The Dermatology Blog

What’s the first thing you should do when you check into a hotel? Look for bedbugs.

To be honest, I didn’t know that bedbugs really existed until my dermatology residency (they’re on our board exam). I always thought that they were the fictional creatures of a nursery rhyme: Good night, sleep tight, and don’t let the bed bugs bite.

Well they are real. Believed to have been brought here by original colonists, bedbugs were nearly extinct a few years ago when DDT was in widespread use. They have since made a significant comeback, increasing by 500% over the last few years. They are known to infest hotels and apartment buildings and can come home with you by hitching a ride in your luggage.

Bedbugs (also spelled bed bugs, or Cimex lectularius) are small brown flat wingless insects about the size of an apple seed. They live in crevices in walls, furniture, baseboards, mattresses, comforters, and even drapes. They can live for months without a meal. In heavily infested rooms they can give off a coriander-like odor.

They come out just before dawn to grab a snack on your skin and secrete a numbing substance that prevents you from waking and discovering them biting you.

If you had been bit, you would develop itchy bumps or welts, often in a straight line, on exposed areas of your skin. The bites are often in 3’s; in dermatology we call it the “breakfast, lunch, and dinner” sign.

Fortunately the bugs aren’t known to carry disease; it is possible they can carry the virus for hepatitis, but there have been no instances of the bugs transmitting that disease. The main problem is the psychological impact they can have on you. Just the idea that there might be bugs living in your mattress that come out to bite can give you plenty of sleepless nights.

Treatment is usually with a topical steroid cream or oral antihistamine for the itching (like for mosquito bites).

How can you prevent getting bed bugs the next time you travel?

• Check the mattress, running your fingers along the seams. Make sure to check the mattress tag, bed bugs often hide there.
• Check crevices in the box spring and headboard if possible.
• Check the night tables. Look for signs of bed bugs in the drawers and along the wall on the side of the bed.
• Keep your clothes in your luggage (not the hotel drawers) and keep your luggage zippered up at night.
• Before you return home, inspect your luggage and clothing. Laundering your items with hot water and a hot dryer (97 °F) should kill all bed bugs.
• Remember that the bugs can live in furniture for months without a meal. You should inspect secondhand furniture (including antiques) thoroughly before bringing them into your home.

So if you suspect your home might be infected what can you do?

• The bugs can’t tolerate extremes of temperature. Freeze your pajamas, sheets, and other bedclothes for at least 24 hours or launder them in hot water and hot dryer.
• Vacuum the area of infestation daily.
• Caulk holes in floors and walls.
• Consider hiring an exterminator. They can use insecticides or other techniques like icy liquid carbon dioxide or super hot room heaters to kill the bugs.

Here is an excellent algorithm from the Harvard School of Public Health.

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