Bed Bugs: Biters & Bites
By DR. STUART MITCHELL
With so many types of biters, and so many types of bites, keeping up with the subtle differences can be a real pain. Is the biter a bed bug? Is it a bed bug bite?
Bed bug bites usually vary in number and are more often distributed in unclothed areas, such as the face, neck and limbs. As opposed to other insect and spider bites, bed bug bites are rarely located in the armpits or kneepits. Bites may be recognizable upon waking up or several days later. Reactions—from delayed to immediate—often develop with ongoing exposures. The characteristic bed bug rash is referred to as “breakfast, lunch and dinner” because numerous bites tend to appear in rows or clusters.
||Itchy red bumps in clusters or lines in unclothed areas
||Irregular groups of red, swollen marks with a small, distinct point in the center and located under loose areas of clothing (lower legs, and waist)
||Scratched skin, identified by examining clothing seams and hair for lice and nits
||Soft, pale, itchy bumps scattered in unclothed areas
||Itchy burrows or blisters where two skin areas may touch or rub together and areas under tight clothing
||Single wound in an area where clothing binds tightly; thin skin is more likely to be envenomed than calloused skin
||Painless red, small, raised swelling area with or without itching, usually discovered in protected sites (hair-covered regions) during the spring and summer
Scratching bed bug bites may cause superinfection, which can progress to impetigo, cellulitis, or folliculitis. Without treatment, bite reactions generally become less swollen within one to two weeks. Rarely, systemic reactions may occur such as asthma, generalized skin rash, angioedema, iron deficiency anemia, and even anaphylaxis.
Generally self-limiting, bed bug bites typically resolve within one to two weeks without medical treatment. There is no evidence that any treatment alters the course of bed bug dermatitis. If itching is present, nonprescription topical medications containing the active ingredient doxepin or intermediate potency corticosteroids may be helpful. With superinfected bites, seek medial attention. A topical or systemic antibiotic treatment may be prescribed.
Suspected vectors of more than 40 microorganisms, there is no conclusive medical evidence that bed bugs are competent in the transmission of disease. However, future medical research and patient treatments may provide an answer to this significant public health question.
Psychological distress may be experienced along with the physical signs of bed bug bites. Bed bugs wrongfully suggest the stigma that they are related to poor hygiene. This can lead to significantly low self-esteem that results in avoidance of family and friends, and possibly interruption of work. Management of a bed bug infestations can be quite stressful, costly and disruptive to everyday life. The consequences of resultant worry and stress may be insomnia, anxiety depression and delusional parasitosis.
Once a pest management professional confirms a bed bug infestation, an integrated pest management (IPM) strategy is employed. Promoted by the Centers for Disease Control and Prevention (CDC), IPM utilizes bed bug biology and behavior coupled with the most up to date and environmentally friendly pest management methodologies.
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