Preventing and Treating Severe Mosquito Bites

My three-year-old son has a tendency toward major localized swelling following mosquito bites. I wonder if there is anything I should do to prevent or treat the swelling? Will he outgrow this? No one in our family has allergies, so we are mystified by this situation and worry that we will have to keep him in some kind of mosquito netting for the rest of his life.
New York, NY

Mosquito Bite Reaction

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.

It’s rare to get any whole-body symptoms from this.

The most common age for it to start is somewhere between age 2 and age 4, and (good news!) once it develops, most kids only have this for several more 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.

For prevention my favorite repellant is oil of lemon eucalyptus (like Repel Plant-Based Lemon Eucalyptus Natural Insect Repellent brand). It can be as effective as DEET, but only lasts 2-5 hours.

Natrapel 8 Hour is another DEET-free formula and uses picaridin as its active ingredient. Picaridin is a synthetic compound similar to that found in black pepper. Natrapel was the only DEET-free formula to make Consumer Report’s 2014 list of top five mosquito repellents.

Mosquitoes bite most at dawn and dusk and especially near wetlands or grass. Timing activities outdoors can make a big difference.

When your son is likely to be bitten, a non-sedating antihistamine like Claritin once a day, taken before the bite, can reduce reactions.

After the bite, an anti-itch cream containing hydrocortisone can have a good benefit-to-risk ratio if he is uncomfortable, or a stronger antihistamine like Benadryl (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.

These bites can get infected – but you won’t see swelling or redness from infection within hours of the bite, so only suspect this if it is not progressing on schedule or he has other symptoms. Most of these large reactions never require antibiotics.

Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. Lynn

    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.

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  2. Tracie Fuchs

    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.

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  3. Kathryn Jones

    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.

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    • Alan Greene

      Quite agree – mosquito nets are a powerful way to prevent bites.

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