The first sign of a bed bug problem is obvious: the bed. After bed bugs feed on humans, they'll leave behind blood stains resembling small rust spots. These will usually be found near the corners and edges of the bed. Bed bugs also shed their skin, or molt, several times as they mature, so you may find their oval brown exoskeletons during your search.
Mix an insecticide labeled for use on bed bugs, such as Temprid FX, with water in a pump sprayer using the ratio found on the product label to create a bed bug spray. Spray onto baseboards, in corners, around door and window frames, around bed frames, and under furniture. Do not broadcast spray an entire carpet or floor. Allow the spray to dry before moving on to the next step.
Preparing for bed bug treatment is tedious yet important. Very comprehensive preparation is necessary when infestations are heavy and the bugs are widely dispersed. More limited prep may be adequate for light infestations since at these levels the bed bugs typically are more confined to sleeping areas (beds, sofas, and recliners). Pest control firms have their own policies, however, regarding preparation requirements which may also depend on the manner of treatment. 
I paid $1200 for extermination heat treatment- lasted a few months and they are back- bought all new furniture! Still bugs- spray bye bye bugs spray which kills on contact but didn’t stop the infestation! This is going on 2 years now!!!! Mainly they are just in the 2 bedrooms. Ours and one that hardly no one sleeps in. But when grandkids come- they get bitten bad- I scrub, spray, vacuum & steam clean, & wash all bedding n still bit!!! Ready to burn the house down!!! HELP!!!!!! Can’t afford another $1200

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”. 

In the chemical-based category, there are two methods included. Though we consider the two as different means, they both rely on the use chemical pesticides. The first method is by hiring bed bug exterminators who use strong solutions to eliminate the pests. It offers an easy yet expensive and risky bed bug treatment even if the exterminator use the best chemical to kill bed bugs.

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.

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.

Select and use insecticides safely. There are no magic sprays that kill bed bugs very well.  Most commercial insecticides will kill bed bugs if applied carefully and directly to the insects and their hiding places. An exception is “Bug bombs”, or aerosol foggers. Foggers are mostly ineffective in controlling bed bugs. Because bed bugs hide in crevices and voids where aerosols do not penetrate, they are able to avoid contact with these insecticides. Their use is not recommended. Some of the products you may find helpful include:

Symptoms may not appear until some days after the bites have occurred.[5] Reactions often become more brisk after multiple bites due to possible sensitization to the salivary proteins of the bed bug.[3] The skin reaction usually occurs in the area of the bite which is most commonly the arms, shoulders and legs as they are more frequently exposed at night.[5] Numerous bites may lead to an erythematous rash or urticaria.[5]
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.

Especially in situations where a large amount of time would be required for a pest management professional to thoroughly inspect a structure, bed bug detecting dogs are sometimes employed. Well-trained and handled dogs can also be of value in structures or units with lesser infestations, i.e., where human inspectors might easily overlook bed bugs because only a few bugs are present.
* Typically used for control of wood-destroying organisms, true fumigation of structures is occasionally performed for bed bug control. Fumigating a structure involves “tenting” it, i.e., draping and sealing it with tarps so that the fumigant, a poisonous gas, can be applied into and contained within the structure where it penetrates the contents and kills all pests within. Like whole-room heat treatments, fumigation has no lasting effect (it leaves no pesticide residue), is labor-intensive, and can damage contents. It is also more expensive, especially in northern states where fumigations are done less frequently. The advantage of fumigation over heat treatment may be that fumigation is more likely to kill all the pests within a structure.

The first sign of a bed bug problem is obvious: the bed. After bed bugs feed on humans, they'll leave behind blood stains resembling small rust spots. These will usually be found near the corners and edges of the bed. Bed bugs also shed their skin, or molt, several times as they mature, so you may find their oval brown exoskeletons during your search. 

One method of applying freezing temperatures to bed bugs entails the use of carbon dioxide (CO2) applied as “snow” with a portable application device, i.e., Cryonite™. When applied directly onto bed bugs, the frozen CO2 will kill them. However, this method is similar to using contact pesticides, that is, there is no residual activity. It can kill only as many bed bugs as the applicator can find. The advantage of using this type of freezing device is that bed bugs may be killed quickly and without the use of more hazardous pesticides. Again, this is not a stand-alone treatment, and it is recommended that it be used as a supplemental to the application of residual pesticides and/or other means of control.
Move your bed away from any other points of contact, like walls, nightstands, and other furniture. Tuck in or remove any hanging skirts or sheets, and remove any storage under the bed that is touching any part of the frame. The only thing your bed should be touching is the floor via its legs. If you don’t have a bed frame with legs, you should purchase one to sleep in, at least until you are bed bug free.

Some people have no reaction whatsoever to bed bugs. In addition to not having much of an effect on the elderly, some are just not allergic. Since the irritation and welting appears as the result of an allergic reaction, it is possible to not even know that you were bitten at all. It is entirely possible for several people to live in the same house, and have one person not be affected.
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.
The life cycle stages of a bed bug are egg, nymph, and adult. The reason they are called bed bugs is that they readily infest mattresses, bed frames and box springs. Eggs are laid along the edges of or around buttons on the mattresses. Eggs can also be glued to rough surfaces. Bed bug females lay about 200 eggs, usually at the rate of three or four a day. Eggs are placed in cracks, crevices and other isolated and protected shelters. Females lay eggs after a blood meal. Eggs will hatch in one or two weeks into Nymphs. Newly hatched bugs (Nymphs) begin feeding immediately. At room temperature, and with an available food supply, the nymphal period will last 14 to 30 days. They shed their skin (Instar) five times before becoming adults. Bed bugs will mate soon after becoming mature, so the time from egg hatch to egg laying is 4 to 9 weeks, under favorable conditions. The average life span of the bed bug is 6-12 months and they feed every 10 days or so during this time. Bed bugs can survive many months without a blood meal and their reproduction is high.

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.


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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