Itchy swollen bites may be the first sign of a bed bug problem. However, these itchy bites can take as long as 14 days to develop in some people, so it's important to look for other clues if you are concerned about an infestation. Bed bugs typically infest mattresses, box springs, bed frames, and couches. You may be able to find them hiding within the cracks and crevices of beds, furniture, floors, and walls. Bed bugs often leave evidence of small dark stains (fecal droppings) and rusty red spots (bloodstains) on bedding sheets, mattresses, and other areas they hide in or travel along. Heavy bed bug infestations can cause a sweet, musty smell.


You can check bedding, mattresses, furniture, and crevices in walls for bed bug infestation. Do your inspection just before dawn, which is when they are the most active. The bugs will be larger and slower after feeding. Bedbugs will quickly flee from light, so live bugs are best located in the folds and seams of mattresses and sheets. Bedbugs are about the size of an apple seed, about 1/4 inch long. They change from light brown to purple-red after feeding. You may also see their eggs, which are about the same size as the adults. The eggs will often be in seams, cracks, or crevices.
Track your success. Interceptor cups under your bed posts are also one of the best ways of keeping track of your success with bed bug control. Check the cups regularly and empty into a trash bag or bucket of soapy water.  You may even want to keep track of how many bed bugs you catch weekly so that you can track your success. Wipe out the interceptors and make sure they are clean. Some devices, like the Climbup Interceptor, require redusting with a very small amount of talcum powder to make them slippery again and reduce the bed bug’s chance of escape. Note that talc is not toxic to bed bugs, but simply makes it harder for them to climb out of the cup.  The talc should be barely visible, and more is definitely not better.
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When people are bitten, they often do not notice at first. It’s a possibility that one reason could be that these blood sucking insects feed late in the night, before the breaking of dawn. Humans are often in a deep REM sleep during that time. Upon arising, individuals can find bite marks; however it can take up to ten days for adverse or allergic reactions to develop.
Most bed bug bites go away by themselves and don't need treatment. Keep the skin clean and try not to scratch. Over-the-counter, anti-itching cream for insect bites can help relieve the itching. If the bites are very itchy, your health care provider may prescribe cream or antihistamines to relieve the itchiness. Oral antibiotics may be prescribed for any secondary skin infection from excessive scratching.
Probably chiggers -- they are very small, red mites that usually cannot be seen with the naked eye. They are about as small as the period at the end of this sentence. To stop the itching, use OraJel (usually sold for teething babies), which contains benzocaine (an anesthetic). Also, rub in hydrocortisone cream. To prevent chigger bites, wear long pants and stuff the cuffs into your socks.

Thus, although these insects usually cause mild cutaneous reactions, more severe responses, including anaphylaxis, may occur. [9] 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.
Itchy swollen bites may be the first sign of a bed bug problem. However, these itchy bites can take as long as 14 days to develop in some people, so it's important to look for other clues if you are concerned about an infestation. Bed bugs typically infest mattresses, box springs, bed frames, and couches. You may be able to find them hiding within the cracks and crevices of beds, furniture, floors, and walls. Bed bugs often leave evidence of small dark stains (fecal droppings) and rusty red spots (bloodstains) on bedding sheets, mattresses, and other areas they hide in or travel along. Heavy bed bug infestations can cause a sweet, musty smell.
A common concern with bed bugs is whether or not they transmit diseases. Although bed bugs can harbor various pathogens, transmission to humans has not been proven and is considered unlikely. Their medical significance is most commonly attributed to itching and inflammation from their bites. Antihistamines and corticosteroids may be prescribed to reduce allergic reactions, and antiseptic or antibiotic ointments to prevent infection. Though not known to carry diseases, bed bugs can substantially reduce quality of life by causing discomfort, sleeplessness, anxiety, and embarrassment. According to some health experts, the added stress from living with bed bugs can have a significant impact on the emotional health and well-being of certain individuals. 
Now that you’ve killed the bed bugs hiding in your bed, it’s time to put up defensive measures to keep them out. Remember, bed bugs can be hiding in all sorts of cracks and crevices throughout your bedroom – in furniture, along baseboards, and inside of the walls – so you need a way to keep them out of your freshly treated bed. By cutting off the infestation’s food supply (you), you halt their breeding and reproductive cycle, making the treatment a whole lot easier.
Mix 3 oz per gallon or 0.75 oz per quart and spray with a low pressure sprayer into the areas where the bed bugs are hiding. Typical areas include bed frames, headboards, under beds, baseboards, moldings, behind pictures,etc. Remember to apply in the joints and crevices of furniture. If the crack and crevice is too small, use an aerosol with a crack and crevice tip (recommendations are below.)
