Bedbugs

You will see raised red insect bites, usually in the morning, as they are active at night. This is usually on the face, neck and arms, as these are exposed during sleep. Three to four bites may appear in a line or a curve. You may even see the mites themselves, as they are visible to the naked eye although tiny, and look red or brown, flat and oval-shaped.

You may notice brown marks in bedding that is likely to be their faeces, or red spots of blood from their bites or from squashing a just-fed bedbug. You may notice a distinctive smell of sweet almond from them.

Insect bites can look quite similar – it's less likely to be bedbugs if you got the insect bites while out and about in warm weather or in parks or wooded areas. Scabies is a possibility in the home – these mites cause intensely itchy bites, especially at night, but can leave distinctive tracking marks, like red tramlines, from bites as the mite burrows under the skin. These are treated with an over-the-counter cream.

To kill bedbugs, you need to wash your bedding and clothes at 60 degrees Celsius or higher, or tumble dry for at least 30 minutes on a hot setting. Alternatively, you can leave clothes in a sealed bag in the freezer for at least four days, which will kill the mites. Regular vacuuming and cleaning will help.

If you have a heavy infestation, you will need to contact a pest control company to use professional-strength insecticides to decontaminate your home – your local council may have a list of companies to help.

If you are staying in a hotel and think you have bedbugs, report this to the management, move rooms, and ensure you decontaminate your clothing, as they can travel home with you.

A cool damp flannel on any bites can help, or a cool shower. You can buy a mild steroid cream (1% hydrocortisone cream) to calm the inflammation and itch. If this isn’t enough, or sleep is interrupted with scratching, you can try anti-histamine cream or tablets to further ease the itching.

Try to avoid scratching: easier said than done. Keep your nails short and clean to avoid breaking the skin if you do scratch, keep the skin clean, and consider using an antiseptic cream or spray on any areas of broken skin.

Occasionally insect bites – or breaks in the skin from scratching – allow bacteria to get in and cause an infection. The area will be sore and have a large red swollen area around the bite. You may feel unwell, be off your food and have a fever. Speak to your doctor urgently or call 111, as this may require antibiotic cream or tablets.

Rarely bedbug bites can cause a severe allergic reaction, including anaphylaxis (problems with breathing). Seek urgent medical help if you are severely swollen or you have mouth or tongue swelling or difficulty breathing.