Bed bugs have five immature nymph life stages and a final sexually mature adult stage. They shed their skins through ecdysis at each stage, discarding their outer exoskeleton. Newly hatched nymphs are translucent, lighter in color, and become browner as they moult and reach maturity. Bed bugs may be mistaken for other insects, such as booklice, small cockroaches, or carpet beetles; however, when warm and active, their movements are more ant-like, and like most other true bugs, they emit a characteristic disagreeable odor when crushed.
Thus, although these insects usually cause mild cutaneous reactions, more severe responses, including anaphylaxis, may occur.  Bullae may be noted. Skin responses at bite sites may evolve from immediate, pruritic, edematous macules into bullae within 24 hours. Histopathologically, an urticarial-like reaction can develop into a leukocytoclastic vasculitis, sometimes with a destructive, necrotizing, eosinophil-rich vasculitis with prominent infiltration of CD68+ histiocytes and collagen necrobiosis.
First, remove all affected areas such as bed linens, clothing, sheets and pillowcases and wash them in borax. For non-washable surfaces, as in drawers or cabinets, dust talcum powder on the affected area. Vacuum the area thoroughly and purchase an enzyme cleaner to clean all possible surfaces. If there are open spots or crevices in the wall, dust them with talcum powder and caulk them shut. This cleaning process should be repeated as often as possible to rid your home of the infestation.
Human infestation with bedbugs, lice, and mites are common causes of dermatologic symptoms. Although these organisms thrive in conditions of overcrowding and decreased sanitation, Americans of all socioeconomic backgrounds may be at risk for infestation. Clinicians must maintain high suspicion in the appropriate set of clinical circumstances to identify and treat infestations, as they can cause substantial dermatologic and psychological discomfort for patients. Images courtesy of the US Centers for Disease Control and Prevention.
Checking beds for bed bugs was a common practice long ago, especially while traveling. Travelers today should consider doing the same, preferably before unpacking. This would entail examining the bed sheets and seams of the mattress and perhaps box spring for signs of bed bugs, especially along the head (pillow end) of the bed. Experts also remove and check behind headboards since this is a frequent hiding place for bed bugs in hotels. Headboards are heavy and cumbersome, however, and untrained persons should not attempt removal themselves.
It often seems that bed bugs arise from nowhere. The bugs are efficient hitchhikers and are usually transported into dwellings on luggage, clothing, beds, furniture, and other items. This is a particular risk for hotels and apartments, where turnover of occupants is constant. Bed bugs are small and agile, escaping detection after crawling into suitcases, backpacks and belongings. Acquiring secondhand beds, couches and furniture is another way that the bugs are transported into buildings. Bed bugs also can be carried in on one’s clothing, shoes or wheelchair. Once bed bugs are introduced, they can crawl from room to room or floor to floor. They can also be transported throughout buildings on people and their belongings.
Bedbugs can live in any area of the home and use tiny cracks in furniture as well as on textiles and upholstered furniture as hiding places. They tend to be most common in areas where people sleep and generally concentrate in beds, including mattresses or mattress covers, box springs, and bed frames. They do not infest the sleeping surfaces of beds as commonly as cracks and crevices associated with the bed frame and mattress. Other sites where bedbugs often reside include curtains, edges of carpet, corners inside dressers and other furniture, cracks in wallpaper (particularly near the bed), and inside the spaces of wicker furniture.
While the mattress and box spring are left to dry, spray down the joints of the bed frame, headboard, and footboard with a contact spray and residual spray. The contact spray will kill bed bugs quickly and then evaporate, while the residual spray will kill bed bugs over several weeks. Remember to follow the sprays’ product labels and MSDS for safe and effective usage.
"We originally thought the bedbugs might prefer red because blood is red and that's what they feed on," study co-author Corraine McNeill, an assistant professor of biology at Union College in Lincoln, Nebraska, said in a statement. "However, after doing the study, the main reason we think they preferred red colors is because bedbugs themselves appear red, so they go to these harborages because they want to be with other bedbugs, as they are known to exist in aggregations."
To treat an allergic reaction, the doctor may prescribe an antihistamine, corticosteroid, or epinephrine injection. If the area is infected, he or she might prescribe an antibiotic or recommend an over-the-counter antiseptic. Finally, if it’s severe itchiness that you’re dealing with, applying corticosteroid or taking an antihistamine in pill or liquid form may be able to help.
Stripping and vacuuming the mattresses and box springs, and encasing them. Double bag your bedding and wash in hot water and dry for at least 30 minutes (discard the inner bag after putting bedding into the washer, as it could have bed bugs). After vacuuming suspected bed bugs from the bed, take your vacuum cleaner outdoors and remove and discard the bag. Purchase a good quality set of bed-bug-proof encasements for your mattresses and box springs. Bed bug-proof encasements are fabric sacks into which you slide your mattress or your box spring. The zippers on bed bug encasements are designed to be tight enough to prevent even the smallest life stages of the bed bugs from escaping. Also, good bed bug-proof encasements are woven to prevent bed bugs from biting you through the encasement. A good encasement will trap all bed bugs in the mattress and box spring inside, and will be smooth on the outside, providing few places for bed bugs to hide. Sears, Target, Walmart and other stores may sell bed bug-proof encasements, but these can also be purchased online. A good place to look for different brands and reviews of mattress encasements is Amazon.com (whether you buy there or at a local store). Go to http://www.amazon.com and search for “bed bug mattress protectors”.
Bed bugs were mentioned in ancient Greece as early as 400 BC, and were later mentioned by Aristotle. Pliny's Natural History, first published circa AD 77 in Rome, claimed bed bugs had medicinal value in treating ailments such as snake bites and ear infections. (Belief in the medicinal use of bed bugs persisted until at least the 18th century, when Guettard recommended their use in the treatment of hysteria.)