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.
Because bed bugs have become so prevalent in the past few years, many fear they’ll be their next victim. They became so anxious and paranoid of the possible bed bug presence. If you eliminate the pests though, you could have a certain sense of peace knowing that you would not be bothered or bitten them. However, you wouldn’t be able to sleep well for long if you would not kill bed bugs right and continuously do the bed bug preventive steps.
Mechanical approaches, such as vacuuming up the insects and heat-treating or wrapping mattresses, are effective.[3][6] An hour at a temperature of 45 °C (113 °F) or over, or two hours at less than −17 °C (1 °F) kills them.[6] This may include a domestic clothes drier for fabric or a commercial steamer. Bed bugs and their eggs will die on contact when exposed to surface temperatures above 180 °F (82 °C) and a steamer can reach well above 230 °F (110 °C).[31][15] A study found 100% mortality rates for bed bugs exposed to temperatures greater than 50 °C (122 °F) for more than 2 minutes. The study recommended maintaining temperatures of above 48 °C (118 °F) for more than 20 min to effectively kill all life stages of bed bugs, and because in practice treatment times of 6 to 8 hours are used to account for cracks and indoor clutter.[32] This method is expensive and has caused fires.[6][15] Starving them is not effective as they can survive without eating for 100 to 300 days, depending on temperature.[6] One expert recommends not trying to get rid of bed bugs exclusively on one's own.[29]
Minimize its spread. First, notify your landlord if you rent in a building to control its spread to other units. Thoroughly vacuum any infested areas, including carpets and mattresses, and then empty the vacuum bag into a plastic bag, seal it, and throw it in the trash outside. If you can’t get the bed bugs out of your furniture, discard items in a responsible manner. To avoid someone else from salvaging infested furniture or mattreses, rip, remove stuffing, or spray paint with the words “bed bugs.”
While most of the bed bugs were wiped out by the chemicals, three groups continued to thrive after being treated with chlorfenapyr, and five groups were still kicking after being treated with bifenthrin. That means that while some bed bugs will respond to these chemicals, others won't—and it's likely that more and more bugs will become resistant over time.
Some preparation is still required (e.g. removal of heat-sensitive items such as aerosol cans, indoor plants and medications), but it is seldom necessary to bag, launder and/or hot dry bedding and clothing since these items will be heated along with other furnishings. Another advantage of heat treatment is that infestations can often be eliminated in one day, rather than over multiple days or weeks. Conversely, heat treatment alone has no lasting (residual) effect should bed bugs be reintroduced into the dwelling. Consequently, some companies recommend concurrently applying residual insecticides. To further minimize reintroduction, occupants are advised to take as few belongings as possible with them while the heat treatment is in progress.    
Discard affected items. In some cases, infested mattresses and box springs will need to be discarded. Since bed bugs can disperse throughout a building, it also may be necessary to inspect adjoining rooms and apartments. Pay it forward: chop up and/or damage the items you discard so nobody will be tempted to take them home and spread the problem further.[17]
Insecticides might also have their work cut out for them: Entomologists have known that the common bedbug has built up resistance to some typical insecticides such as those containing certain pyrethroid chemicals like deltamethrin, according to Entomology Today. Deltamethrin apparently paralyzes an insect's nervous system, according to Cornell University. 

Killing all bed bugs on your bed frame and headboard. Normally this would be done by a pest control professional. Approximately 70% of all bed bugs in the typical infestation are located on the mattress, box spring and bed frame.  You’ve encased the mattress and box spring and taken care of that problem.  Now you have to make sure that your bed frame is bed bug free. Vacuuming alone won’t do this.  Vacuuming can remove many bed bug adults and nymphs, but it isn’t very good at removing eggs.  For this job you’ll need insecticide sprays and possibly dusts to treat every crevice and void in your bed.  For insecticide spray and dust options see below. Remember that insecticides can be hazardous if you don’t follow label directions.  Read the whole label before spraying or dusting.  The label directions are the law and failure to follow the label not only puts you and your family at risk, it is against the law.  Homemade sprays, by the way, are usually less safe than commercial insecticides.  Stick with the legal stuff.

