At a glance

  • Bedbugs feed on human blood, but they are harmless.
  • Their bites leave small red marks that itch.
  • Various things can help relieve the itching.
  • Bedbugs are usually brought into the home after traveling or on second-hand objects.
  • They are not a result of poor hygiene.
  • It is difficult to get rid of bedbugs and professional help is usually needed.


Man packing a suitcase on a bed

If people wake up in the morning with reddish marks on the skin of their arms, legs or face, they usually first think they are mosquito or flea bites. But it might also have been bedbugs: These little parasites feed on human blood at night. They hide during the day.

It is difficult and time consuming to get rid of bedbugs once they are in your home. Pest control specialists can help. Bedbugs have nothing to do with poor hygiene. They don’t spread diseases, either.

Bedbugs are small reddish-brown insects. They look like beetles, with their flat oval body and six legs. If they get the chance, they bite every 3 to 5 days to feed on blood. Bedbugs are masters of survival: They can live for up to a year without food.

Illustration: Bedbugs (bedbug on the right full of blood). The units shown are centimeters.


Bedbugs often leave small red, slightly swollen marks on the skin. Sometimes a small dot can be seen in the middle. But skin can react in different ways to bedbug bites: As well as red marks, they can also cause blisters or nodules in some people.

Typical signs of bedbug bites are

  • Several marks in a line or around one place, because if they don’t find a blood vessel the first time they bite, they will bite again.
  • Marks on body parts that are often not completely covered by the comforter or duvet, like the arms, shoulders, face and legs
  • Very itchy patches of skin

The skin reaction normally already starts the next morning. But sometimes the marks only appear a few days later.

Illustration: Bedbug bites

Causes and risk factors

Bedbugs are now more widespread than they used to be because of frequent travel and international trade. Bedbugs spread particularly quickly in Australia and the United States. A lot of chemical products (insecticides) are also no longer effective against the insects.

Bedbugs spread when things are transported, hidden among luggage or in gaps in furniture and goods, and usually unnoticed.

Bedbugs are often brought back from travels. The risk of getting bedbugs is particularly high in places where are lot of people stay. But bedbugs can also be found on trains, buses and planes.

Bedbugs can be brought into your home in second hand furniture, like from flea markets or online platforms. Second hand bed frames and mattresses are affected especially often. But the insects can also hide in electrical appliances, clothing, books and even CD cases.

Bedbugs spread quickly within a few weeks in lived-in places. That happens especially quickly where lots of people share a confined space. For example, bedbugs can easily spread to other rooms in residential homes.

Diagram: Development stages of bedbugs: from egg to adult insect


Bedbug bites usually go away within a week. Scratching can slow down the healing process. As long as the parasites haven't been gotten rid of completely, you will keep getting new bites.

If the bedbugs reproduce a lot and bite more and more, more severe skin reactions are possible. Hives with reddened skin, wheals and itching or a bacterial are rare, though. Allergic or anaphylactic reactions are exceptions.

According to current knowledge, bedbugs do not spread diseases.


Severe itching at night can cause loss of sleep and tiredness. But worrying about being bitten by bedbugs at night can also keep you from sleeping.

Lots of people find it difficult to cope with having bedbugs in their home. Mental stress caused by the parasites can lead to anxiety and nightmares, and in very rare cases to hallucinations. Medical or psychotherapeutic help is then needed.

Some people feel ashamed, others withdraw. But bedbugs have nothing to do with a lack of cleanliness.


It can be difficult to tell whether a skin reaction is caused by bedbugs, or by other types of bugs, fleas or mites. Other insects are a possibility in summer in particular. Allergies, various skin diseases and chickenpox can also cause red patches and itching. If you are unsure, dermatologists might be able to advise you. That can also help to rule out any diseases.

It is more likely that bedbug bites are the cause if you have been traveling. But it is only definite if you have actually found a bedbug, its eggs, body shell or droppings.

