Guide to Bed Bugs

Bed bugs: the two words alone are enough to strike fear into the heart of house and apartment dwellers alike and for good reason. The common bed bug, otherwise known as Cimex lectularius, is a very common pest in the United States: according to a 2018 survey, 1 in 5 Americans has had or suspected they had a bedbug infestation in their home, and over half of all Americans take some form of precaution against bed bugs. However, the history of bed bugs in the United States is a little more complicated..

Bed bugs have, in fact, existed alongside humans for a very long time. Originally, they were cave-dwelling bugs that fed off of the blood of bats. When early humans moved into those caves, the bed bugs started feeding on their blood instead. Once humans moved out of caves and started settled agricultural societies, bed bugs moved with them. The warmth from human shelters and fires created a more comfortable environment for the bugs, so they multiplied and spread throughout Asia and Europe.

Bed bugs were brought to North America by European colonists and were recorded as a regular problem there throughout the 18th and 19th centuries. As American cities grew and people started to live in more densely populated urban areas, bed bugs flourished. By the early 20th century, they were still one of the most prevalent pests in American households.

This all changed around WWII when a combination of improved detection and prevention techniques and the use of potent insecticides like DDT all but decimated bed bugs in the United States. For around 50 years, bed bugs were extremely rare, and most Americans--even pest professionals--had never even seen one.

However, in the past fifteen years or so, bed bugs have made a huge resurgence. It’s still unclear exactly why this happened, but it’s theorized that increased international travel and less effective insecticides may have played a role. In any case, bed bugs are once again a widespread problem, infecting all manner of places where people sleep, including homes, hotels, hospitals, nursing homes, dorms, and shelters, and also places like movie theatres, office buildings, schools, daycares, and public transportation.

What are Bed Bugs?

The common bed bug is a small insect. They are obligate haemovores, meaning that they feed exclusively on the blood of other animals. Though they primarily feed on human blood, they have also been known to bite other warm-blooded animals, such as bats, cows, dogs, cats, birds, and rodents.

Adult bed bugs are approximately one-fourth of an inch long--around the size of an apple seed. They have flat, oval-shaped, reddish-brown bodies that balloon out when recently fed. They also have what are called “true bug” characteristics, including a beak with three segments, antennae with four parts, vestigial wings not used for flying, and short, golden-colored hairs used for sensory purposes. This sometimes leads them to be mistaken for other common household insects, like carpet beetles or small cockroaches.They do not fly or jump, but they can crawl rapidly over floors, walls, ceilings, doors, windows, and other surfaces. Some adult bed bugs also emit a smell--described as an unpleasant, “musty-sweetish” odor--from glands on the lower side of their bodies.

Bed bugs have six developmental life stages. When they hatch, they are tiny, straw-colored and almost impossible to see with the naked eye. They then go through five cycles as a “nymph”, or a sub-adult. Bed bugs have their skeletons on the outside of their body (called “exoskeletons”), and they need to shed that exoskeleton in order to grow. This is called molting. In order to molt and advance to the next life cycle, the bed bug must have a blood meal.

 

Bed Bug Size

After the nymphs eat (courtesy of whatever host is around), they shed their exoskeleton and move on to the next life stage. During this process, nymph bed bugs generally look like adult bed bugs, only smaller and lighter in color. After five of these moltings, the bed bug assumes its adult form. With regular access to blood and favorable temperatures (of around 65 to 85 degrees Fahrenheit), the development process from egg to adult generally takes around 6 to 7 weeks. With less access to blood and either cooler or hotter temperatures, the development process may take longer.

Once bed bugs reach adulthood, both males and females need to have regular blood meals in order to reproduce. Females lay their eggs in secluded places, usually laying 1 to 3 eggs per day—though ultimately, they can lay up to 500 eggs in their lifetime. Bed bug eggs are tiny, around the size of a speck of dust, and are coated in a sticky substance that helps them adhere to surfaces and stick between cracks.

