Dr. Greene’s Answer:
Many kids (including my daughter Claire) develop large local reactions to mosquito bites – charmingly called Skeeter Syndrome. It’s a reaction to proteins in mosquitos’ saliva. There’s usually some reaction within hours of the bite, which progresses over 8 to 12 hours or more, and then disappears within 3 to 10 days. The reactions can be quite dramatic, and occasionally even blister or bruise; however, thankfully they rarely become infected or cause serious problems.
The most common age for reactions to start is somewhere between age 2 and age 4, and (good news!) once it develops, most kids only have this for a few summers before the reactions disappear. It takes a few extra years to go away for kids who live in Alaska, northern Canada, and the Nordic countries.
In the meantime, the keys are preventing mosquito bites and dealing with bites that do occur.
New Mosquito Bite Prevention
For prevention, there is an exciting repellant created by the CDC and registered with the EPA in August 2020 – the first new, effective treatment in over a decade. It’s as effective as DEET or other strong repellants, but safe enough to drink! The active ingredient was isolated from cedar (the Alaskan Yellow Cedar. Think Grandma’s cedar chest keeping her clothes safe from moths). It’s also found in grapefruit zest and is used in our food to impart the aroma and taste of grapefruit. The active ingredient is called nootkatone, after the scientific name for the cedar. It’s effective against ticks, bedbugs, and other biting insects, in addition to mosquitos. I’m eagerly awaiting products containing nootkatone to appear on the market.
As we await the exciting newcomer, my favorite repellants are DEET-free and use picaridin as the active ingredient. Picaridin is a compound similar to that found naturally in black pepper. I prefer using one with 20% picaridin — long-lasting, at least as effective as DEET, and without the safety concerns. Two brands that meet these criteria are Natrapel and Sawyer.
Natrapel has been consistently listed as a top recommended natural insect repellent by Consumer Reports for many years. It is widely available and comes in a couple of different forms including wipes and sprays.
Oil of lemon eucalyptus is another effective ingredient (like that found in Repel Plant-Based Lemon Eucalyptus Natural Insect Repellent). The ingredient also goes by the less memorable name PMD (P-methane-3,8-diol). It can be as effective as DEET, but only lasts 2-5 hours.
Many mosquitoes bite most actively at dawn and dusk and especially near wetlands or grass. If your son tends to get large reactions to bites, try timing your outdoor activities to avoid dawn and dusk. This can make a big difference in the number of bites he may get.
In some regions, other environmental control measures make sense, including mosquito nets, treated fabrics, and draining standing water.
When you know your is likely to be bitten, an antihistamine like Claritin or Zyrtec once a day, taken before the bite, can reduce reactions.
Mosquito Bite Treatment
After the bite, an anti-itch cream containing hydrocortisone can have a good benefit-to-risk ratio if he is uncomfortable, as well as an antihistamine like Benadryl or Zyrtec (by mouth, not topically). There are stronger medicines if the bite happens to be in a spot that interferes with vision, eating, drinking, or walking.
It is possible, but not common, for these bites to get infected. You won’t typically see swelling or redness from infection within hours of the bite; and most of these reactions recover on their own without any need for antibiotics. However, if the bite does not progressively improve, or he develops fever, pain, or worsening redness and swelling, a visit to your pediatrician is warranted.
References and Resources
Clinical Pediatric Dermatology. Saunders; 1993.
Nguyen QD et al. Insect repellents: An updated review for the clinician. J Am Acad Dermatol. 2018;S0190-9622(18)32824-X 2018.
28 CommentsAdd a Comment
I am 69 years old from South Louisiana, mosquito country. I had the insects enter my house recently and my back and butt are covered. A head doctor put me on an antipsychotic (I am not and never been psychotic, just lifelong depressive) for a sleep aid and I reacted with severe hives (Forearm swole to 3 x and turned purple. Itched like hell. Took a week to go away). I got off the bad drug this week. Since then, I developed severe skeeter syndrome. I’ve been unable to sleep or relax for 3 days. Last night I took temazepam (heavy narcotic) and am finally almost human feeling. I used aloe leaves, Cortisone cream, alocane, epson salts baths, showers, rubbing alcohol, and prayer. Nothing worked for a while. Today the screaming itching is less. I feel almost sane. To anyone that must endure this, my deep condolances and more prayer. This is serious shit.
I am so sorry. This sounds horrific.
Thanks for sharing your experiences and may you recover steadily from here.
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.
