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
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, they progress over 8 to 12 hours or more, and have disappeared within 3 to 10 days. They 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 Lemon Eucalyptus Natural Insect Repellent brand). It can be as effective as DEET, but only lasts 2-5 hours.
There is a gentle herbal product (available at amazon.com Parakito Mosquito Repellent Clip.
There’s an exciting new idea called Kite Patch that’s a 2 inch square patch you stick on a backpack, etc. and makes kids close by invisible to mosquitos. Really cool.
Mosquitos 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.