BZZZZ…. Swat. 

Missed. 

Ugh, too late. 

Soon, the itching, swelling, and the redness sets in..

Then, the urge to scratch builds until you can’t resist anymore. 

Sweet relief from those nails…

Growing up a stone’s throw from the Wisconsin state border and with a pond in my parent’s backyard, my sister and I joked that our state bird should be the mosquito. 

Mosquito bites reactions are caused by an immune response to mosquito saliva. Some people will develop more significant reactions called large local reactions (sometimes termed “Skeeter Syndrome). These reactions involve a more robust immune system response that causes increased swelling and redness that can last longer than run-of-the-mill bite reactions. 

These responses can evolve over time. For most people, reactions will diminish over the years as the immune system becomes more accustomed to the proteins in the mosquito saliva. 

Thankfully, severe allergies to mosquito bites are rare. Symptoms that would be concerning for a systemic or whole-body allergy include generalized hives or rarely anaphylaxis- a group of symptoms that can include difficulty breathing, swelling, hives, and passing out. 

But what about the more robust, local reactions that so many of us, myself included, struggle with? 

Studies have indicated that those who frequent the outdoors, young children, newcomers or visitors to an area with a different species of mosquitoes may have more robust local reactions. Interestingly those with immune deficiencies may paradoxically have increased reactions too. 

In addition to the systemic reactions which are rare. Scratching mosquito bites can open up the skin to developing a secondary bacterial infection called cellulitis. If this is left untreated it can progress and become dangerous. If swelling, redness, or pain is worsening or enlarging a couple of days after the initial bite and/or if you develop a fever or chills you need to be evaluated.

Prevention of bites is the best treatment but unfortunately, this is not 100% effective. 

Some tips for avoidance:

1. Stay inside around dawn and dust
2.  Minimize standing water around the home
3. Make sure screens on windows and doors are well maintained. 
4. Wear clothing and use camping gear that is made with fabric treated with permethrin.
5. Use effective repellants. DEET and picaridin repellents are the most effective. Of the more natural varieties, citronella and lemon eucalyptus oil may have some effect but are relatively short-acting lasting 20 minutes and 2 hours respectively.  

Ok, it's too late and you have some bites… What can you do to ease the itch? 

1. Over the Counter long-acting antihistamines like loratadine, cetirizine or fexofenadine can help take the edge off. 
2. Topical steroid cream can also help but more often a prescription-strength cream may be much more effective. 
3. Avoiding Benadryl (diphenhydramine) cream as it can commonly cause skin allergy rashes over time.
4. An ice pack can help take the itch away temporarily too. 

Is it worth seeing an allergist/immunologist about my mosquito reactions?

Outside of the most severe, whole body, type reactions, allergists, unfortunately, don’t have much to offer this really frustrating problem. We all wish we did! 

Unfortunately, allergy testing and shots for mosquito bites have not proven to be helpful due to a different mechanism than more typical allergic reactions to pollens, animals, and dust. 

Do you suffer from Skeeter syndrome?