General housecleaning measures, (e.g. vacuuming floors and surfaces), seldom reach where bed bugs hide. For this reason, repetitive vacuuming by occupants may not be worth the effort, especially compared to other important preparatory activities. Targeted vacuuming of bed bugs and infested harborages, however, can help remove some of the bugs before other treatment measures are undertaken. Bed bugs and especially the eggs can be difficult to dislodge. Optimum results will be achieved by moving and scraping the end of the suction wand along infested areas such as seams and fabric folds of beds and sofas, and the perimeter edge of wall-to-wall carpet. Bed bugs can survive the high speed trip down a vacuum, so it’s important to carefully dispose of the vacuum contents in a sealed trash bag afterwards. 
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. 
Kept replacing the sticky traps just in case but never caught anything other than the occasional spider. Always cycled the sheets and such using the car+sun. They were still getting to us. Bed bugs cannot fly or jump. They had to be in the bed frame. I check it over and notice rusty spotting, which is apparently bed bug fecal matter. Luckily ours was from IKEA so it was easy to take apart – and sure enough – there they were. The way my bed works is a metal frame with holes, rubber end caps fit into those holes, and wooden slats run across the frame in the end caps. So every few days I’d mix up a 50/50 mix of bleach and water in a bucket and soak the wooden slats and end caps for ten minutes. The bed bugs were gone a couple of weeks and came back. I started soaking the things longer and scraping them with a disposable spoon, which was hard to do on the end caps. It warped the wood a little but nothing too bad. After a couple of weeks or so, I stopped finding bed bugs in the frame. I was worried they were in the metal too, but I completely stopped getting bites. I think the added time and scraping got rid of eggs. Not a lot can survive a 30 minute bleach bath.
Waking up with bites might be the first indicator that you have a bed bug problem. Their bites are often arranged in lines or clusters on the face, neck, arms or hands. Where there are bed bugs in large numbers, you might smell a sweet, musty odor (from the bugs’ scent glands) or see rust-colored spots on your bedding or mattress caused by bed bug blood or excrement. If you look closely, you might see adult bed bugs themselves, usually in mattress folds or seams or on the wall behind the headboard. Bed bugs prefer to stay close to their food source and are typically found hiding out within 1 to 5 ft of infested beds or furniture.
Bed bugs are tiny, flat, wingless insects that range in color from nearly white to deep brown/reddish. The parasitic pests get their name from their hiding spot of choice – they prefer burrowing into bed frames and mattresses during the day, then become active at night when they feed on people and pets. Bed bugs are resilient pests that can hitch a ride on luggage, furniture, storage boxes, backpacks and clothing (but rarely humans), very quickly causing an infestation.
A cloth and hot soapy water: Like the sticky tape, a cloth with hot water can be useful for capturing bed bugs. Have a bucket of water handy and as you wipe an area, check the surface of the cloth for bed bugs and then immerse the cloth in the bucket. Wring the cloth to remove excess water; you do not need to soak the surface that you are wiping. Also, check the area that you just wiped because heat may cause hungry bed bugs to move. The cloth is particularly effective when you find a cluster or group of bed bugs. Keep in mind that wet surfaces will reduce the effectiveness of sticky tape as a trapping method.
For more information about bed bugs, including their biology and how to recognize them, see other factsheets on the Citybugs bed bug page.  The State of Michigan has also recently published a very detailed guide to Do-it-yourself bed bug control. Also, if you decide you need professional help, check out our advice onHow to Select a Bed Bug Control Professional, ENTO-033
When you return home, quarantine your bags. Decontaminate your luggage and clothing by putting your entire suitcase into a large chest freezer (if you have one) for four days, suggests Gondhalekar, before bringing them back into your home. Extreme hot or cold temperatures kills bed bugs. You can also put your clothes in the dryer on a hot setting for 30 minutes, and try steam cleaning your luggage and clothing.
Bedbug bites can lead to anxiety, sleeplessness and even secondary infections, but there have been no reported cases of bedbugs transmitting disease to humans. They do, however, harbor human pathogens: At least 27 viruses, bacteria, protozoa and more have been found in bedbugs, although these microbes do not reproduce or multiply within the insects. Canadian researchers announced (pdf) in the June issue of Emerging Infectious Diseases that bedbugs isolated from three individuals in a Vancouver hospital carried methicillin-resistant Staphylococcus aureus, aka MRSA. Still, there have been no reported cases that the bugs actually transmit human disease.
If all other options have been exhausted, you may need to seek a professional PMP (Pest Management Professional). There are pesticides that are approved for professionals to use during a infestation. These pesticides, however, are not always effective, and typically not as effective as steam cleaning, excessive heat, or excessive cold. The exterminator may opt to treat the area with carbon dioxide.
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.
In the case of beds, a more economical option is to encase both the mattress and box spring in a protective cover like those used for allergy relief. Encasements specifically designed to help protect against bed bugs are available through retail or pest control firms. Higher quality ones tend to be more durable and comfortable to sleep on. Once the encasement is installed and zipped shut, any bugs which happen to be inside are entombed and eventually will die. Encasements also help protect newly purchased beds, and make it easier to spot and destroy any bugs residing on the outer surface during subsequent examination. Encasements will not, however, keep bed bugs from crawling onto a bed and biting a sleeping person.
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