In terms of behavior, bed bugs are nocturnal, meaning they are mostly active at night. During the day, they like to hide out in cracks and crevices close to where people sleep. They are attracted to areas where humans sleep by carbon monoxide, body warmth, and various other chemicals, and tend to squeeze their flat bodies into areas where they can easily access a sleeping host. Though they don’t have nests, dens, or hives as such, they do often congregate together in hiding and feeding spots brought together by airborne pheromones. They tend to only come out to feed every five to seven days, so most of their lives are spent in their hiding spots.

One of the most important things to know about bed bugs is that they are extremely resilient, which is what makes it so difficult to stop an infestation. Though it is ideal for them to have regular access to blood, and though they need blood meals to grow and reproduce, both nymphs and adult bed bugs can survive without feeding for months. At cooler temperatures (of around 55 degrees Fahrenheit or less), they can go into a sort of hibernation mode and can last for up to a year without eating in that state. Bed bugs are also extremely resourceful: if they are starved, they often go to adjacent residences in search of a meal and then return to their preferred hiding spot.

Causes and Identification

What causes bed bugs?

It is a common bed bug myth that infestations in dwellings are caused by a lack of hygiene. This is rarely the case. Rather, bed bugs are usually brought into new places by attaching themselves or their eggs to items brought into that place. This can happen in many ways. A person may inadvertently pick up bed bugs or their eggs by visiting an infested area, or by bringing infested items (especially furniture) into their home. A bed bug infestation can also be caused by proximity to an infested dwelling: if, for instance, an apartment in your building has a bed bug infestation, the bed bugs may find their way into your apartment through ducts, false ceilings, wall cracks, and other passages. Other factors, such as pesticide resistance developed by the bed bugs themselves, may increase the likelihood of an infestation.

Where are bed bugs found?

Bed bug infestations are around three times more frequent in urban areas than in rural areas. This is because there is a greater density of people in urban areas, as well as a greater rate of apartment/home rental and a much higher usage of shared public areas and public transportation. However, they can be found throughout almost every region in the world, and in all fifty states. Studies like the National Pest Management Association’s Bugs Without Borders survey have found that, in addition to dwellings like apartments and houses, there are a number of places where bed bug infestations are increasingly common. They include:

  • Hotels, Motels, and Hostels
  • Nursing Homes and Senior Centers
  • Schools and Universities
  • Day Care Centers and Nurseries
  • Civic Buildings, such as the Post Office or the DMV
  • Public Libraries
  • Used Book and Clothing Stores
  • Hospitals and Residential Medical Facilities
  • Office Buildings
  • Public Transportation (like city busses or subways) and Mass Transportation (like interstate buses, rail, and airplanes).

Exposure to bed bugs in these places can cause an immediate impact (ie, bites), and also may lead you to inadvertently bring hitchhiking bed bugs and/or their eggs back into your home.

How do I know I have bed bugs?

If you suspect you might have bed bugs, there are several steps to take in order to find out.

First of all, it’s important to know where to look. Bed bugs like to be as close as possible to the place where their human hosts sleep, while still staying hidden. This means that most often, they are found in the cracks and crevices around a bedroom. This includes mattress seams, headboards, box springs, bedside tables, bookcases, and dressers, as well as any cracks, loose paneling/wallpaper, and/or junctions in the walls. However, they are not always limited to the bedroom. Bedbugs can be found in virtually any room of a home, especially the living room, or in/around sofas, recliners, and loveseats. They tend to hide under furniture and appliances, and even in light switch plates and electrical outlets.

So, now that you know where to look, what are you looking for?

Usually, you will not directly see live bed bugs during the day, as they are nocturnal. Instead, you will want to look out for the marks and detritus they leave behind. These include:

Fecal Spots: As gross as it sounds, everybody poops, and that includes bed bugs. They will sometimes leave behind spots of digested blood, which are usually dark brown, or black. Often, these spots will be grouped in areas where bed bugs tend to hide out.

