Bed Bug Treatment
For bed bug infestations, implement integrated pest management combining non-chemical methods (vacuuming, heat treatment, mattress encasements, decluttering) with professional application of insecticides such as silica gel dust, diatomaceous earth, or synthetic pyrethroids, as this combined approach provides both immediate elimination and residual protection.
Treatment of Skin Reactions
For patients presenting with bed bug bites, treatment is symptomatic and self-limited 1:
- Topical pramoxine and oral antihistamines for pruritus relief 1
- Topical corticosteroids for significant eruptions to control inflammation, reduce itching, and hasten lesion resolution 1
- Recognize that reactions range from erythematous maculopapules in clusters or linear patterns to exaggerated responses including vesicles, urticarial wheals, bullae, or nodules in sensitized individuals 1
Environmental Eradication Strategy
Non-Chemical Methods (Foundation of Treatment)
These interventions are essential and can eliminate bed bugs in lightly infested apartments 2:
- Keep affected areas clean and decluttered to eliminate hiding places 1
- Vacuum thoroughly all surfaces, cracks, and crevices 1
- Wash all linens in hot water (>130°F) 1
- Encase mattresses, box springs, and pillows in zippered, allergen-proof covers 3, 1
- Caulk wall holes and cracks where bugs hide 1
- Properly dispose of heavily infested items that cannot be salvaged 1
- Place bed bug interceptor traps at the base of beds and furniture legs 1, 2
Chemical Methods (For Residual Protection)
Silica gel dust or diatomaceous earth provides superior residual control compared to insecticide sprays 4:
- Silica gel dust application reduces bed bug counts by 99% at 6 months, significantly outperforming non-chemical methods alone (89% reduction) 4
- High-quality diatomaceous earth (from professional pest management companies) achieves 75-100% efficacy, while consumer-grade products from supermarkets or pet stores are often ineffective 5
- Sommières earth demonstrates comparable efficacy (75-100%) to professional-grade diatomaceous earth 5
Additional chemical options include 1:
- Synthetic pyrethroids
- Neonicotinoids
- Chlorfenapyr
- Insect growth regulators
- Plant essential oils
Critical caveat: Multiple mechanisms of insecticide resistance exist; chemical treatment should only be undertaken by trained professionals who understand current resistance patterns 1.
Integrated Pest Management (IPM) - The Optimal Approach
Combining non-chemical and chemical methods yields the best results 1, 2:
- In comparative studies, IPM achieved bed bug elimination in 44% of apartments after 10 weeks, with median final counts of 1 bed bug (range 0-38) 2
- Non-chemical methods alone eliminated bugs from 67% of lightly infested apartments but struggled with heavier infestations 2
- Steam treatment combined with diatomaceous earth dust reduced tropical bed bug populations by 94.1% after 14 weeks in dormitory settings 6
Monitoring and Follow-Up
- Install active monitors using heat or carbon dioxide attractants, or passive monitors with sticky pads 1
- Conduct biweekly to monthly inspections for at least 10 weeks to assess treatment effectiveness 2
- Retreat as necessary based on inspection findings 2
- Recognize that spatial distribution shows aggregated patterns, with neighboring units sharing walls at higher risk 6
Important Safety Considerations
- Avoid insecticide overexposure, particularly cardiovascular and neurologic toxicity risks in homes with young children 1
- Consult professional exterminators for full eradication, as they understand resistance patterns and proper application techniques 1
- Ensure resident cooperation, as lack of compliance contributes significantly to treatment failure 2
Common Pitfalls to Avoid
- Using consumer-grade diatomaceous earth products instead of professional-grade formulations 5
- Relying solely on insecticide sprays without non-chemical interventions 4
- Failing to treat neighboring apartments in multi-unit buildings 6
- Discontinuing treatment prematurely before complete eradication is confirmed 2