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.
Some pest control firms utilize specialized heating equipment to de-infest furnishings, rooms, and entire dwellings. The procedure involves heating up the infested item or area to temperatures lethal to bed bugs. Portable heaters and fans are used to gradually heat the air to about 120 - 130°F while monitoring with strategically placed sensors. By carefully controlling the temperature, bugs and eggs are killed wherever they may be without damaging household items. 
"By every metric that we use, it's getting worse and worse," says Coby Schal, an entomologist at North Carolina State University in Raleigh. Health authorities and pest control operators are regularly flooded with calls, and the epidemic may not have yet peaked. And because bedbugs are indoor pests, there are no high or low seasons throughout the year, he adds, only continual bombardment. "It's just the beginning of the problem in the U.S.," Schal says.
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 bug infestations usually occur around or near the areas where people sleep. These areas include apartments, shelters, rooming houses, hotels, cruise ships, buses, trains, and dorm rooms. They hide during the day in places such as seams of mattresses, box springs, bed frames, headboards, dresser tables, inside cracks or crevices, behind wallpaper, or any other clutter or objects around a bed. Bed bugs have been shown to be able to travel over 100 feet in a night but tend to live within 8 feet of where people sleep.
Bed bugs are attracted to their hosts primarily by carbon dioxide, secondarily by warmth, and also by certain chemicals.[4][16][17][18] Cimex lectularius only feeds every five to seven days, which suggests that it does not spend the majority of its life searching for a host. When a bed bug is starved, it leaves its shelter and searches for a host. It returns to its shelter after successful feeding or if it encounters exposure to light.[19] Cimex lectularius aggregate under all life stages and mating conditions. Bed bugs may choose to aggregate because of predation, resistance to desiccation, and more opportunities to find a mate. Airborne pheromones are responsible for aggregations.[20]
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.
Turns out, C. lectularius is also forming a resistance to other insecticides, according to a study published online April 10, 2017, in the Journal of Economic Entomology. The researchers, from Purdue University, found that three out of 10 bedbug populations collected in the field showed much less susceptibility to chlorfenapyr, and five of the 10 populations showed reduced susceptibility to bifenthrin, according to a post on Entomology Today. The scientists defined "reduced susceptibility" as a population in which more than 25 percent of the begbugs survived after seven days of exposure to the particular insecticide.
Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: University of Alabama at Birmingham; University of Alabama Health Services Foundation
Serve(d) as a speaker or a member of a speakers bureau for: Ferndale Laboratories
Received research grant from: NIH, Veterans Administration, California Grape Assn
Received consulting fee from Astellas for review panel membership; Received salary from Massachusetts Medical Society for employment; Received salary from UpToDate for employment. for: Astellas.

Do encasements work? Yes. When you put an encasement on your mattress or box spring you can lock bed bugs in and prevent new bed bugs from getting in. No chemical control is needed, so you don't have to worry about being poisoned by powders or some other toxin in your bed. The problem is that encasements by themselves, or when used with traps, are simply a bandaid. They are not likely to contain or stop a bed bug infestation. As mentioned above, this method can lead to the growth of an infestation and, ultimately, a prolonged and frustrating infestation.
^ Johann Friedrich Wolff; Johann Philip Wolff. "According to Scopoli's 2nd work (loc. cit.), found in Carniola and adjoining regions. According to Linnaeus' second work on exotic insects (loc. cit.), before the era of health, already in Europe, seldom observed in England before 1670". Icones Cimicum descriptionibus illustratae. p. 127. Retrieved 1 December 2016. fourth fascicle (1804)
Dismantling bed frames in infested areas typically exposes bed bug hiding sites. Having access to these areas during cleaning is important. Stand up the box spring and shine a flashlight through the gauze fabric and look for bed bugs. If the fabric is torn (possible hiding place), remove fabric to prepare for spraying. If the mattress and or box springs are infested, you may want to consider Encasements by Mattress Safe. Once covered with these encasements, bed bugs can not enter or exit. There is no need to treat the mattress or box spring when using these encasements. Keep them on for a year.
Are there pesticides that kill bed bugs? Yup. There sure are. Pest control companies often use pesticides to exterminate these bugs as part of a heat treatment, and also by themselves. But chemicals have some drawbacks that pest professionals are aware of. These products can drive bed bugs into walls, like an improperly applied heat treatment, and they can be ineffectual if bed bugs are deep inside furniture. There are also safety considerations that need to be considered when applying any pesticide.