 

Blood Smears: Sometimes, during the course of a feeding, a bed bug will either expel blood, or will be crushed by an unknowing hand or foot or by furniture being shifted around. This will cause their engorged bodies to, for lack of a better word, explode. This produces a blood smear, which is more red in color than a fecal spot.

Molted Exoskeletons: Each time a bed bug molts during its life cycle, it leaves its previous exoskeleton behind. This is the main indicator of bed bugs. Generally, these molted exoskeletons (also called “exuviae”) look like clear versions of the bed bugs themselves. They may be quite small or almost adult-sized, as different stages of nymph leave differently sized exuviae behind.

Eggs: As stated above, bed bug eggs are very small and very difficult to see. However, spotting them is not entirely impossible, and, if they are spotted, it’s a clear sign that bed bugs are present. They are about one millimeter long and pearly white, and are generally laid in clusters of 2-3.

Dead Bed Bugs: Just as everybody poops, everybody dies--bed bugs included. You may find a dead bed bug during your search. If you find a single bed bug body, this means one of two things: either it was a lone traveller, or there are other bed bugs around. By in large, it means the latter. If you find a dead bed bug, you should continue searching for additional signs.

 

There is also a small chance you may discover a cluster of live bed bugs themselves. This is usually only the case when an infestation is quite advanced, but you may also catch the bed bugs unaware, either inadvertently or during a deliberate search. Usually, though, your best bet of detecting bed bugs is to look for the signs they leave behind.

It is important to note that you can “age” an outbreak judging by some of the clues you find. This means figuring out approximately how long the bed bugs have been in the area, and therefore how bad the outbreak may be. The bed bug’s own life cycle can be used as a rough measure of time in aging an outbreak, in several ways. Some methods include:

  • Exoskeletons: Shed exoskeletons, especially when found an advanced-stage nymph, can be used to mark time. With an adequate blood supply and normal room temperature, there is around a week between each nymph stage. Therefore, if you find an advanced nymph in a hiding place with three shed exoskeletons, it’s probable that it has been there for around three weeks.
  • Eggs: Eggs can also be used to establish a timeline. At room temperature, they take about 10 days to hatch after being laid. This means that the bed bugs have been in the area for at least that long.
  • Presence of Adults: One of the best indicators of how long bed bugs have been in your house is the number of adult bed bugs present. It takes around seven weeks for bed bugs to grow from eggs to adults. If there are many adult bed bugs present, it is likely that they were laid in the house as eggs, and that, therefore, the infestation has been going on for at least that long.

 

Fecal spots and stains are harder to use for this purpose, because they are more of an indicator of how much the bugs have been feeding recently than how long they have been there. However, a very noticeable, high volume of these spots and stains can generally indicate a large bed bug population.

Though these methods aren’t entirely foolproof, they can be a helpful source of general information for you and for your pest control professional when evaluating the scope of your problem.

What Do Bed Bug Bites Look Like?

For many people, the first indication that they might have bed bugs is the appearance of bed bug bites. These generally occur on skin that is exposed while sleeping, especially the face, neck, and arms, but can appear on many other parts of the body as well.

Bed Bug Bites

Bed bugs feed by piercing the skin with an elongated beak and withdrawing blood. Their mouths produce a natural analgesic, so the bite itself is painless when it occurs. After the bed bug is done feeding and crawls away, some people have no reaction. However, in others, the bites create raised red spots on the skin.

For most people who react to bed bug bites, the reaction consists of one to several days of uncomfortable itching. However, for others, bed bug bites can be much more severe. Though they do not transmit disease, they can cause more severe allergic reactions, which can lead, in rare casis, to anaphylaxis. They can also lead to secondary skin infections, such as impetigo (a bacterial infection on the outside layers of the skin), ecthyma (a bacterial infection deep within the skin layers), and lymphangitis (an infection of the lymph channels).