Hiring a pro to wipe out bed bugs isn’t cheap. Expect to pay about $200 per room to kill bed bugs, and you’ll likely need a few chemical treatments in order to eradicate bed bugs. Professional heat treatments will cost even more. And even if you hire a pro, you’ll still have to do lots of work yourself (moving furniture, washing all clothes, etc.). So consider declaring a DIY war on bed bugs. If you’re willing to spend $100 to $200 and do things right, your chances of success are excellent.
Bed bugs tend to live in clusters similar to German cockroaches. Adult bed bugs generally travel 15 to 20 feet, or less, from their harborage sites. Common bed bugs feed on human blood just below the surface of the skin with their piercing-sucking mouthparts. Those bitten by a bed bug may develop small, white to red, hard welts at the bite site. These bites itch intensely.
Bedbugs reproduce by a gruesome strategy appropriately named "traumatic insemination," in which the male stabs the female's abdomen and injects sperm into the wound. During their life cycle, females can lay more than 200 eggs, which hatch and go through five immature "nymph" stages before reaching their adult form, molting after each phase. [Infographic: Bedbugs: The Life of a Mini-Monster]
To know it's bedbugs, it's important to find the bugs themselves. Look at bedsheets and mattresses for little spots of blood, rusty-looking stains (crushed bugs), or black dots (bugs' poop). You might see live bugs around the seams or tags of mattresses and box springs, or in cracks of bed frames and other furniture. They can even hide in books, carpet edges, and electrical outlets.
Vigilant travelers may also want to elevate suitcases off the floor on a stand, tabletop or other hard surface rather than storing them on the floor or another bed. Hyper-vigilant travelers may further opt to keep belongings in sealed plastic pouches and their suitcase in a zippered tote — however each traveler must decide how cautious they wish to be. 
"In the past, bedbugs have repeatedly shown the ability to develop resistance to products overly relied upon for their control. The findings of the current study also show similar trends in regard to chlorfenapyr and bifenthrin resistance development in bedbugs," study researcher Ameya Gondhalekar, research assistant professor at Purdue's Center for Urban and Industrial Pest Management, said in the Entomology Today statement. "With these findings in mind and from an insecticide resistance management perspective, both bifenthrin and chlorfenapyr should be integrated with other methods used for bed bug elimination in order to preserve their efficacy in the long term."
Other types of bed bug traps include those that do not rely on humans as bait, but instead use CO2and/or other attractants. CO2 is thus far the most powerful lure for bed bugs, as it is the primary cue they follow to locate hosts. Traps that issue CO2 for a period of time are more expensive than Climbup™ traps, but can effectively trap bed bugs when no host is present, such as in common areas, vacant homes or units, offices, schools, and theaters. Thus they can help confirm infestation and eradication.
Bed bugs have a fast and large reproduction nature. On an average, they can reproduce within 200 to 250 eggs at one time, and hatch during an interval between 6 to 10 days. Bed bugs largely live between 4 months to 6 months, and a 1-time treatment is not sufficient to cover the Bed Bug life stages. A 3 times treatment integrated with steam treatment and follow ups across 1.5 to 2 months is usually recommended. Read more here on 6 Questions to Get the Best Treatment for Bed Bugs.
Check to see if you can identify the rust-colored fecal stains, egg cases, and shed skins (exuviae) in crevices and cracks on or near beds. A sweet, musty odor is sometimes present. You should also look at other areas such as under wallpaper, behind picture frames, in couches and other furniture, in bedsprings and under mattresses, and even in articles of clothing. While fecal stains and skin casts suggest that bedbugs have been present, these do not confirm that the infestation is still active. Observing the bedbugs themselves is definitive confirmation that an area is infested. You may require professional assistance from a pest-control company in determining whether your home has a bed bug problem.
Bites on dogs and cats will look much like bites on people, and the pet owner may actually suspect a mosquito or flea bit the pet. As with people, bed bugs do not stay on pets, but return to a protected harborage site after feeding. In addition to bites, the presence of the bug’s feces, cast skins and the animal’s irritation at night are also indicators of bed bugs biting pets. Therefore, one of the best things to do is inspect the pet’s bedding and frequently groom the animal while being vigilant for the telltale signs of bed bug presence.
Minimize its spread. First, notify your landlord if you rent in a building to control its spread to other units. Thoroughly vacuum any infested areas, including carpets and mattresses, and then empty the vacuum bag into a plastic bag, seal it, and throw it in the trash outside. If you can’t get the bed bugs out of your furniture, discard items in a responsible manner. To avoid someone else from salvaging infested furniture or mattreses, rip, remove stuffing, or spray paint with the words “bed bugs.”
