Bed Bugs

Hilliard Pediatrics, Inc. - Dr. Tim Teller, MD


Bed bugs (Cimex lectularius) are making a comeback in the last few years. They are small, flat insects that feed on the blood of sleeping people and animals. Although we know there is a major “ick” factor with bed bugs, they are not known to spread disease. The following is information to help inform you about what to do if your child has bed bug bites.

More about Bed Bugs

Bed bugs are 3/16 to 1/5 of an inch long, are reddish-brown in color, and can live for 4-18 months. They have no wings. An adult can crawl as far as 100 feet in one night, but they tend to live within 8-10 feet of where people sleep. Because of their shape, they can hide in cracks and crevices. They hide during the day in seams of mattresses, box springs, bed frames, dressers, and under or along the walls. Bed bugs travel from one place to another on luggage, bags, clothes, and bedding.

When bed bugs bite, they inject an anesthetic (so you do not feel the bite) and an anticoagulant (so you bleed more readily). They can live for as long as 4-12 months without feeding. Female bed bugs lay multiple eggs each day. It takes a few weeks for the eggs to mature into an adult (faster when it is warmer and the eggs have ready access to food).

Bed Bug Bites

Most people do not know they have been bitten until the marks appear. The bites are a raised, red, swollen area. Unlike flea bites, they are less likely to have a while center. The bites tend to be on the exposed areas while you sleep: neck, arms, and legs. But the bugs can easily bite you in other areas – including under clothes. Just as with mosquito bites, people react differently to bed bug bites. You or your child may have been bitten and you do not realize it since you may have no reaction – and no bite marks. But many people are quite itchy for days after bites. The bites often are in rows of three or more. Bites generally appear quickly but can take up to 14 days to appear.

If you are repeatedly bitten over night, you could have itchy bites that go on for weeks (or longer). Sometimes the bites will become infected from scratching open the skin and bacteria entering under the skin.

Signs in Your Home of Bed Bugs

Bed bugs can be spotted in the mattress and sheets. You may find rusty-colored blood streaks (their fecal material) on the bedding. Sometimes the bed bugs exoskeleton is spotted after they molt. When there is a heavy infestation, the area can have a sweet, musty odor from the bugs’ scent glands. 


What to Do For the Bites:

The bites are treated like other itchy insect bites. If the bites are not itchy, they will resolve without treatment. If they are a little itchy, try one of the over-the-counter creams or gels below to help control the itchiness:

  • Itch-X® Gel Apply to bite marks 3-4 times a day as needed.
  • Benadryl® Cream Apply to bite marks 2-3 times a day as needed.
  • Hydrocortisone 0.5 or 1% Cream Apply to bite marks 2-3 times as needed.

If the itchiness is not responding to the medicine that you put on the bites, the next step would be to have your child take Benadryl® (diphenhydramine) by mouth. This antihistamine is more likely to work for the itching, but may make your child tired (drowsy).

  • Benadryl® (diphenhydramine) All forms of Benadryl are every 6 hours as needed.
  • Allergy Elixir 12.5mg/5ml - Less than 25 pounds: ½ tsp (2.5ml). 25-49 pounds: 1 tsp (5ml). Over 50 pounds: 2 tsp.
  • Allergy Chewables 12.5mg - 25-49 pounds: 1 chewable. 50 pounds and above: 2 chewables.
  • Allergy Capsules or Tablets 25mg - 50 pounds and above: 1 capsule or tablet.

A few children will not respond to the over-the-counter medication and will benefit from an office visit to further evaluate and decide if prescription strength creams or medicine by mouth are needed.

If any of the bites are scratched and are open and sore, apply Triple Antibiotic® or Neosporin® ointment 3 times a day to the area to better allow the areas to heal.

What to Do For the Bugs:
  1. Eliminate clutter from your home, especially in the bedroom.
  2. Call an exterminator – there is no safe home treatment for you to use.
  3. Wash or dry clean all of your clothing in hot water and dry them in a hot dryer for at least 20 minutes. Store the clean clothing in sealed bags or plastic totes.
  4. Wash all of your bedding in hot water and dry it in the dryer on the hottest setting (bed bugs are killed if the temperature is at least 115 degrees) for at least 20 minutes.
  5. Thoroughly vacuum the floor and baseboards in your home. 

When We Should See Your Child

  1. If you would like confirmation that the bites could be bed bugs (no one can tell you with complete certainty, but we can be fairly accurate with recognizing these bites).
  2. If you have not had success with the over-the-counter treatments for itching.
  3. If you suspect your child has scratched so much there is now a skin infection at the site of the bites.

With any of these reasons for a visit, it would be fine to call for an appointment during regular office hours or to come in for walk-in hours at 8 am Monday through Friday.