In addition, the experience of receiving bed bug bites and of simply knowing about the presence of bed bugs in your home can cause significant mental health distress and sleep loss. One study showed that in some people, bed bug biting events can result in nightmares, flashbacks, hypervigilance, anxiety, avoidance behaviors, personal dysfunction, and insomnia.

When it comes to the treatment of bed bug bites, there is a range of medical options, depending on the severity of the reaction. For most people, good hygiene and over the counter anti-itch treatments like colloidal oatmeal and aloe are enough. In more severe cases, treatments like antibiotics, antihistamines, corticosteroids, and even epinephrine have been used. In the most severe cases, topical steroid creams and systemic antibiotics are generally prescribed.

Preventing Bed Bugs

The task of preventing bed bugs may seem daunting, and for good reason: because bed bug infestations can be caused by many factors, and because bed bugs are so resilient, they are difficult to prevent entirely. However, there are specific steps that you can take to reduce the chance of a bed bug infestation in your life, no matter where you live or where you travel.

Home Prevention

  • Reduce Clutter: Clutter is a huge boon for bed bugs because it gives them more places to hide and reproduce undetected. Starting out with a less cluttered home will give you an advantage over the bed bugs by reducing their hiding places.
  • Vacuum Frequently: Make a regular habit of vacuuming all carpets and rugs, preferably once a week at least. This prevents any bed bugs or eggs that may have just arrived from taking root in the house. Make sure to promptly empty, seal, and dispose of all vacuum bag contents after each session.
  • Protective Covers for Mattresses and Box Springs: Invest in a plastic protective cover for your mattress and box spring. There are specific plastic coverings that are specially designed for this purpose, and to be basically undetectable while you sleep while offering you protection from crevasse-seeking bed bugs. These covers serve the dual purpose of preventing bed bugs from actually getting inside the mattress/box spring, and making them easier to detect if they do show up around the bed.
  • Be Careful with Secondhand Items: Though you don’t have to swear off second-hand books, clothes, and furniture altogether, you can protect yourself by carefully checking those items for signs of bed bugs before bringing them into your home. If at all possible, avoid bringing items in from the curb, as you have no real way of knowing whether or not the items carry bed bugs. This is especially true for furniture like mattresses and sofas, which may have bed bugs in the seams or deep inside the item itself.

Dorm and Apartment Prevention

All of the bed bug tips for single standing homes apply when it comes to people who live in multi-unit buildings, such as apartment and dorm dwellers. However, there are also tips that are specific to multi-level units, and the unique bed bug threats posed by that kind of living arrangement.

  • Isolate Your Unit: If bed bugs see an easy channel to spread from one unit to another, they frequently take it. You can prevent this by preemptively closing those channels. Install door sweeps or door jams to cover potential open spaces on the sides, top, and bottom of the doors. If you see cracks or other potential open spaces in the walls, floors, or ceilings, no matter how small, either request a repair or repair them yourself.
  • Be Careful in Shared Laundry Facilities: Most apartment or dorm dwellers either use a shared laundry facility in the building or do their laundry at a laundromat. Because of the many people passing through with their belongings, this can put you at an increased risk of inadvertently picking up a bed bug traveler. Make sure to stay vigilant and take precautions. Transport items to be washed in plastic bags (preferably sealable), and remove them from the dryer directly to fold at home.
  • Know Your Rights: Many states, counties, and cities have laws regarding bed bugs. If you are renting an apartment, your landlord is often responsible for bed bug prevention, and, in the event of an infestation, bed bug extermination. Read up on the rights available in your area. Always ask before moving in if there is a history of bed bugs in the apartment or even the building. Ask what preventative measures your landlord is taking to decrease the risk of an infestation.

Travel Prevention

Between public and mass transportation, staying in hotels, and visiting potentially bed bug-heavy locations, travel can pose a pretty significant risk of bed bug exposure. Therefore, one of the best ways to protect your home from bed bugs is to be careful while you’re travelling--especially if you travel frequently. Here are some tips to protect yourself as much as possible from bringing home unwanted souvenirs.

