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DermLetter.
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Bed Bugs, What to Look for and Prevention

  • January 18, 2019
  • 6 minute read
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Good night, sleep tight, and don’t let the bedbugs bite. You wake up with a trail of red rashes on your body, bad right? Worse, maybe you wake up fine. Then you get back from your road trip, and find that you’ve invited vampiric insects into your own bed, and now have nested comfortably. How do you deal with this?

What are bed bugs?

Bedbugs make for reasonable comparisons to mosquitoes – not in a taxonomical sense1 but in that we are their food source. They’re both vampiric, and massively annoying pests. Both bloodsuckers give us a bit of an anesthetic before biting, and we get rashes on our skin thanks to our immune response to this.

Bed bugs typically produce a raised itchy bump on the skin. Bed bugs can bite anywhere there is skin, but they typically hit the exposed areas like the arms, legs, shoulders, and neck areas. While severe reactions can occur, these tend to be extremely rare. Generally, compared to mosquito bites, bed bug bites are not that problematic. The inflammation dies down within a week in most cases without any intervention. An antihistamine or applying ice over a towel can effectively control the itch while the skin is inflamed. The physical symptoms of bed bug bites are rarely severe. Most of the problems center around:

  • Stigma and other psychological impacts
  • Cost of removal
The social and psychological effects of bed bugs are very real. Yes, it’s primarily based on ignorance, but the fact remains – many people will associate bedbug problems with poor hygiene or perhaps lack of housekeeping. You will also get bitten in your sleep, which can drive you crazy in a short time.

The main issue, however, is that a bed bug infestation is notoriously hard to deal with. Female bed bugs can lay up to 500 eggs, so they multiply very quickly. To get rid of them you need to kill every single one of them. Worse, bed bugs can go without feeding for a year or more, so you can’t practically “starve them out by going on a short vacation.” Many bedbugs are also resistant to popular insecticides. All of this meaning, you are going to have serious problems if you get bed bugs into your home. It’s going to be a huge pain to get them out of there, and you will most likely have to hire professional services to remove them.

Understanding the Bed Bug Cycle

Bed bugs spread and make new colonies by using people as transport and as their food source.
Travel: Bed bugs are master hitchhikers – they can travel in clothes, bags, and any other fabrics you can carry, and therefore spread quickly and travel far.

Nesting: Once you get home, bed bugs can relocate to your bedroom, hiding under creases, seams, and the tiniest of spaces, and make themselves a new permanent base to start their colony. As their size is small (3-9 mm), it’s very easy to miss them, and once they begin to lay eggs, your problem only amplifies from there.

This simple survival strategy has worked for them for thousands of years. You might wonder why are they still a thing in the age of personal hygiene? A shocking number of people still believe that lice are caused by poor hygiene, which is simply untrue. Rodents are attracted by garbage because that’s what they eat; vampiric insects like mosquitoes and bed bugs are attracted primarily by carbon dioxide and body heat.2 This is why vampiric insects are still very much a thing. While it’s true that bed bugs were somewhat beaten back by the advances in pesticides, many factors help bedbugs to thrive better in today’s environment:

  • Developed resistance to common insecticides
  • Traveling is far more common today, allowing for its faster spread
  • A higher concentration of humans live in crowded spaces (cities)
  • Better indoor heating allows bed bugs to survive the winter

Prevention and Risk: It’s all about Traffic

Prevention is, as is most often the case, the best cure. The easiest way to disrupt the life cycle of the bed bug is to prevent them from ever entering your home in the first place.

Once a bed bug infestation starts, it could cause significant damage, not just emotionally, but financially as well. Bed bugs can be extremely difficult to remove but relatively easy to prevent.
When it comes to bedbugs, the vast majority of risk will come from staying at public accommodations like Hostels, B&Bs/Airbnbs, Motels, and Hotels. These are all high traffic; all kinds of travelers stay for the night, and since it only takes one guest with a hitchhiking bed bug to start an infestation, these places should all be considered high risk. Follow these steps to prevent the bed bugs from latching on to you.

