How to Tell Bed Bugs and Hives Apart

If your home has a bed bug problem, you might notice red, itchy welts on your skin. These are triggered by an allergic reaction to the saliva left behind when a bed bug bites you. However, red welts can also be a sign of hives, caused by an allergy to something else.

Bed bug bites are small, raised, itchy spots that appear 1-3 days after being bitten. They appear in clusters or lines. Individual reactions to bed bug bites can differ. Hives can appear in larger patches and have different patterns. The surrounding skin is usually red and inflamed.

It’s important to find out what’s causing the problem, so that you know how to resolve it. We’ll look at what bed bugs and hives are, and how you can tell hives from bed bug bites. We’ll also explore the recommended treatments for both hives and bed bugs.

What Are Bed Bugs?

Bed bugs are insects. They are distantly related to stink bugs and cicadas. But rather than feeding on sap from plants, bed bugs are parasites. They need to drink animal blood to survive.

Because bed bugs prefer human blood, they have adapted perfectly to life inside our homes. They thrive at normal room temperatures and are attracted to carbon dioxide, which we give off.

Bed bugs can fit into the smallest cracks and crevices inside our beds and other furniture. Unless the infestation is large, you might not notice they’re there. You’ll probably notice the bite marks, though.

About once per week, bed bugs feed by piercing a small hole in your skin. The leftover saliva triggers an allergic reaction in most people.

Bed bug bite marks appear around 1 to 3 days after being bitten. Most people develop small, red spots, which may be flat or raised. They’re often intensely itchy.

Some people develop more severe reactions than others. Because bed bug bites can vary in appearance so much, people often confuse them with hives.

How Do You Get Bed Bugs?

Any home can develop a bed bug problem. The myth that they only infest dirty, poor or messy homes is untrue.

You could pick up a bed bug in any public place, like a hotel, hospital or office. Bed bugs can also be inadvertently dropped off by visiting friends or family members. They can even enter your home through the walls, if you live in an apartment.

Once the bug enters your home, it will find its way to your bedroom. There, it will choose a secluded spot to hide in until it’s time to feed.

If the bug is a pregnant female, your home could soon be infested.

What Are Hives?

The proper name for hives is urticaria. It’s an uncomfortable, unsightly skin reaction which is normally triggered by an allergy.

Depending on what’s caused the hives, and how sensitive you are, they can vary drastically in appearance.

Some urticaria breakouts consist of hundreds of tiny pimple-like bumps. Others take the form of large, irregularly shaped wheals. They can be as big as a dinner plate.

Sometimes, you may only develop a small patch of hives in one area. In other cases, they may connect to form huge rashes.

Hives can be white, pink or red. They are usually raised, and extremely itchy. They can also cause a stinging or burning sensation.

Hives are caused by your skin reacting to a foreign substance. However, instead of bed bug saliva, hives can be triggered by any number of things. It all depends on what you’re allergic to.

What Causes Hives?

Hives are the physical result of your body going through an allergic reaction.

When your body detects a substance that it thinks is harmful, your immune system releases histamine. This causes fluid to accumulate under the skin, resulting in the raised areas.

It’s hard to figure out exactly what substance your body is reacting to. People can be allergic to:

  • Certain foods and ingredients
  • Medications
  • Animals
  • Trees and pollen
  • Cleaning products, such as laundry detergents
  • Skin products, such as lotions and soaps

In rare cases, hives can even develop as a reaction to sunlight, or pressure on the skin.

Hives don’t usually last long. However, according to the Indian Journal of Dermatology, urticaria can sometimes be chronic. Chronic urticaria can last for weeks, months or even years.

difference between hives and bed bug bites

Bed Bugs vs. Hives Compared

Hives and bed bug bites, as you know by now, are two entirely separate problems.

As they’re both the result of an allergic reaction, they can be hard to tell apart. But it’s vital that you learn to distinguish them, as they have very different treatments.

If you’re struggling to tell whether you’ve got hives or bed bug bites, there are six questions that you should ask yourself. You should have a good idea of what you’re dealing with.

What Do the Welts Look Like?

Examine the welts themselves. Though bed bug bites and hives look similar, there are some differences.


Bed bug bites are usually around the size of an eraser on the end of a pencil. They may be slightly bigger if you are more sensitive. Bear in mind that two bite marks close together can sometimes look like one large bite.

Hives, on the other hand, can be very small or very large. Some kinds of hives can be as small as pimples, bunched together to form a big rash. Other hives are very large indeed. Wheals could be the size of a quarter, a beermat or even a dinner plate.


Bed bug bite marks are red. The skin immediately surrounding them should look normal, though it may be a bit paler than usual.

Hives can vary in color. Sometimes, they’re the same color as your skin (or even paler). Other kinds can be pale to dark red. In some case, they can even look purplish. The flat skin surrounding the hives is often inflamed and red looking, too.


Both hives and bed bug bite marks are usually raised. That means that they stand out, so you can feel them if you have your eyes closed. As they start to go away, they flatten out.

Bed bug bites are usually round, like flea bites and mosquito bites. The edges are quite even. Many bites may be clustered together, or form zig-zag lines.

