What should you know about severe bed bug bites?

Bed bug bites often appear as itchy red spots or raised welts on skin exposed during sleep. Several marks may occur close together or in a line, but appearance alone cannot confirm the insect responsible. Some people develop large local swelling, blistering, or itch that continues after the insects have been removed.

Scratching can break the skin and allow bacteria to enter. New marks after sleeping, blood spots on bedding, or insects in mattress seams can support an environmental clue, but a clinician should consider eczema, hives, fleas, scabies, and other causes.

Wash the skin gently, use a cool compress, and keep fingernails short. A clinician or pharmacist may suggest an oral antihistamine for itch or a topical corticosteroid for inflammation, depending on age, pregnancy, medical history, and the treated area. Do not apply products near the eyes or on broken skin unless advised.

The home needs attention as well as the skin. Arrange professional pest control, wash and heat-dry suitable bedding and clothing, and follow local advice for mattresses and furniture. Treating bites alone will not prevent fresh exposure.

Seek urgent help for breathing difficulty, facial or tongue swelling, faintness, rapidly worsening widespread hives, or feeling very unwell. Arrange prompt review for spreading redness, warmth, pus, fever, severe pain, extensive blistering, or swelling that limits movement. Infants, older adults, and people with weakened immunity may need earlier assessment.

Ask whether the marks fit bites or another rash, which anti-itch option is suitable for you, how to care for scratched skin, and whether signs of infection need treatment. Mention all medicines and show photographs of the rash if it changes quickly.