Please be sure to read the product label of any insecticide you choose to use to get information on the personal protective safety gear you will need. In most situations, it is recommended that you wear long pants, a long sleeved shirt, closed toe shoes with socks, chemical resistant gloves, and goggles. In areas where ventilation is poor, a manufacturer may recommend you wear a mask or a respirator. We have put together two different safety kits that will make selecting the correct safety gear easier for you.
Unlike cockroaches and flies that feed on filth, there is often no relationship between bed bugs and cleanliness. Since the bugs feed solely on blood, pristine dwellings can be as vulnerable to infestation as are places of squalor. That said, poverty and privation can lead to increased risk of bed bug problems, as can the inability to hire a professional exterminator.    
Apply as a coarse, low-pressure spray to harborage areas including crevices, baseboards, loose plaster, behind bed frames and headboards, beneath beds and furniture, and to bedsprings and bed frames. After removal of bed linens, apply Transport Mikron to mattress and boxsprings. Apply to tufts, edges, seams and folds (do not spray clothes or bed linens). Your may apply it to furniture, but not to areas where there is direct access to seating or arm placements. Infested bed linens should not be treated, but should be removed, placed in sealed plastic bags, and taken for laundering and drying at high temperatures.
Monitor your home. Bed bugs like to hide in cracks and crevices like walls, luggage, boxes, and clothing, but since they feed on humans while they sleep, they’re most commonly found in beds. If you suspect an infestation, or if you live in an apartment building with a bed bug problem, regularly inspect your bed sheets, mattress (including underneath), and box-spring seams for bugs. They’re flat and oval-shaped, with red or brown bodies, roughly the size of an apple seed. Watch for adults, nymphs, and eggs, as well as exoskeletons (casings that the bugs leave behind when they molt) and dark, rust-colored spots (feces).
As mentioned earlier, applying insect repellent at bedtime will probably not deter bed bugs from biting. When working in severely infested dwellings, there may be some benefit to spraying tops and bottoms of shoes with DEET-based repellents. Those working in bed bug-infested environments may also want to hot wash or run clothing, etc. through a dryer upon returning home or to the office.    

Bed bugs are small, brownish, flattened insects that feed solely on the blood of animals. Although the common bed bug (Cimex lectularius) prefers feeding on humans, it will also bite other warm-blooded animals, including dogs, cats, birds and rodents. It has done so since ancient times; bed bugs are mentioned in medieval European texts and classical Greek writings back to the time of Aristotle.
But the bites will look different from person to person, and some people won’t develop any reaction whatsoever. “The same bedbug could bite two different people and one could have no reaction at all and the other can have an extreme reaction with a swollen arm or itchy rash,” says Eric Braun, a board-certified entomologist and business manager for the national pest control company Rentokil Steritech, who is based in Redding, Pennsylvania. Some people end up developing a rash that looks like eczema. (5)
To check for signs of a bedbug infestation, Dr. DerSarkissian says that you may notice rusty-colored spots on bed linen and mattresses. These spots could be either blood stains or bedbug excrement. You may also find shed skins around bed frames, mattresses, and other hiding places. Also, a musty smell is usually present where a large number of bed bugs are living.4
Dusts have been used to ward off insects from grain storage for centuries, including plant ash, lime, dolomite, certain types of soil, and diatomaceous earth or Kieselguhr.[60] Of these, diatomaceous earth in particular has seen a revival as a nontoxic (when in amorphous form) residual pesticide for bed bug abatement. While diatomaceous earth performed poorly, silica gel may be effective.[61][62]
Isolating your bed from the rest of the house.  If you don’t use a bed, purchase a frame that gets your mattress off the floor and install bed bug interceptors under all feet of the bed frame to keep bed bugs off your bed while you are sleeping. Interceptors are special platforms or cups that are purchased to prevent bed bugs from climbing on to your bed.  An interceptor can be as simple as a sticky card placed under a bed post (sticky and messy).  Better are one of the commercial pitfall traps made specifically for this purpose.  The Climbup™ Bed bug Interceptor and BlackOut BedBug Detector (Google them) are two such products sold online. Relatively inexpensive, these cups trap bed bugs attempting to climb (or exit) the bed. If you have encased your bedding, treated your bed frame thoroughly and installed interceptors, you will be instantly protected against bed bugs.  Don’t take out your clean bedding or put it back on the bed until the bed has been treated (and dried) and encasements installed. And note that for this method to be effective, beds and bedding must not touch the floor, furniture or walls.  This would provide bed bugs other ways to climb onto the bed and foil your defenses.
