Bed Bug Bites. How to Tell Them From Flea and Mosquito Bites

CDC says bites often look like mosquito or flea bites, a slightly swollen, red, itchy area. They may appear at random or in a straight line.¹ Some people have no visible signs at all.¹

EPA says reactions range from none to a small bite mark.² Because the look is so common, you cannot name the biter from the skin. Confirm the pest first.³

Fleas leave a small red spot with a red halo and little swelling.⁵ Compare both bugs above, then read the bed bug guide to find them.

Adult bed bugs feed about every 5 to 7 days.⁴ A feeding takes 3 to 10 minutes.⁴ Each of the five nymph stages needs a blood meal before it molts.⁴

Eggs hatch in about 10 to 15 days.⁴ Egg to adult takes five weeks to four months.⁴ That is why new bites keep showing up after you wash the sheets. The bugs behind them are still there.

Go back to the bed bug hub for the full life cycle.

Nymphs start near 1.5 mm and reach about 4.5 mm, and unfed ones can be nearly invisible.⁷ So the bugs biting you may be too small to spot.

Do not diagnose from the bites. Look for the bugs. CDC lists these signs.¹

• Shed skins.
• Bed bugs in the folds of mattresses and sheets.
• Rusty colored blood spots on mattresses or nearby furniture.
• A sweet, musty smell.

Fleas are a close lookalike. Walk around where pets rest in white socks pulled up to the knee. Fleas jump on and are easy to see.⁵

Start at the bed. UC IPM says about 85% of bed bugs are in or near it.⁴

CDC says bed bugs are not known to spread diseases to people.¹ EPA agrees that they have not been shown to transmit disease.²

The risks are other things. Bites cause itching and lost sleep, and rarely an allergic reaction with enlarged bite marks and painful swelling.¹ In rare cases the reaction is anaphylaxis.²

Scratching can lead to skin infections such as impetigo, ecthyma and lymphangitis.² Living with bed bugs can also bring anxiety and insomnia.²

Most bites do not require medical treatment.¹

Most bites need no medical treatment. CDC says antiseptic creams or lotions can ease the itch and an antihistamine may help. Avoid scratching to prevent infection.¹

Call your healthcare provider if you think you are having an allergic reaction.¹ Get help right away for trouble breathing or fast swelling, since EPA says a rare reaction can be anaphylaxis.²

Treating the skin does not remove the bugs. EPA says to try nonchemical methods first, use tested encasements and hire a professional if needed.³

The bites cost little. Removing the bugs costs more. A cost guide puts chemical treatment at $150 to $400 per room.⁶ A whole home runs $1,500 to $5,000.⁶

Follow up visits to check that they are gone run $100 to $150 each.⁶ Ask for the follow ups in writing before work starts.

See the bed bug guide for the full cost table.

Mild cases run $225 to $800 and severe ones $3,500 to $5,000 or more.⁶ Heat treatment alone ranges from $400 to $5,500.⁶

• Find and remove the bugs, since lotions only calm the skin.³
• Declutter and use tested encasements on the mattress and box spring. Leave them on for a year.³
• Launder bedding and clothes that touch the floor and heat dry them.³
• Inspect sleeping areas when you travel. Bed bugs can be in any hotel, so cleanliness does not decide it.¹
• Vacuum the bed frame, bed legs and cracks, then seal and bin the bag.³

Check for signs on a regular schedule. Early detection makes control easier.¹

There is no safe month. Bed bugs live indoors and feed all year.⁴ They develop fastest between 70 and 82°F, a normal room temperature.⁴

So winter bites are as likely as summer bites. If new marks keep showing up, think bed bugs, fleas or another indoor biter, and look for the bug itself.^1,5

Marks can take up to 14 days to appear in some people.¹ A mark you see today may come from a feeding two weeks ago. Fleas, the other usual suspect, finish their life cycle in about 18 days at room temperature.⁵

If bed bugs are confirmed in an Ohio home, a company that applies pesticides for hire needs a commercial applicator license.⁸ Pesticide businesses also need a business license.⁸ Applicators pass a core exam and a category exam with a 70 percent passing score.⁸

Ask to see the license before treatment. See the Ohio section of the hub for more.

Apartment complexes with more than four units fall under the same licensing rule.⁸ Renters should report bugs and bites to the landlord in writing.

UC IPM says heat treatment providers in California must be licensed and bonded by the Structural Pest Control Board.⁴ Structural pest control covers inspections, contracts and pesticide use for household pests.⁹

Verify the company on the Board's license lookup before you sign.⁹ Then read the California section of the hub for treatment options and follow ups.

UC IPM says to run a home dryer on the hottest setting for at least 10 to 15 minutes.⁴ Interceptor monitors under bed legs trapped six times more bugs than searching by eye.⁴