On the other hand, hives can be all kinds of shapes. Some hives are round, but even then, they usually have wobbly or uneven edges.

Where Do the Welts Appear?

Bed bugs look for areas of the skin that are uncovered. If you wear pajamas, you’ll probably find bite marks on the parts of your body that aren’t covered in fabric.

The most likely places are the arms, legs, and neck. Of course, if you sleep naked, the bites could appear anywhere.

Hives can appear anywhere on the body. Sometimes, they occur in response to an allergen directly touching the skin (such as poison oak).

In this case, they’ll appear where the allergen touched you. However, there’s often no clear reason why hives have appeared in a particular place.

Are Family Members Affected?

If you’re being bitten by bed bugs, it means your home is infested. It’s doubtful that the problem only exists in your bedroom.

Ask your partner, family members or roommates whether they have any similar-looking welts on their skin. You’re most likely not the only person with these bite marks.

Hives aren’t contagious. You can’t pass them from one person to another. If you’ve got hives, other people in the house probably won’t have them.

That being said, it isn’t a guarantee. Allergies can run in families. If you and your family are allergic to the same thing, you could both be experiencing hives at once. However, it is unlikely.

And, of course, bear in mind that some people don’t react to bed bug bites at all. Don’t assume you don’t have bed bugs just because someone in your home hasn’t got any bite marks.

Do You Have a History of Allergies?

If you have any known allergies, consider whether you might have been exposed to any recently. If you suffer from hay fever, for example, the pollen count may be high in your area at the moment.

Have you accidentally used a soap, laundry detergent or cleaning product that you’ve had a reaction to in the past?

Remember that the allergenic substance doesn’t need to touch your skin for it to trigger hives. It could be in something that you’ve eaten or drank. Have you visited any restaurants lately, where there could have been cross-contamination issues?

Have You Encountered Any New Products or Foods?

Even if you don’t have a history of allergies, new ones can develop all the time. It’s possible for a person of any age to become allergic to something they’ve never reacted before.

So, figure out whether you’ve tried any new foods or used any new products lately. Are you trialing a new kind of shampoo? Has someone brought a new plant or some flowers into your home? Have you recently got a new pet, or has someone visited who has a pet at home?

Hives can also develop as a response to stress or extreme heat. Have you been particularly anxious or worked up about anything lately? Have you recently started exercising? All of these factors could cause a skin reaction.

Are There Any Signs of Bed Bugs in Your Home?

If you think your welts may be bed bug bites, there’s one way to be sure. Check your home for the tell-tale signs of a bed bug infestation.

The best place to start is the bedroom – particularly the mattress, headboard, and box spring. Signs of a bed bug infestation include:

  • Fecal spots. Look for flat, small dots, almost like ink spots from a pen. They’re almost black in color, and typically appear in clusters. Bed bug droppings won’t rub off easily.
  • Shed bed bug exoskeletons. Look for translucent, bug-shaped pieces of shell.
  • Blood stains on your bedsheets. These are caused by the bites bleeding when the bed bugs detach themselves.
  • Eggs and eggshells. These are 1mm long and whitish in color.
  • Live or dead bugs. Adult bed bugs are around 4mm long, oval-shaped and reddish brown. They look almost like apple seeds. Nymphs (juveniles) are smaller and paler.

Remember that bed bugs can fit into any gap which is wide enough for a credit card to slide into. They prefer tight, secluded spots, so pay attention to cracks and crevices.

After you’ve checked the bed, don’t forget to search the rest of the room. Bed bugs can live almost anywhere.

What is the Treatment for Hives and Bed Bugs?

By now, you should have an idea of whether your problem is more likely to be hives or bed bugs. However, to make sure, it’s a good idea to get a professional opinion.

Schedule an appointment with a dermatologist. They should be able to tell whether the welts are an allergy or insect-related.

If you’ve got hives, your dermatologist will refer you to an allergy specialist. They’ll carry out testing to try and determine what you’re allergic to. In the meantime, you may be prescribed antihistamines.

If your dermatologist thinks that you’ve got bed bug bites, contact an exterminator to arrange an inspection.

Getting rid of bed bugs is, unfortunately, quite complicated. The best way is to seek professional heat treatment. This involves heating your entire home, and everything in it, to a temperature high enough to kill 100% of bed bugs and eggs.

You’ll have to leave your home while this is carried out. If this isn’t an option for you, there are many ways you can try and keep on top of the infestation.

Store-bought insecticides can help. You can also use a mattress encasement and bed bug interceptor traps. You should also launder your clothes and bedsheets at 140 degrees Fahrenheit.

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Lou Carter

Hi, I'm Lou. I’ve long been fascinated by bed bugs, ever since a friend’s life was turned upside down. That’s why I’ve put together this specialist site. You’ll find detailed answers to all of your questions on how to get rid of a bed bug infestation. I hope you find it useful!

1 thought on “How to Tell Bed Bugs and Hives Apart”

  1. Thanks, Lou! I can’t get what’s happening to my skin to go away and I’ve tried everything (including extermination for my house and car!) Now I KNOW that I should go to a doctor! Everyone around me has said to try everything else before going to the doctor, and I’ll sure be kicking myself if it was hives the whole time! Thanks for sharing


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