bites themselves, there are a few steps you can take to soothe the itch and prevent them from becoming infected:

1. Don’t scratch them. “When you scratch an inflamed area, your chance of infection skyrockets,” Friedman says. Another reason not to scratch that itch: Irritated bites can sometimes leave a dark mark on skin that you might not want there.

2. Use ice packs several times a day to soothe the bites and help take the itchy sensation away.

3. Moisturize the affected skin. Moisturizing can have a cooling effect, which also should help cut down on itching.

4. Use over-the counter topical creams or products that can help address itching. These can include products with:

— Antihistamines.

— Calamine lotion.

— Colloidal oatmeal.

— Hydrocortisone 1%.

— Lanolin, but not if you’re allergic to it. Some people are, Friedman says.

— Sarna, a cream that contains camphor and menthol in its original formula.

These products work best when applied to damp skin. Usually, the bites will go away after a week or two.

[Read: How to Recognize and Treat Spider Bites.]

When to See a Doctor for Bed Bug Bites

If your home remedies for bed bug bites don’t work after a couple of weeks or you find you’re getting more bites, it’s time to see a primary care doctor or a dermatologist. There are a few other times when you’ll want to see a doctor for suspected bed bug bites:

— You’re not entirely sure what’s causing the bites. Bed bug bites can also mimic a few other skin conditions, such as hives.

— You have swollen red skin with hives. An allergic reaction from bed bug bites is uncommon but still possible, Gonzalez says.

— The bites are getting itchier, more painful or they are oozing puss.

Doctors often will use a prescription-strength steroid cream for bug bites or an antibiotic if there’s an infection.

[READ: A Patient’s Guide to Skin Diseases.]

Bed Bug Prevention Tips While Traveling

With bed bugs commonly associated with travel, there are a few tips you can follow to help prevent bed bug bites while on the road:

1. Don’t put your luggage on the bed. If you have your bags on there for a minute or two, you should be safe. The important point is to not leave luggage on the bed for a long time or overnight when the bugs tend to come out, Friedman says. Instead, look for the fold-out luggage stand usually provided in hotel rooms, made of wood and canvas. If there’s not one in the room, ask for one.

2. Inspect for bed bugs before you lay down, Elliott advises. Look behind the mattress and sheets. You can even strip the entire bed and make it up again after you examine everything. She also suggests not laying down on mattresses at a mattress store when shopping. Put something clean between you and the mattress for extra protection, like a sheet.

3. Beware of a room with a stale, musty or sweet smell. That could be the sign of an infestation, Gonzalez says.

4. If you find bed bugs in your room, let the manager know and either switch rooms or hotels. Plan to wash and dry all your belongings in hot temperatures. Consider posting a review or writing a letter regarding the service you received and whether it was helpful or not.

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How to Treat Bed Bug Bites originally appeared on usnews.com

Update 05/03/22: This story was previously published at an earlier date and has been updated with new information.

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