After bedbugs find a food source, they bite down with their mouths and inject anticoagulant and anesthetic compounds into the skin. Depending on the species, these parasites feed on the host blood via 1 of 2 mechanisms. Vessel feeders directly insert their mouthparts into superficial capillaries, whereas pool feeders damage the superficial tissue and feed on the accumulated blood. As bedbugs feed, their color may change as they swell with the host blood, as shown in this picture of a larval bedbug feeding on a volunteer host. Image courtesy of the US Centers for Disease Control and Prevention (CDC).

Application entails treating all areas where the bugs are found or tend to hide or crawl. This takes considerable effort and follow-ups are usually needed. Companies typically treat seams, folds and crevices of bed components, chairs and sofas, but usually will not spray the entire sleeping surface or seating area. They also do not spray bed sheets, blankets or clothing, which instead should be hot washed or heated in a dryer. 
Our place is pretty cluttered so I was freaking out. Luckily we have hardwood floors and not carpet. We tried different things. It gets really hot here, so I loaded up any nearby sheets, pillows, comforters, clothes, etc into trash bags and tied them off so nothing could get out. I put those in the car so the sun could beat heat into them all day. Never thought I’d be so thankful for Texas summers… Still got bites. We bought a mattress cover. Still got bites. We thought, okay, maybe they’re coming from the wall socket from a neighbors or something. We couldn’t close it so we kept the bed away from furniture and walls and put sticky traps on the legs. Caught NO bed bugs but STILL GOT BITES. I was losing my mind.
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.
Bed bug incidents in schools are best handled by knowledgeable pest control firms. Widespread insecticide treatment of classrooms, hallways, buses, etc. is unnecessary, ineffective and imprudent. Effort instead should be spent checking chairs, desks, lockers, coat rooms, etc. in the vicinity of where the bugs were found, and treatment should be focused on those specific areas. Canine inspections can also be useful in finding small numbers of bed bugs in schools and other establishments where there are no beds.      
Bedbug bites themselves are typically painless. However, the subsequent allergic reaction that may develop can cause intense pruritus. While feeding, bedbugs may inject one of several pharmacologically active substances, including hyaluronidase, proteases, and kinins. These compounds may induce different skin reactions, such as erythema, wheals, vesicles, or hemorrhagic nodules. Repeated bites may sensitize individuals, leading to more pronounced cutaneous manifestations or systemic hypersensitivity reactions. The local trauma from bedbug bites can lead to secondary bacterial infection, causing ecthyma, cellulitis, or lymphangitis. There is some evidence that bedbugs may also be a vector for hepatitis B and Chagas disease. Histologic findings from bite-site biopsy specimens typically show eosinophilic infiltrates, which are indicative of the allergic nature of the reaction. The image shown is papular urticaria, which may develop from bedbug bites.

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.
When bed bugs are suspected, sleeping and resting places should be thoroughly inspected. Check all possible hiding places, mindful that bed bugs, especially the young nymphs and eggs, can fit into very tiny cracks and crevices. Don’t overlook places where pets rest, and where bats or birds have entered structures. In these instances, bat or bird bugs, not bed bugs, may be present. If bats or birds are a source of infestation, they should be excluded from the premises. Note that bats and most bird species are protected by law and should not be killed. Contact the Illinois Department of Natural Resources for guidelines on bat or bird exclusion and removal.
Turns out, C. lectularius is also forming a resistance to other insecticides, according to a study published online April 10, 2017, in the Journal of Economic Entomology. The researchers, from Purdue University, found that three out of 10 bedbug populations collected in the field showed much less susceptibility to chlorfenapyr, and five of the 10 populations showed reduced susceptibility to bifenthrin, according to a post on Entomology Today. The scientists defined "reduced susceptibility" as a population in which more than 25 percent of the begbugs survived after seven days of exposure to the particular insecticide.
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