SkinCarePhysicians Spotlight Article
Sleep Tight, Don’t Let the Bedbugs Bite

This saying can be good advice if you are planning a trip. Bedbugs are finding their way into hotels, condominiums, and cruise ships worldwide. In the United States, travelers from coast to coast are waking up with itchy welts on their skin.

Why bedbugs are once again a problem is not entirely clear. Some say increasing world travel is the culprit. Scientists say this alone does not fully explain the resurgence. They believe that people’s concerns about toxicity — which can cause reluctance to use insecticides or lead people to switch to less potent insecticides — and the ability of insects to develop resistance to insecticides also play a role.

The good news is that you do not need to cancel your travel plans. There are steps you can take to find out if bedbugs have checked in ahead of you. If you are bitten, you can take comfort in the fact that bedbugs, unlike mosquitoes, are not known to pass any disease to humans. Here is what you should know:

When you check in
To prevent these pests from biting you or hitching a ride in your suitcase, the first thing you should do after checking in is to look for bedbugs. These tiny, wingless insects hide during the day, coming out when it is dark to feed on blood. To find out if they checked in ahead of you:

  • Place your luggage on the luggage rack not the floor. Bedbugs can hide in the carpet and crawl into your suitcase.

  • Take a deep breath. Does the room have a sweet, musty odor? Bedbugs communicate by producing chemicals called pheromones. These chemicals emit odors that help them locate each other and warn of danger. With a heavy infestation, there are enough pheromones to produce a sweet, musty odor.

  • Lift up all blankets and sheets. Look at the mattress. The bugs themselves are wingless, oval-shaped insects that are about one-quarter inch in size. If they have not had a meal for a while, they are flat and brownish in color. After feeding on blood, they become red and swollen.

    You may not see bugs, but rather telltale signs that they are around. Look at the mattress and box spring. Are there pinprick-size drops of blood or tiny blackish spots? The latter is their droppings. As bedbugs grow, they shed their skin. Do you see these remains?

    Be sure to check underneath the mattress buttons. Inspect the crevices of every mattress, box spring, and sofa. Don’t forget to look underneath each box spring.

Even in the finest hotels and the cleanest rooms, you should inspect before settling in. Reports of bedbugs in exclusive hotels and well-scrubbed homes have been making headlines.

Should you find evidence of bedbugs, don’t be shy. Ask for another room or reservations at another hotel.

If you are bitten, it helps to know what the bites look like, how to treat the bites, and what to do to help prevent these pests from infesting your own home.

How to recognize a bite
Not everyone responds the same way to bedbug bites. Some people have no reaction. Others develop unbearably itchy welts. The reaction really depends on how your body responds to the insect’s saliva. Most people wake up with intensely itchy welts that resemble hives or scabies. Unlike hives or scabies, bites from bedbugs tend to appear in a row, often in threes. Since bites of three are common, the marks are frequently referred to as “breakfast, lunch, and dinner.” Bites also may appear alone.

Sometimes the intense itching does not begin for several hours after waking. In rare cases, the reaction is severe, and a person develops large blisters, a fever, and general malaise. If this happens, seek immediate medical care.

If you discover one or more bites, wash the bites thoroughly with soap and water. Applying ice will help relieve some of the swelling, and an antihistamine or no-itch cream can help alleviate the itch. For most people, the bites persist for several days. Icing and antihistamine help relieve the discomfort. If the itch becomes unbearable or you see signs of infection, be sure to seek immediate medical treatment. Signs of infection include tenderness around the bite and oozing of white, yellow, or green discharge from the wound.

A souvenir you do not want to bring home
Bedbugs travel well. They can hide in packed clothing or the cuff of a garment you are wearing. They can survive for months without eating. If you suspect that you have been bitten by bedbugs, taking some precautions can help prevent them from infesting your home.

Before taking your luggage home or to another hotel, buy some large trash bags. Place all of your suitcases, sleeping bags, and everything else inside the bags. Secure the bags tightly, and find a washing machine. Before using any items, machine-wash everything in hot (at least 120° F) water and dry everything in a hot dryer. If luggage cannot be washed, it should be thoroughly vacuumed before it is stored. Use a crevice tool to clean all seams and crannies. And, then empty the vacuum cleaner. Do not discard the contents from the vacuum cleaner inside. Take it outside immediately.

If you do spot a bedbug in your home, pest care professionals recommend giving them a call. Bedbugs can be extremely difficult to eradicate once they settle in.

Liebold K et al. “Disseminated bullous eruption with systemic reaction caused by Cimex lectularius.” Journal of the European Academy of Dermatology and Venereology. 2003 Jul;17(4):461-463.

Leverkus M et al. “Bullous Allergic Hypersensitivity to Bedbug Bites Mediated by IgE against Salivary Nitrophorin.” Journal of Investigative Dermatology. 2006. Nov;126(11):2364-2366.

National Pest Management Association, “Bedbugs Fact Sheet.” Last accessed November 16, 2006. Located at

All content solely developed by the American Academy of Dermatology


You should seek immediate medical care if you are bitten and:

  • A severe reaction occurs. Large blisters, fever, and general malaise indicate a severe reaction.

  • Signs of infection appear. Tenderness around the bite or oozing of white, yellow, or green discharge indicates an infection.

© American Academy of Dermatology, 2010  All rights reserved.
Page last updated 12/5/06

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