  • Investigate Hotels: Before booking a hotel, research customer reviews and comments. If someone noticed bed bugs at a hotel, it’s very likely that they will be vocal about it on the internet. You can also check the Bed Bug Registry, a public database of user-submitted bed bug reports from across the U.S. and Canada. In addition, you can simply call the hotel itself and ask candidly about any history of bed bugs, and/or what they are doing to actively prevent bed bugs. Many hotels do have active bed bug prevention plans in place and will tell you about them if asked.
  • Keep Your Luggage in a Safe Space: When entering a hotel room, you always want to keep your luggage off the carpeted floor, as this is where bed bugs frequently attach to peoples’ belongings. Many hotel rooms have a luggage rack where you can put your bags, or you can place them in the bathroom, as both are unlikely spots for bed bugs to be hiding. If possible, keep your suitcases zipped closed on the luggage rack or on a hard surface for the length of your stay.
  • Inspect Everything: As soon as you have your luggage secured, make sure to do a thorough search of the hotel room for signs of bed bugs. Pull back the sheets, examine the headboard, and look through the seams and pillows of any couches or sofas. It’s especially important to look through the mattress seams (particularly the corners), and, if possible, lift up the mattress to check underneath.
  • Be Careful With Your Clothes: Try hard not to spread your clothes or belongings all over the room, or even put them in the drawers. If you have clothing items that need to be hung up, use the closet. Otherwise, it’s best to keep your clothes zipped in your suitcase. Additionally, you should bring or purchase a large plastic bag to store your dirty clothes in: bed bugs are attracted to the chemical traces we leave behind on clothing and are therefore drawn to dirty clothes.
  • Post-Travel Precautions: When you get home, inspect your suitcase thoroughly before you bring it into the house. If possible, use a portable vacuum or hand-held garment steamer to clean it off. Then, wash all the clothes you took with you--even the ones you didn’t wear, in hot water, and dry on high (if possible). Temperatures above 122 degrees will kill any potential bed bugs.If you have clothing you need to get dry cleaned, place it in a sealed bag and take it in as soon as possible.

Bed Bug Treatment

Sometimes, even with the best prevention efforts, bed bug outbreaks happen. However, they vary widely in terms of severity: some are quite small and local to one room or piece of furniture, while others can be much more widespread and ingrained throughout the dwelling. Just as there are many different types of outbreaks, there are also many different types of treatment.

Bed Bug Removal

The bed bug treatment that’s right for you depends entirely on what sort of outbreak you’re dealing with. While some outbreaks can be handled on your own with basic, if aggravating, cleaning, others require more heavy-duty interventions, some of which may involve hiring a pest control professional.  Though some of the more extensive bed bug treatments may be costly, they may also be necessary: if left untreated, bed bug infestations can become totally out of control, and can throw your entire life off base.

Here is a rundown on the most commonly utilized treatments for bed bug infestations: Please note that severe bed bug infestations usually warrant the help of a professional. DIY methods can be costly, ineffective and even dangerous if not done properly. Be sure to do your research before attempting to do this on your own! You don't want to go through all this expense and effort only to realize you're back at square one a few days later.  

Finding a Professional

Figuring out you have bed bugs can be totally overwhelming, even if you’ve done your homework, and you may have decided that it’s time to look for professional help. But, as a cursory Google search will show you, there are tons of bed bug professionals out there, and even more people who may be claiming to be bed bug professionals under shaky pretenses. So, if you’re scrolling through potential bed bug treatment professionals, how do you know which one to pick? Here are some things to look for:

