What should you know about scratching bed bug bites?

Bed bug bites may form itchy red or swollen spots, sometimes grouped or arranged in a line. Scratching can create tiny breaks, scabs, bleeding, and soreness. It may also spread germs from fingernails into the open skin. The bite itself is not proof that every itchy mark has the same cause; new marks can also reflect continued exposure or another skin problem.

Wash bedding and clothing according to their care instructions, and arrange appropriate pest control if bed bugs may still be present. Treating the skin alone will not stop new bites from occurring.

Clean the area gently with soap and water, pat it dry, and keep fingernails short. A cool, damp cloth can calm the urge to scratch. Avoid squeezing blisters or removing scabs. A pharmacist or clinician can advise whether an oral antihistamine, such as [Antihistamine Treatment](/treatments/medical-dermatology/oral-antihistamine-therapy/), is suitable. For marked local inflammation, ask about [Topical Corticosteroids](/treatments/medical-dermatology/topical-corticosteroids/) and how to use them safely.

Arrange medical advice if redness, warmth, swelling, pain, pus, or tenderness is spreading, or if fever develops after scratching. Seek urgent help for trouble breathing, faintness, or swelling of the lips, tongue, or throat. Get prompt advice if a child, pregnant person, or person with a weakened immune system has extensive broken skin.

Could the marks be infected or caused by something other than bed bugs? Which itch treatment fits my age, medicines, and skin location? What should I do if bites continue appearing after cleaning and pest-control measures?