Bed bugs like to travel and are good hitchhikers. They will hide in suitcases, boxes and shoes to be near a food supply. They are elusive, nocturnal creatures. They can hide behind baseboards and in cracks, crevices, and folded areas of beds, bedding and adjacent furniture, especially mattresses and box springs. Bed bugs can also hide in electrical switchplates, picture frames, wallpaper and nearly anywhere inside a home, car, bus, or other shelter. Bed bugs usually come out at night for a blood meal. However, they are opportunistic insects and can take a blood meal during the day, especially in heavily-infested areas. Bed bugs usually require 5-10 minutes to engorge with blood. After feeding, they move to secluded places and hide for 5-10 days. During this time in the bed bug life cycle, they do not feed but instead digest their meal, mate, and lay eggs.
Determine which rooms are infested. Bedrooms are the principal locations for bed bugs; however, any room where people sleep in the home may provide harborage for bed bugs. Living rooms with sofas and sofa beds are the next most common sites for bed bugs. Typically an infestation starts in one room and spreads slowly to other places where people sleep.  The sooner you find and treat bed bugs the easier it will be to get rid of them.  Wait too long and bed bugs may be found throughout your home.

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Treatment for bedbug bites is typically supportive. Local antiseptic lotions or antibiotic creams can be applied for secondary infections, whereas corticosteroid creams and oral antihistamines can be used for allergic reactions. Bedbugs can be eliminated through the use of permethrin insecticides, baited traps, special bedbug-free beds, and bed nets. Homemade methods, such as wrapping duct tape around bed legs as shown, may be effective, but bedbugs have been known to climb other objects and then fall down onto a bed. Image courtesy of Wikimedia Commons.
The best method of inspection is always using your body. Bed bugs have to have a blood meal, so if they persist after your treatment, they will find you. If you don't want them biting you and you want to get a good nights rest, then be sure to encase your mattresses, using climb-up bed bug interceptors on your bed frame and post and place Bed Bug Traps around to help monitor bedbug movement.  Replace traps every 90 days.
Some patients develop blisters filled with blood or bloody fluid, especially on the arms and legs. These blood blisters are extremely rare and can burst, causing bleeding or oozing of the bloody fluid. Healthcare providers are not sure if the cause of these blisters is related to the bug or the human but have found groups of patients that were all bitten by bugs on the same train exhibiting this sign.
The most frequent bed bug encountered in the United States is Cimes lectularius, the common bed bug. However, one other bed bug species occasionally found in the southern United States, is Cimex hemiperus, the tropical bed bug. Both of these species are oval, flat and reddish brown. They range from one-fourth inch to five-eighths inch in length. Nymphs and adults have piercing-sucking mouthparts and are incapable of flight. However, small stubby wing remnants can be observed on the adults.

Bed bug females lay between 200 and 500 eggs during their lifetime in batches of three to four eggs per day. These eggs hatch after 6 to 17 days. Nymphal bed bugs molt five to six times before becoming adults. Under the best conditions, the life cycle is complete in four to five weeks, but since ideal conditions are rarely found it can take four to five months. Adult bed bugs can live 10 months or more without food. Nymphal bed bugs are known to survive for more than two months without feeding.
Bed bugs could be hiding in all sorts of tight spaces in your room, like wood cracks, inside books and furniture, and along the baseboards and the edges of the carpet. In this step, we’re going to clean, vacuum, and steam those areas that bed bugs are likely to be. This will cut down on the bed bug population while making it harder for survivors to hide.
Bedbugs do, however, have a unique bite pattern. Although some bites may appear alone, most bites occur in a row of three to five bites (termed "breakfast, lunch, and dinner") or in a cluster of red bumps (a rash called bedbug dermatitis). The bites often appear in a zig-zag formation, but may appear in a straight line if the bugs bite you in the morning.
The type of reaction provoked depends on previous exposure; repeated bites may lead to an allergic reaction, which may lead to pronounced cutaneous manifestations. Some patients show a severe systemic hypersensitivity to arthropod allergens. The site of the bite can also become secondarily infected with bacteria infection and lead to ecthyma, cellulitis, and/or lymphangitis.
