What do bed bug bite lesions look like? - briefly
Bed‑bug bites manifest as small (2‑5 mm), red, raised papules that frequently occur in a line or cluster and are intensely itchy. A subtle central punctum may be present, and the lesions can swell or develop a surrounding halo of redness within hours.
What do bed bug bite lesions look like? - in detail
Bed‑bug bites appear as small, raised papules that are typically 2–5 mm in diameter. The initial lesion is a pale, pink spot that quickly becomes erythematous and may develop a central punctum where the insect’s mouthparts entered the skin. Swelling around the core is common, producing a raised, dome‑shaped bump.
The lesions often occur in groups of two to three, arranged in a linear or “break‑fast‑cereal” pattern. This distribution reflects the insect’s feeding behavior, as it moves along exposed skin while taking successive blood meals. Isolated bites are less typical but can happen when a single bug feeds for a longer period.
Pruritus is a hallmark symptom; the itch may begin within minutes to several hours after the bite and can persist for days. Scratching can enlarge the erythema, generate a wheal, or lead to secondary excoriation. In some individuals, the reaction is delayed, with redness and swelling appearing 12–24 hours post‑exposure.
Color variation depends on the host’s skin tone. On lighter skin, the lesions are conspicuously red; on darker skin they may appear as darker, violaceous spots or hyperpigmented macules after healing. Healing typically proceeds through a crusted stage, leaving a faint, flat hyperpigmented patch that can last weeks.
Key characteristics to recognize:
- Size: 2–5 mm, sometimes up to 10 mm if inflamed.
- Shape: round or oval, slightly raised.
- Color: pink to deep red, may darken with time.
- Arrangement: clusters, linear rows, or zig‑zag patterns.
- Timing: onset of itching within minutes to hours; redness may peak after 12–24 hours.
- Evolution: initial papule → wheal → crust → hyperpigmented residual stain.
Differential considerations include mosquito bites (usually isolated, larger, with a central punctum), flea bites (often on the lower legs, with a “target” appearance), and allergic reactions (widespread, not confined to exposed areas). The combination of a pruritic, grouped, linear pattern on exposed skin, especially near the head, neck, arms, or hands, strongly indicates bed‑bug activity.