Always Check: Don’t let your guard down just because you’re staying at a high-end hotel. Bed bugs don’t check Yelp reviews before deciding where to stay.3 Whether you’re staying at a 5-star hotel or a sketchy party hostel in a third world country, understand that the primary risk factor is traffic, not how much you paid for your stay or how many stars your accommodation has.

Luggage in the bathtub: Bed bugs can travel (slowly) but generally keep close to their nest. Don’t huck your bags on the beds automatically, as they may jump ship right then and there. Protect your bags.

Odor: Some people can identify a distinct bed bug odor (similar to coriander) which comes from the insects releasing pheromones. Detection dogs are quite accurate at identifying infestations.4 Unfortunately as a mere human you are not likely to notice unless the outbreak is already severe. If you smell it, you very likely have a serious problem and should get out then and there.

Visuals: Red or brown stains are the most noticeable signs, especially against white linens and mattresses. They can be from blood or fecal matter. You may also notice tiny eggshells. Note that these signs may not be so obvious.

Inspect the common hiding spots: Bed bugs are large enough to be visible, but they are very good at hiding. Pull the blankets out, and check the corners of your bed. They can hide in the seams of the mattress and the folds. Although bed bugs seldom travel far from home base, they may be hiding on chair creases or the curtains, areas often missed by cleaning staff.

Flashlight: Bed bugs hate light. They generally hide in the dark and stay quiet and inactive until night when they go to sleep. A sweep with the flashlight into dark corners behind the bed will often have the bugs scamper away, alerting you to their presence.

The Aftermath

If you do spot the bite marks on your body during travel, in a sense, you’re lucky. The reaction is often delayed when you are bitten the first time which means that you may not know that bed bugs have bitten you until the next week.

Barrier Up: If you had a bed bug issue during your travel, leave your luggage outside, or in the vehicle isolated from your home. Run all of your clothes through the washer and dryer on the highest setting for 30 minutes or longer.

Symptom Management

Managing the bites themselves is usually quite simple. They generally require no treatment, and the reaction will subside after a week or two. If the itch or inflammation is severe, your doctor may prescribe you something (but this should be relatively rare). Some common treatments that are used include:

  • Antipruritics
  • Corticosteroids
  • Antihistamines
  • Apply ice (over a towel)

Pest Control

Unfortunately, once they’ve made a home for themselves, bed bugs can be incredibly difficult to remove. There are a few steps that you can take to remove them yourself:

  • Create a barrier: Leave your bags outside or in your vehicle. Isolate the bugs away from your home.
  • Laundry: Steam the clothes and bags if possible. Wash and dry, ideally twice for at least 30 minutes using the highest, hottest setting. Thoroughly clean your vehicle if you leave your bags there.
  • Vacuum: Vacuum your room thoroughly. Don’t expect that this will eradicate bedbugs, but it will help to control their numbers.

Realistically, you will likely need to call pest control if an infestation has started. Common pesticides can be problematic when used on beds and other areas of the house close to where you sleep. Let the experts handle this.

Use #AskDermLetter to ask us skincare questions on Twitter. Follow us @SkinExpertsTalks for daily tips and articles on skincare.

Ask DermLetter


1Bedbugs are true bugs; mosquitoes are flies.
2http://www.skintherapyletter.com/bedbugs/recognition-management/
3https://www.dailymail.co.uk/news/article-2092541/Bed-bugs-crawl-New-Yorks-swanky-Ritz-Carlton-hotel.html
4 http://calag.ucanr.edu/archive/?article=ca.v067n03p172

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Table of Contents
  1. What are bed bugs?
  2. Understanding the Bed Bug Cycle
  3. Prevention and Risk: It’s all about Traffic
  4. The Aftermath
  5. Symptom Management
  6. Pest Control

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