Bed Bug Bites: Pictures, Signs and What to Do

What do bed bug bites look like?

Typical marks are small, raised, red bumps, often with a darker or lighter center. They show up on the face, neck, arms, hands and legs, because those areas are exposed while you sleep. Many people notice them on waking.

Marks sometimes appear in a row or a tight group of three or more. That pattern is a clue, not proof. Skin tone changes how redness shows, so on darker skin the bumps may look purple, brown or just slightly raised. The images in this article are illustrations meant to show common patterns, and your skin may look different.

How can you tell bed bug bites from other bites?

Bites are among the weakest evidence of bed bugs, so use them to prompt a closer look, not a conclusion. Here is how the common suspects usually compare.

Because the possibilities are many, a doctor is the right person to say what a rash is. We can only say whether bed bugs are in the room.

Why do some people have no bed bug bites at all?

Reactions vary. Some people develop welts within hours, others take a day or more, and some never develop a visible reaction. That means two people in the same bed can have very different skin, and an unmarked sleeper is not proof that the bed is clear.

It also means a sleeper who reacts may be unsure whether marks are from this week or last. If you wake with new marks and are unsure of the cause, look for the other signs in the next section and book an inspection if you find any.

How long after a bite do marks appear?

The CDC says most people notice bite marks one to several days after the bite, and in some people marks take up to 14 days to appear. That delay makes bites a poor clock. The mark you see this morning may come from a night last week, so it cannot tell you which bed, hotel or trip it came from. Room evidence has no such lag.

What signs of bed bugs should you look for in the room?

Evidence in the room is more reliable than marks on skin. Use a flashlight and check in this order, starting where you sleep.

1. Mattress seams, piping, tags and the corners of the box spring.
2. The headboard and bed frame joints, especially crevices.
3. Sheets and pillowcases, for tiny rust-colored or reddish spots.
4. Dark ink-like specks that smear on fabric, wood and paper.
5. Shed skins, which look like pale, hollow, bug-shaped shells.
6. Live bugs, which are flat, brown and about the size of an apple seed as adults.

A sweet, musty odor can show up in rooms with larger populations. Our bed bug inspection page explains how we go through a home when signs turn up.

How far from the bed should you look?

The CDC says bed bugs tend to live within about 8 feet of where people sleep, though they can travel more than 100 feet in a night. Start at the bed, then widen the search to these spots in order:

• Nightstands and dressers within arm's reach of the bed, including drawer joints.
• Baseboards and carpet edges along the wall behind the headboard.
• Upholstered chairs and couches where you sit or nap, especially seams and under cushions.
• Behind loose wallpaper, picture frames and outlet covers near the bed.
• Curtain folds and luggage kept near the sleeping area.

Do bed bugs spread disease, and do bites need treatment?

The CDC says bed bugs are not known to spread diseases to people. They cause itching and lost sleep, and scratching can lead to infection. The CDC adds that bites usually need no medical treatment, and it suggests keeping the area clean, avoiding scratching and asking a health care provider about an antihistamine for itching.

That is general public health guidance, not advice for your skin. See a doctor if you think you are having an allergic reaction. The CDC lists enlarged bite marks and painful swelling at the bite site as possible signs, and anaphylaxis, though rare, is an emergency.

The takeaway for the home is separate from the skin. A bite that is not dangerous can still point to an infestation that grows, so look at the room the same week you notice marks.

What should you do if you think you have been bitten?

For the skin, see a doctor or other health care provider, especially for severe itching, swelling, signs of infection or any reaction that worries you. If you have trouble breathing or swelling of the face or throat, call 911. We cannot advise on skin symptoms, and we do not want you to rely on a pest company for them.

For the home, do not spray or move bedding between rooms. Save a bug or photograph what you find, then call us. If you are in a rental, tell the landlord in writing as soon as you have evidence, as our guide to bed bugs in Columbus rentals explains.