Bedbugs prefer to hide close to the bed during the day, which is why it is best to start looking for them in the bedroom. Gaps in the bed frame or mattress are popular. But bedbugs are also happy in other places like in cracks in the wall, wallpaper, picture frames, floors and skirting boards, curtains, sockets and clothing.

Bedbugs’ droppings can sometimes be seen as dark spots on the bedsheets, mattress or on the wall around the bed.

Illustration: Mattress with bedbug droppings

Small dots of blood on the bedsheets are also a sign of bedbugs. It might also smell a little stuffy and sweet if the bedbugs have already reproduced a lot. The smell often gets stronger if you clap the mattress.

It is difficult to find bedbugs, especially if there are only a few. Bedbug traps try to attract the little critters with fragrances. But it is not clear whether they can effectively find them all. It is best to contact pest control professionals.

If you find something you think might be a bedbug, you can also catch it and have an expert look at it. Sealable jars or boxes that the bugs can't escape from are good containers for that.


Two things are particularly good at stopping bedbugs from getting into your home:

  • Check for bedbugs where you stay when traveling, particularly the bed and mattress. Dark spots and insect casings are a sign of bugs. You can then at least spot a severe infestation and look for different accommodation as soon as possible.
  • Carefully check second hand items for bedbugs before taking them into your home.

There are various ways of getting rid of bedbugs on your belongings if you come into contact with them while traveling:

  • Wash non-sensitive clothing at least at 60° Celsius (140° Fahrenheit) and dry it as hot as possible in the dryer.
  • Seal smaller items and sensitive clothing in plastic bags and put them in the freezer for several days.
  • Larger items like suitcases and wheelchairs can be treated with hot steam. You can use normal household steam cleaners.
  • Vacuuming is also an option. But it is then important to seal up the vacuum cleaner bag tightly afterwards. It’s best to put the bag in the freezer for a few days to kill any bedbugs that might be in there. The normal seals on vacuum cleaner bags are not tight enough.

It is not a good idea to wait and hope that the bedbugs starve. They can live for up to a year without food.

Treating bedbug bites

The skin reaction normally goes away without treatment within a week.

To relieve the itching and speed up healing, it can help to

  • keep the skin clean and dry,
  • not scratch, and
  • use itch-relieving ointments, creams or lotions available without prescription from the pharmacy.

Steroid creams or antihistamine tablets can be used for a few days to relieve severe itching. Many of those products are only available on prescription. Antibiotics might also be an option if the skin becomes inflamed.

Supportive psychological advice or treatment can help if the situation becomes very mentally distressing.

The German Federal Environment Agency (UBA) recommends seeking help from a pest control company to prevent further bedbug bites and to get rid of the bedbugs. But there are also some simple things you can do yourself.

Everyday life

It is extremely unpleasant to have bedbugs in your home. Especially the idea of them biting you at night can be very distressing and cause disgust or anxiety.

There are some things you can do straight away to tackle bedbugs, like vacuuming, but looking for all their hiding places and killing all of the insects and their eggs is difficult and takes a long time.

Especially if the bedbugs have already reproduced a lot, you might need to turn your home upside down, moving furniture away from the walls, dismantling it, or sealing gaps in the floorboards. Often perseverance is needed in addition to professional help. But with the right support and a little patience, sooner or later your home will be free of bedbugs again.

Bernardeschi C, Le Cleach L, Delaunay P et al. Bed bug infestation. BMJ 2013; 346: f138.

Hildreth CJ, Burke AE, Glass RM. JAMA patient page. Bed Bugs. JAMA 2009; 301(13): 1398.

Parola P, Izri A. Bedbugs. N Engl J Med 2020; 382(23): 2230-2237.

Rahlenbeck S, Utikal J, Doggett SW. Cimikose: Bettwanzen – Weltweit auf dem Vormarsch. Dtsch Arztebl 2015; 112(19): A-870 / B-732 / C-708.

Umweltbundesamt. Bettwanzen: Erkennen, vorbeugen, bekämpfen. 2017.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Created on September 21, 2022

Next planned update: 2025


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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