PracticalDermatology

Bed Bugs

“They’re everywhere. About the only place that hasn’t reported bed bug infestations is Greenland, not a high-visitor destination. They’ve not gone away, there’s been a resurgence now that’s been going on for a number of years, and virtually anywhere you travel now you could encounter bed bugs,” says Dr. Rosen.

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There are several registries available where travelers can report infestations they’ve encountered, and it’s clear that bed bugs are everywhere. Bed bugs have not gone away, explains Dr. Rosen, adding that a resurgence has been going on for a number of years; Virtually anywhere you travel you could encounter bed bugs.

Is it a Bed Bug Bite?

Short of having patients present to the office with the bugs—and Dr. Rosen says he’s had patients who looked for them, found them, put them in a container, and brought them to his office, it really comes down to patient history.

“Since bed bugs tend to bite at dawn and dusk, particularly around dawn, it’s the person who goes to sleep with no bites who wakes up with bites in the morning. Usually they’ll be grouped–it’s the old breakfast, lunch, dinner and bed time snack because there are multiple bites ususally in close proximity to one another. Bed bugs like to bite on the extremity, so the bites should be on arms, legs, not on the neck and not on the covered parts of the body,” explains Dr. Rosen. “And then it’s just a surmise, it’s a guess, and then you can also go and look and see where bed bugs infestations have been reported and if the patient stayed at bed bug motel, then it’s pretty obvious that’s what happened.”

Treatment and Eradication

With bed bugs, dermatologists are treating the bite and essentially any mid-potency topical steroid will relieve the symptoms, says Dr. Rosen. The hard part is eradicating the bugs. If the person has been traveling, they’re out of the environment unless they brought bed bugs back on their luggage. If that is the case or if a patient discovers an infestation in their home, there are several steps that should be taken to get rid of the bed bugs. That process involves several maneuvers like vacuuming, encasement of things like the mattress, application of steam, application of topical insecticides, growth hormone inhibitors, and traps that physically will trap the bedbugs.

Dr. Rosen says the best advice is to prevent an infestation in the first place. Patients can take steps when traveling to avoid bringing bed bugs home with them. For example, keep luggage away from the bed and on a high piece of furniture because the bugs are not going to climb up a piece of furniture. Before getting settled in a hotel room, travelers should check for signs of bed bugs on the mattress, box spring, and bedframe, particularly around the corners, and on both sides of the headboard. They should also check the inside and back of nightstands. n