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.

Treat or isolate your bagged items. For washable items research shows that dry cleaning, washing in hot water for 30 minutes, or tumble drying for 30 minutes on high will kill all stages of bed bugs. Non-washables are a little trickier.  Items that aren’t needed for a while can just be stored. It takes 2-5 months to kill bed bugs by isolating them in bags (the warmer the temperature, the shorter the survival time for starving bed bugs). Heating bags by placing in direct sunlight is one of the most effective methods during the warm summer months.  Seven pounds of items placed in clear bags in direct sunlight on a 95 degree day will get hot enough to kill all bed bug life stages in one afternoon.  Also, placing bagged items in a chest freezer (0 degrees F) for 8-10 hours is lethal for bed bugs and their eggs. Some toys may be disinfested by cleaning with hot soapy water and/or rubbing alcohol.

Bedbugs are a species of insect known as cimex lectularius (literallycimex is Latin for bug and lactularius is Latin for bed). There is a second common species of bedbugs known as cimex hemiptera. These are known as the tropical bedbugs, staying within 30 degrees of the equator. There are published reports, many without supporting evidence, that each of the common bedbug species has chemically different saliva. Some researchers, however, have found no difference in the reactions caused by each species.
Low toxicity contact sprays like SteriFab™ or Bedlam® are likely to kill bed bugs only on contact. Alcohol- and soap-based sprays, are only partly effective. All of these products, once dry, are likely to provide no further control. Eggs will not be killed by alcohol-based sprays, so repeat treatments are usually needed. Be careful when using sprays containing alcohol because they may be flammable.

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.

Reactions to bed bug bites vary among individuals. Many persons show no signs of bites. Others don’t realize they’ve been bitten until redness and swelling appear around the bite, sometimes with intense itching. Some exhibit inflamed swollen spots that may occur in linear series or have a rash-like appearance. Such bite marks, when they appear, may not show for several days after the person is bitten.
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