Bed bugs, scabies and fleas all cause intensely itchy spots, but they are treated in completely different ways, so working out which one you have is the most important step. Bed bug bites usually appear in a line or cluster on skin uncovered in bed, such as the face, neck, arms and hands, and new bites appear after nights in a particular bed. Scabies is caused by tiny mites living in the skin, and according to the NHS it causes intense itching that is worse at night, with a rash that often appears between the fingers, around the wrists, under the arms and around the waist, groin and bottom, and usually spares the head and neck in adults. Flea bites are usually small clusters around the ankles and lower legs, often in homes with cats or dogs. Hives, eczema and other rashes can look similar. Scabies spreads through close skin contact and needs a cream or lotion over the whole body, repeated after 7 days, for everyone in the household at the same time. Bed bugs need professional pest control, and fleas need treatment of pets and the home. Bed bug activity in the UK is rising, and council bed bug visits rose 35% from 2022 to 2024 according to Freedom of Information data published by Direct Line. At The Wellness a doctor can review photos by video the same day from £150 and arrange an examination when needed. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated 14 October 2026.
Send a doctor a photo of your rash on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
Key facts about telling bites and rashes apart
- Bed bug bites often appear in lines or clusters on skin uncovered in bed.
- Scabies itches most at night and often affects the finger webs, wrists, waist and groin.
- Flea bites usually cluster around the ankles and lower legs.
- Scabies treatment must be used by everyone in the household at the same time.
- Bed bugs need professional pest control, according to the NHS.
- Council bed bug visits rose 35% between 2022 and 2024.
How to tell bed bug bites from scabies
Where the spots are is the best clue. Bed bug bites are on skin left uncovered while you sleep, while scabies favours the webs between the fingers, the wrists, the armpits, the waist, the groin and the bottom.
How it spreads is the next clue. Scabies passes between people through close skin contact, so partners, children and others in the household often itch too. Bed bug bites affect people who sleep in the infested bed or room, and some people living with the same bed bugs never react.
Timing helps as well. Scabies itch builds over weeks, is worst at night and can continue for a few weeks even after successful treatment. Bed bug bites appear as new crops after nights in a particular bed or after a trip, and usually settle in about a week.
You may see tiny wavy lines on the skin with scabies, called burrows, and you may find bugs, blood spots or dark droppings on the mattress with bed bugs.
How to tell bed bug bites from flea bites
Flea bites are usually small, very itchy spots, often in clusters around the ankles and lower legs, because fleas jump up from carpets and furniture. They are common in homes with cats or dogs, including after a pet has been away. Bed bug bites are more often on the upper body, face and arms.
Ask a doctor what is causing your itch on WhatsApp or email team@thewellnesslondon.com.
What else can look like bites
Hives, also called urticaria, cause raised itchy welts that move around and often fade within 24 hours. Eczema causes dry, itchy patches, often in skin creases. Mosquito bites, contact dermatitis and some viral rashes can also look similar. A doctor considers these before settling on a cause.
How is scabies treated
According to the NHS, scabies is treated with a cream or lotion applied over the whole body, including the scalp and face but not around the eyes, repeated 7 days later. Everyone in the household should be treated at the same time, even without symptoms, along with anyone you have had sexual contact with in the past 8 weeks. Bedding and clothing should be washed at 60°C or higher on the first day, and items that cannot be washed sealed in a bag for at least 3 days.
Children under 2 need to see a doctor rather than use pharmacy treatment. See a doctor too if your skin may be infected, if you have eczema, if you have a crusted rash on the elbows, knees, hands or feet, or if itching continues 2 to 4 weeks after treatment.
How are bed bugs and fleas dealt with
Bed bug bites are treated like other bites, with a cool damp cloth, a mild steroid cream and an antihistamine at night, while the bed bugs themselves need a pest control service, as they are very hard to remove yourself. Fleas need treatment for every pet in the house and treatment of the home, with frequent vacuuming.
Why getting the diagnosis right matters
Treating scabies as bed bugs means the mites keep spreading through the household. Treating bed bugs as scabies means weeks of creams that cannot work and bites that keep coming. Getting it right first time saves money, sleep and worry.
What does a private doctor for itchy rashes cost in London
Fees depend on the type of consultation, examination and treatment needed. Confirm the full cost before booking.
Confirm the total consultation fee, any separate prescription fee and pharmacy medicine costs before booking.
- Signature Membership: enquire for current scope, access terms and fees.
- Home visit £450. Hotel visit £495 daytime or £595 evening. Enquire for additional household members, office, weekend and out-of-area fees.
- Skin examination with dermoscopy: enquire for scope and fees.
- In-person consultation with examination: enquire for scope and fees.
- Video consultation with photo review from £150. Prescribing depends on assessment and is not guaranteed. Confirm availability and any separate prescription and pharmacy medicine costs.
Appointments are available 7 days a week by video, at our London clinics, including Marylebone and Belgravia, or at home.
Why people choose The Wellness for itchy rashes
Because a doctor can review your photos by video today.
Because the doctor separates bed bugs, scabies, fleas and other rashes, so the treatment works first time.
Because the whole household can be seen together at home.
Because infection and eczema flares are recognised and treated.
And because prescriptions go to a pharmacy near you.
Related reading
Bed bug bites covers bites and treatment in detail, bed bugs in a London hotel covers what to do as a visitor, online skin doctor covers photo consultations, and acne, rosacea and eczema covers other skin conditions.
Book a video consultation on WhatsApp or call 020 3951 3429.
Frequently asked questions
How do I know if it is bed bugs or scabies
Bed bug bites are on skin uncovered in bed and appear after nights in a particular bed. Scabies itches most at night, affects the finger webs, wrists, waist and groin, and often affects others you live with.
Does scabies look like bed bug bites
They can look similar, but scabies favours the hands, wrists, waist and groin and spreads between people, while bed bug bites are on exposed skin and often in lines or clusters.
Can you get scabies from bed bugs
No. Scabies is caused by mites living in the skin and spreads through close skin contact. Bed bugs are insects that bite and do not cause scabies.
Should everyone in the house be treated for scabies
Yes. According to the NHS, everyone in the household should be treated at the same time, even without symptoms, and treatment is repeated after 7 days.
What do flea bites look like
Small, very itchy spots, often in clusters around the ankles and lower legs, common in homes with cats or dogs.
Can a doctor tell from a photo
Often, yes. At The Wellness a doctor can review photos by video the same day from £150 and arrange an examination if needed.
The Wellness is a doctor-led private healthcare group providing medical care from our London clinics, including Marylebone and Belgravia. All doctors are GMC-registered. Prescriptions are issued only following a consultation and clinical assessment. The Wellness does not provide pest control. In an emergency call 999. This article is general information and not a substitute for medical advice about your own health.
Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
References
- NHS, scabies
- NHS, bedbugs
- US Centers for Disease Control and Prevention, about bed bugs
- Aviva and Direct Line, council pest infestation visits in 2024
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