I was outside for a bit and I got eaten alive by mosquitoes. I told my husband that I’m allergic to mosquito bites and he didn’t believe me until he saw the nickle/quarter sized welts. I’ve been getting them since I was a kid and I still react to the bites to this day. While I’m not enjoying my legs burning and itching, I’m glad I get to say “I told you so” to my husband as I ice my legs and pray.
My name is Arianna and recently I woke up in the middle of the night to see these weird swollen bumps in my arms and hands. Being worried and all I check online to see what type of bed bugs or any type of insect that might have bite me and how to treat it. Turns out that I’m having a “severe allergic reaction” to multiple mosquito bite. However, I’m still worried because the bite itself is huge and does not look good at all.What should I do next?
Hello. I am writing this at 3:36 am. I have had several mosquito bites. My first round of bites, I scraped and itches until the skin broke and I know have scabs. My second round of bites, I basically coated my legs with anti itch bug cream. My 3rd round wasn’t as bad only about 6 bites total. I used the cream but put bandaids over to avoid scratching. Most recently (2 days ago) I went outside in a long sleeved shirt, leggings, socks, and a hat. When I get back inside and check my body for bites, I now have 11 bites on my lower butt cheek/the crease between thigh and butt. Now I am walking around the house with most of my freezers ice down my pants. Please help
Sounds like you need to get out of your current mosquito-rich environment so you can get some relief. Is that possible? Can you go stay with a friend who lives somewhere without mosquitoes?
Hi, I am a 34 year old female, I live in MN, every time I am bitten by a mosquito I develop a circular red rash with raised edges, this one time the circular rash is developing smaller bumps that look like additional bites; may years ago (about 9-10) I was tested positive to lymes, I am cured but ever since mosquito bites are very severe. The itch is severe but not always present, the only times it itches is when the rash expands, currently the bite is about 2 inches in diameter, warm to the touch and the area is also swollen. This has happened in the past and at one point I was seen and referred to rheumatologist, dermatologis and allergist, had all kinds of tests done and none gave me an answer to the reaction, then I learned about skeeter, my question is, is it possible that after a disease such as lymes that the immune system reacts aggressively to foreign bacteria such as bug bites? I was told there were a lot of white blood cells in the biopsy area indicating my immune system was over reacting to something.
your answer is greatly appreciated.
I don’t know if this will help or not, but I have learned from personal experience, that if I can avoid scratching the bite, especially immediately after getting bitten, that my reaction is wayyy less severe and resolves rather quickly. I don’t know why this is, but this has been my recent experience.
Hi I’m 25yrs old and ever since my Bone marrow transplant I’ve been super sensitive to bites, they swell up and make my entire body ache afterwards I drink 3ml of benadryl and put a little on the actual bite and its gone within an hour. I have also tried benadryl insect bite gel and works amazing but burns on site.
I am 53 and last year the huge welts from mosquitos started. I would be happy if mine were the size of the ones on the picture! Some are 3 inches long and an inch wide! Why all of a sudden am I having this reaction? And why am I suddenly a target for mosquitos? Even the spray with deet wont keep the little buggers off me. I used to use a blend of lavender and mint and rarely did I get bit, now it’s like theres a beacon on me! After a few bites I get extremely fatigued too, and allergy meds dont help.
We’re hearing this more and more. I wonder if mosquitos are becoming more potent.
Does anyone reading this have scientific data that might support that theory?
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.
Helpful article. My child has sensitive skin and reacted quite severely to a mosquito bite. As we are an allergy family, I’m wondering if the key would be to lower total histamine load in the body. If you make the body less reactive overall, then I’m certain reactions to insect bites might calm down over time as well. In a way anti-histamines do this, but the goal would be to do this year round, so that by the time you are bit your body is not already in over-reactive mode. Lots of work though as I’ll bet it involves lifestyle changes. As for Canada, I am in Canada and I think the best options would be naturopaths in that they are already specialists in helping people with allergies and digestive problems (often involving allergies). For now I’m just praying my child’s next mosquito bite is not so dramatic, otherwise I think we’re candidates for doing some histamine work. Thank you for the article, it was reassuring.
I’m 65 and think I developed Skeeter Syndrome in just the last few years. I now get bit and the results are horrific, unlike any mild reaction that I used to receive. Now the welts are huge, red, and exceedingly itchy.
I found a scrub that promises to aid in releasing toxins, but I have no great findings yet. Benedryl seems to work well, as well as Calamine lotion for the itch. Still, I’m covered in nasty-looking welts.