Bed bug bites are caused primarily by two species of the insect Cimex: Cimex lectularius (the common bed bug) and Cimex hemipterus.[3] Their size ranges between 1 and 7 mm.[7] They spread by crawling between nearby locations or by being carried within personal items.[2] Infestation is rarely due to a lack of hygiene but is more common in high-density areas.[8][2] Diagnosis involves both finding the bugs and the occurrence of compatible symptoms.[5] Bed bugs spend much of their time in dark, hidden locations like mattress seams or cracks in the wall.[2]

We are often asked, "How do you kill bed bugs?" While we would love to give a simple answer, this is actually a loaded question. There are many ways to kill a bed bug but, if you want to kill all of the bed bugs in your home or business, it is important to pay attention to the details. Here are some ways you can kill bed bugs, and what you should know about each.
If at all possible, pull up the carpet where it meets the wall and puff powder around the whole perimeter of the room. Inside outlet boxes is a great place to use powders because sprays and electricity don’t mix. Bellow dusters work great for spreading residual insecticide powder. An old makeup brush is a good tool to spread the dust around on hard surfaces. Bed bug powders are available the same places you’ll find the spray pesticides.
In order to get rid of this pest, you need to understand how it works. Getting rid of bed bugs can be a tricky task because they are expert hitchhikers. The best thing you can do is to entrust the task with an experienced pest control professional. However, if you are planning to do it yourself, I've provided you great tips and information about bed bugs to help you in your battle. That way, you can use your knowledge to eliminate them and keep them away.
It was stated in 2012 that no truly effective insecticides were available.[6] Insecticides that have historically been found effective include pyrethroids, dichlorvos, and malathion.[4] Resistance to pesticides has increased significantly over time, and harm to health from their use is of concern.[3] The carbamate insecticide propoxur is highly toxic to bed bugs, but it has potential toxicity to children exposed to it, and the US Environmental Protection Agency has been reluctant to approve it for indoor use.[33] Boric acid, occasionally applied as a safe indoor insecticide, is not effective against bed bugs[34] because they do not groom.[35]
Bedbugs bite and suck blood from humans. Bedbugs are most active at night and bite any exposed areas of skin while an individual is sleeping. The face, neck, hands, and arms are common sites for bedbug bites. The bite itself is painless and is not noticed. Small, flat, or raised bumps on the skin are the most common sign; redness, swelling, and itching commonly occur. If scratched, the bite areas can become infected. A peculiarity of bedbug bites is the tendency to find several bites lined up in a row. Infectious-disease specialists refer to this series of bites as the "breakfast, lunch, and dinner" sign, signifying the sequential feeding that occurs from site to site. In some people, the bites can take several days to develop. The signs may become apparent up to 14 days after the bite has occurred.

Bites on dogs and cats will look much like bites on people, and the pet owner may actually suspect a mosquito or flea bit the pet. As with people, bed bugs do not stay on pets, but return to a protected harborage site after feeding. In addition to bites, the presence of the bug’s feces, cast skins and the animal’s irritation at night are also indicators of bed bugs biting pets. Therefore, one of the best things to do is inspect the pet’s bedding and frequently groom the animal while being vigilant for the telltale signs of bed bug presence.
In order to get rid of this pest, you need to understand how it works. Getting rid of bed bugs can be a tricky task because they are expert hitchhikers. The best thing you can do is to entrust the task with an experienced pest control professional. However, if you are planning to do it yourself, I've provided you great tips and information about bed bugs to help you in your battle. That way, you can use your knowledge to eliminate them and keep them away.
Insecticides might also have their work cut out for them: Entomologists have known that the common bedbug has built up resistance to some typical insecticides such as those containing certain pyrethroid chemicals like deltamethrin, according to Entomology Today. Deltamethrin apparently paralyzes an insect's nervous system, according to Cornell University.
Once the mattress and box spring are dry, encase them in sealed bed bug encasements. Encasements are crucial, as they prevent bed bugs from entering or escaping the mattress and box spring, cutting off key hiding places. Remember to leave the encasements on for at least 18 months to ensure that any bed bugs already inside have starved to death. Once the encasements have been applied, you can put your mattress and box springs back on your treated bed frame, and put your laundered bedding back on your bed.
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