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Bed bugs go 'chomp' in the night?

Dear Alice,

For the past few nights, I've been getting bug bites while I'm asleep in my bed. The bites are small, circular, and slightly raised, also extremely itchy. I live in an apartment by myself, with no pets, although there is a dog that lives in the building, two floors above me. I live in a studio on the bottom floor of this house. My compact kitchen is located very near my bed. I'm wondering about the cause of these bites. Bed bugs? Fleas? I'm also looking for ways to stop this. Insecticides? Changing my diet to make me less yummy?

Dear Reader,  

Sounds like your bedmates are keeping you from sleeping tight! While the information you provided about your bug bites and living situation is a great starting point, it’s tough to say whether the exact source is bed bugs, fleas, or another insect (more on these in a bit). Depending on where you are in the world and other contextual details, there could be a host of pesky pests causing your nighttime nibbles. To figure out the source of bug bites, it’s helpful to consider both the symptoms of the bite (appearance, location, reactions such as pain or itching) and traces of the bug (such as the bug carcass and eggs). A health care provider such as a dermatologist can best diagnose your bites and recommend treatments to ease any discomfort. You might also consider getting your home checked by having a pest control specialist look for signs specific to different creatures and advise on mitigation strategies.   

It’s possible that bed bugs could be causing your symptoms since they’re nocturnal parasites that love to dine on sleeping humans. Therefore, no matter your diet, if you've got blood, they would find you delectable. Found in even the cleanest of homes, bed bugs, despite their name, live just about anywhere — upholstered furniture, carpets, and wall crevices, in addition to beds and mattresses — and spread easily. They most often infest places where occupancy frequently changes, such as hotels, dormitories, hospitals, apartment buildings, and movie theaters. These tiny pests (adults are about a quarter of an inch long and resemble apple seeds) hide in nooks and crannies and come out late at night to gorge themselves.  

Not everyone who has been bitten shows visible bites, but those who do may have telltale signs such as small, itchy welts with dark red centers, usually in a zigzag pattern and in groups of three to five. In large numbers, these bites may produce rashes, significant discomfort, and potentially an allergic reaction in some. Although irksome, they aren't known to transmit any diseases to people and are considered more of a nuisance. In addition to these symptoms, if you see any of the following signs, these pests may have taken up residence with you:  

  • Tiny spots of blood on sheets or bedding (the result of squishing a sated bed bug).  
  • Brownish stains (from feces) around hiding places, including the bed frame, mattress cover, or cracks in doors, window frames, or walls around the bed.  
  • Brown exoskeletons that bed bugs molt every two months during their approximately ten-month lifespan.  

If you suspect that you may have bed bugs, the best way to get rid of the little buggers may be to call an exterminator. They may recommend non-chemical treatment, often the most surefire way to eradicate bed bugs, which may be best left to professionals. These strategies could include whole room heat treatments or removing of bed bug eggs. While insecticides approved for bed bugs may help, they may pose their own health risks if they aren’t administered properly, especially for children or those with breathing problems. Not only that, a lot of bed bugs are now resistant to insecticides. Though infestations are difficult to control without professional help, you can also try some do-it-yourself mitigation steps:   

  • Expose infested bedding and other fabric items to extreme temperatures. Wash and dry all bedding and other infested fabric items in hot water and a high-heat dryer. You might also try exposing them to the cold (i.e., store them bagged in a freezer) for a few days.  
  • Seal any items that can’t easily be washed. Put mattresses and box springs (if applicable) in approved, specially designed zippered cases for at least a year until all bed bugs have died.  
  • Clean all exposed surfaces. Steam clean any non-washable furniture or carpeting. For other areas and surfaces, vacuum, vacuum, vacuum (especially crevices in and around baseboards and bed frames) then immediately remove and dispose of the bag in sealed plastic.  
  • Prevent future infestations. Check hotel furniture and luggage for signs of bed bugs when traveling and thoroughly inspect or steam clean any used furniture you bring home. It’s also a good idea to avoid places with known infestations (since bed bugs may hitch a ride on your clothing) and to reduce clutter that could allow more hiding spaces for bed bugs.  

For more information, visit the United States Environmental Protection Agency’s Do-it-yourself Bed Bug Control.  

It’s worth mentioning that there are a host of pests that could infiltrate the home, with signs ranging from respiratory symptoms to property damage. In addition to bed bugs, other potential sources of the bites you describe include (but aren’t limited to):  

  • Fleas are reddish-brown insects about an eighth of an inch long with the ability to jump, that generally prefer pets to their owners. They cause small, itchy, red bumps usually in groups of three.   
  • Mosquitos are small, flying insects that usually feast between sunset and sunrise. They cause small, puffy, and very itchy red lumps that may develop into blisters. In some cases, they may be unpleasant, but other times they may transmit illnesses (often indicated by other symptoms). For more information, visit Mayo Clinic’s Mosquito bites page.  
  • Mites are generally small, wingless, and about an eighth of an inch long and there are several different types. Bites are usually itchy, red, and on uncovered skin, though the size and shape may vary. If they're the type that burrow into the skin, they may cause scabies.   

It’s also possible that you could have papular urticaria, a skin condition of hypersensitivity (similar to an allergic reaction) caused by bug bites from insects (including bed bugs, fleas, mosquitos, and mites). It most often occurs in children between two to ten years old but may affect some adults. Symptoms may include red, swollen, itchy lumps on exposed skin that may lead to blisters.  

Seeing a health care provider, especially if your bug bites cause great distress (nausea, swelling  

of the face, lips, or throat, difficulty breathing, abdominal pain, dizziness, fainting, or hives), may clarify the type of bites you have, as well as proper next steps. With the help of some precautionary measures and treatments, here's hoping you'll soon be bite-free, able to sleep tight, and... well, you know the rest.

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Last updated Jun 30, 2022
Originally published Jan 11, 2002

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