Thanks for your comment.
Please come back and let us know how the scrub works. If it’s a winner, we’d like to know the brand.
Its called Technu poison ivy scub. After 3 days of application, it’s okay. It advertises that itching is relieved and is cooling. It does both. I apply in the shower after a wash, and am pretty much itch-free for the day. It leaves a beneficial scrub feeling and psychologically seems right. I don’t want to ever take medication, or in this case, antihistamines.
I don’t think I have poison ivy complications, and I know Skeeter Syndrome is due to proteins, but to me it’s all toxins. The welts MAY be getting smaller.
My reaction to some bites 6-7 years ago took over 2 years to disappear—after the redness went away, there was still a sign. My Dr had given me a steroid at that time. 2-3 years ago, I was a target again. Like this year, welts seemed to come out over days. Many are ¼” and bright red on pale, Celtic skin. Looks amazing!
One calf seems better from the scrub. Fewer and smaller bites. The other looks like I was hit with a shotgun.
Yesterday, I took my daughter to a beach and turned back immediately, almost running to the vehicle. Less than a minute later, she has a huge bump on her eyebrow. It just kept swelling and now she can hardly open her eye. She has been dealing with these abnormal bites since she was less than a year old. Yes, I put repellents on her. I tried a lot of natural remedies because regular bug spray isn’t a good thing to use on a baby or on faces. I used vanilla extract and that seemed to work the best but she still gets attacked. I was ALWAYS outdoors when I was a child and I would have so many bits but I have never seen so many on one child in my life.
Im 13 years old and i was biten by a mosquito, after a few days, the bite actually begins to itch, again after a few days im shocked that i saw my bite is turned into a red bump and many very little red bump is surrounding it, what kind of bite is this?
I’m from Australia and I’ve had this my whole life with no relief (I’m 28 now). Only just realised it was a legit thing and not just my overly-sensitive skin being ridiculous (I also get severe dermatitis and have bad reactions to things like deodorants, perfumes, sunscreen, insecticides, etc.)
Spring is beginning to show up finally and I’m already covered in horrendous bruises, hives and disgusting welts, but now I think I’m going to ask my doctor what I can do.
Nice to know that after nearly three decades of itching I may be able to at least decrease this discomfort.
Any suggestions for people with sensitive skin who cannot use insecticides?
Don’t scratch it spreads proteins, immediately use topical benedryl to stop allergic reaction… reduces itching. Reapply frequently, but do not rub hard. Cover with bandaid in case you forget and scratch. Taking an oral antihistamine like the doc says is good idea. When I was two I got bit near my eye and my whole eye was swollen shut and black and blue. I don’t react quite as bad now but the welts are huge and itchy for weeks… if you don’t deal with it immediately.
Great advice! I’ve recently leaned (after years of suffering) that avoiding to scratch significantly decreases the symptoms.
Are there any Canadian doctors specializing in Skeeter Syndrome? My 9yr old has dealt with this her whole life. Last year she was prescribed a dbl dose of adult Aerius as a daily preventative as well as a Rx steroid cream in case of a bite. Last year it worked. This year we are back to a single bite causing extreme swelling wib blister and oozing, “sympathy bites” all over her body, headaches and lethargy.
Can someone from Canada chime in here?
I would like to know as well please.
My daughter is now 11yrs old and we continue to battle this…. has anyone found a Doctor in Canada that is knowledgeable about this!?!
I m 61 year s old and still swell up like I did when I was a little girl on the farm. Mosquitoes bite’s are the only thing that makes me swell up, what should I do.
I am 43 and have the same reaction. The picture above is exactly what occurs on my skin. I have tried every home remedy and off brand mosquito repellent that is made but the only thing that works is Deet. (Which I hate to use but am sometimes forced to) my husband and I can be standing within inches of each other and I will have 5 million bites and he will have none. I continue to read articles about why some or more desirable to mosquitos then others but there are no clear answers as of yet.
My teenage daughter is going through this too. Every day she gets more bites. She seems to get 10 to 20 a day. Her whole body including face, fingers and toes are affected. Nothing we have tried stops her from being bit. This is the first year she has had ever had mosquito bites, and it’s out of control. She is miserable and I feel so sorry for her. I took her to a doctor and he wanted to biopsy a bite and I didn’t see the need for that. She doesn’t have cancer. I feel so bad for her and I don’t know what to do to help.