  • They’re licensed and insured. Most states require pest control agencies and operators to be legally licensed. Make sure your potential agency, as well as all of their operators, have current, up-to-date licensure. It is preferable if the agency/operators are also bonded, meaning they are obligated to reimburse you if they cause any loss or damage. It is highly preferable that the company has general liability insurance, including insurance for accidental pollution. Most states do not explicitly require pest control companies to buy liability insurance, but it is definitely advisable to go with a company that is insured.
  • They have experience with bed bugs. Bed bugs are particularly difficult to exterminate, and require specific skill sets, knowledge, and experience. Make sure that the professional you choose has experience working with bed bugs specifically. If you go with an agency, make sure the individual who will be working with you has bed bug experience. Ask how long they have been working with bed bugs, how many bed bug jobs they completed in the last year, and if all of them were successful.
  • They have experience with your type of housing. Different types of housing also require different skill sets, especially when it comes to bed bugs. Make sure the professional you choose has experience with your sort of housing. This is especially true if you live in a multi-unit building, which poses unique challenges to bed bug extermination.
  • They don’t offer a price until they personally inspect--and when they do, they put it in writing. Professional exterminators will tell you that the amount of work and effort that goes into an extermination job depends on the specifics of the residence they’re working on and the details and severity of the infestation. Though they may offer a minimum quote over the phone or in the office, most trustworthy pest control professionals will not commit to a quoted price before actually seeing the residence themselves. Once a price is established, be sure to clarify if it is a final quote or an estimate. In either case, make sure that the pest professional documents and signs all money-based agreements.
  • They communicate clearly and answer questions. Look for clear, honest communication in a pest control professional. They should be experienced in explaining to their customers what they need them to do before they arrive, as well as what will happen when they get there. They should offer this information proactively. Any information that is not offered proactively and is asked as a question should be answered thoroughly, graciously, and openly. Ask specific questions about the experience: how long the service will take? Who specifically will be working on-site, and will they be supervised? The provider should be happy and able to answer anything you have to ask, within reason.
  • They can explain their methods. Be sure to ask exactly what extermination methods they intend to use on your home, and are able to answer any questions about how the methods work, why they have chosen to use it in your case, and if there are any risks. They offer a warranty/guarantee their work. Your pest control professional, whether as an individual contractor or as part of an agency, should offer some form of guarantee or warranty. Unfortunately, because of the nature of bed bug treatment, one visit rarely eliminates all the bugs. Most reliable bed bug experts offer at least one or two follow up visits as a part of their services, included in the initial charge. Be very specific when asking about the details of the warranty. Your provider should be able to tell you how long it lasts for, and how many additional visits it covers.
  • They have positive reviews. In the age of Yelp, we all know one bad review can just be a fluke. However, online reviews are, by in large, a reliable way to tell if a pest control professional is reliable, skilled, and easy to work with. Check sites like Yelp and Angie’s List and get a sense of how people are feeling about the professional in question. Don’t be afraid to follow up if you see a review that’s particularly good or bad.

Additional Reading

Bed bugs, small as they are, still loom large in the imagination, and definitely impact the lives they enter in real and serious ways. However, the best tool we have in our arsenal against them is knowledge. Here are additional readings and resources on bed bugs and what you can do about them:

  1. Bed Bugs: Symptoms and Causes: The Mayo Clinic’s explainer on bed bugs, bed bug bites, and bed bug treatment.
  2. Bed Bug Hub: An extensive information and resource base from Pestworld.org, including informative articles and professional pest control advice.
  3. EPA Bed Bug Resource: An authoritative run down on bed bugs and their impact from the Environmental Protection Agency.
  4. Bed Bug Madness: The Psychological Toll of the Bloodsuckers: A broader but fascinating article by Rose Eveleth at The Atlantic about the psychological impact of bed bugs.
  5. Bed Bug Resources: A comprehensive list of bed bug related resources, including state and local bed bug agencies and regulatory departments.
  6. Bedbugger: This crowd-sourced website offers articles, online support groups, videos and other tools about all things bed bug related.
  7. Bedbug Registry Info List: A list of resources from bedbugregistry.com, including tips for prevention at home and abroad.
  8. Get Rid of Bed Bugs 101: Pests.org’s ultimate complication of bed bug prevention and treatment tips.
  9. Bed Bugs Fact Sheet: Up-to-date information from the Centers for Disease Control about bed bug prevalence and treatment rates in the United States.

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