Bed Bug Bites vs. Flea Bites: How to Tell the Difference

There are a few telltale signs that can help you discern what kind of bite you have.

Bug bites are annoying for multiple reasons, but what is sometimes most frustrating about getting a bug bite is not knowing what kind of insect is to blame. So many bug bites look (and feel) so similar that it can be difficult to tell if you're suffering from a mosquito bite, a chigger bite, a fire ant bite, or something completely different—which, of course, is important in terms of getting the right treatment for your skin.

Two of the more common bug bites—bed bug bites and flea bites—are especially difficult to tell apart. Health spoke to experts to find out how you can tell the difference between the two.

What do bed bug bites look and feel like?

Contrary to popular belief, bed bugs—small, flat, reddish-brown insects—don't just live on your mattress; they can be found in couch and chair seams, in curtain folds, and in between cushions, according to the US National Library of Medicine's MedlinePlus resource. Additionally, bed bugs can live in crevices in walls, John Anthony, MD, a dermatologist at Cleveland Clinic, tells Health. While bed bugs are found mainly in living areas, it's important to know that the presence of bed bugs isn't determined by the cleanliness of the living conditions where they're found, according to the Centers for Disease Control and Prevention (CDC).

Bed bugs feed on human blood, but you likely won't notice when they bite—that's because, according to the CDC, the bugs inject an anesthetic (along with an anticoagulant) so the person doesn't know they're being bitten. "Most people don't feel when the bed bug is biting," says Dr. Anthony. "The bed bugs bite at night, [then] retreat by the time you wake up."

Bedbug bites are visible on the back of a woman standing in a hotel room , bedbug-bites
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You'll only realize you've been bitten by bed bugs when small marks appear on your skin. While everyone reacts to bed bug bites differently, bed bug bites, in general, look similar to mosquito bites with a point in the middle (called a punctum) where the actual bite occurred, Tania Elliott, MD, who works in NYU Langone's department of Infectious Disease, Allergy and Immunology, tells Health. "Bed bug bites usually occur in a linear fashion, and mainly affect exposed areas of the body while you sleep, like your hands, arms, legs, or face," Dr. Elliott says. It's also worth noting that bed bug bites can have a purplish color, Dr. Anthony says.

Aside from seeing the tiny bites on your skin, you may also be alerted to a bed bug infestation if you see the small insects on your furniture (they're about the size of Lincoln's head on a penny, per the CDC). Tiny specks of blood on your sheets can also be an indicator of bed bugs, Dr. Anthony says.

What do flea bites look and feel like?

While bed bugs prefer human blood, fleas are small insects that actually prefer to live on cats and dogs, per MedlinePlus. The presence of pets, then, can help you determine if you're dealing with a flea bite or something else. "People mainly get flea bites from pets, so if you have had no pet exposures, it's less likely to be a flea bite," Dr. Elliott says.

While they prefer household pets, though, fleas will resort to humans if they don't have another option—sometimes that happens when a person's pet has been gone from the house for a while, and the flea needs another source of food


Extreme case of flea bites on humans.
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Flea bites, like bed bug bites, usually appear as small red dots on the body. You'll usually notice flea bites in creases of the body (think: elbows, waist line, groin, the backs of your knees). Flea bites often present as three small bumps together, and may cause a rash of bumps called papules, Dr. Elliott adds. Flea bites, like bed bug bites, can also resemble mosquito bites, Dr. Anthony says.

I addition to itchy skin and red bumps, you might become aware of the presence of fleas in your home if your pets are exceptionally itchy, if you see tiny dots on their fur, or if you see the tiny insects (which are smaller than bed bugs) on your furniture or other household items.

What to do about bed bug bites and flea bites

For bed bugs in particular, they don't usually pose a serious medical threat, so the best way to treat them is through antihistamines, antiseptic treatments, and to avoid scratching the affected area on your skin. Past that, bed bug infestations are treated by insecticide spraying, per the CDC.

While fleas are usually only an annoyance too, it's important to know that fleas also carry bacteria that cause diseases in humans, like typhus and plague. Most of the time, however, flea bites can be treated with 1% hydrocortisone cream and/or antihistamines, according to MedlinePlus. You can also get rid of flea infestations with pesticide treatments. Additionally, applying a DEET-based insect repellent can help you ward off flea bites. "The active ingredient DEET is recommended by the CDC for effective, long-lasting protection against fleas and other insects," Dr. Elliott says.

Overall, if you're unsure of what's causing your symptoms, it definitely won't hurt to schedule a visit with your primary care doctor or dermatologist.

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