Most don't require medical treatment at all. CDC describes bites as capable of causing itching and loss of sleep and, rarely, an allergic reaction — but as a rule they resolve without intervention. The bite itself is often not felt while it happens, because bed bugs inject an anesthetic and an anticoagulant while feeding.
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Why do bite marks take so long to show up?
They can take as long as 14 days to develop in some people, per the CDC and EPA joint statement, and swelling specifically may not appear until a day or more after feeding. Some people show no symptoms at all. That delay is exactly why a bite cannot be used to time or confirm an infestation — the mark you see today may be from a feeding more than a week old, or there may be no mark from a recent one.
What do the bites look like, and can they get worse?
A slightly swollen, red, itchy area, similar in appearance to a mosquito or flea bite, with marks that may appear randomly or in a line. Reactions range from none at all to, in rare cases, anaphylaxis — a severe, whole-body reaction. Scratching can lead to secondary skin infections including impetigo, ecthyma and lymphangitis, and CDC also notes reported effects on sleep and anxiety from an active infestation.

Should I see a doctor?
For most people, no — CDC's framing is that bites usually don't require medical treatment. The exceptions are a severe reaction (any sign of anaphylaxis warrants immediate medical attention) or a bite site that shows signs of secondary infection from scratching, such as spreading redness, pus or fever.
Sources
3 cited- Bite timing, symptoms and reaction range: CDC & EPA, Joint Statement on Bed Bug Control in the United States, 2010 (checked 2026-08-18).
- Current clinical framing: CDC, About Bed Bugs, last reviewed 2024-04-26 (checked 2026-08-18).
- Why bites cannot be used to diagnose an infestation: UC IPM Pest Notes Publication 7454, Bed Bugs, May 2013 (checked 2026-08-18).
