Mosquito Bites


Dr. Greene, my 8-year-old daughter has had a problem with mosquito bites for as long as I can remember. Our physician hasn’t had any answers or treatment ideas (rather than to stay indoors). When Lauren is first bitten the bite appears normal, but given a few hours it can turn the surrounding area hot, red and the whole area becomes inflamed — at times as big as an orange. She gets a blister where the bite initially took place. She often runs a low grade fever with the bites and develops bruises in the area. Our doctor assures me that it is nothing more than an allergic reaction to mosquitoes, but says there is no treatment. I have heard that taking garlic pills can help repel insects. Insecticides haven’t done much good. What can I do to at least treat her symptoms when bitten? Thanks,
Cynthia Reamers – Douglas, Arizona

Dr. Greene`s Answer:

Cynthia, I now receive many questions each week from around the world. While I can’t possibly answer all of them, each question does make a difference. One of the unforeseen results of this website for me is being able to watch clusters of concerns arise from people who don’t even know each other. This week, I’ve received a flood of questions about mosquito bites. Those fragile little insects can be quite a nuisance. Your daughter Lauren suffers much more than most, and I trust we’ll be able to give her some relief.

Mosquitoes wouldn’t be such a problem if it weren’t for the blood-sucking habits of the females. The males (and often the females) feed on plant nectar, but the females also depend on a blood meal to get the protein they need to mature their eggs, which they then lay on the surface of still water.

Mosquitoes are delicate little insects with long, fragile-looking legs and mouthparts. Appearances deceive, however — the female is equipped with blade-like, piercing mouthparts that enable her to get what she needs for her babies.

Meanwhile, mosquitoes are known to pass blood-borne illnesses from one victim to another. They are a major health hazard and are responsible for the transmission of yellow fever, malaria, dengue fever, encephalitis, and many other serious diseases. In parts of the world where mosquito-transmitted diseases are not common, it is the bite itself which presents the greatest difficulty. More infants and children are bitten by mosquitoes than by any other insect.

When the mosquito stabs her needle-like mouthparts through the skin of her victim, she injects her saliva — teeming with digestive enzymes and anticoagulants. The first time a person is bitten, there is no reaction. With subsequent bites, the person becomes sensitized to the foreign proteins, and small, itchy, red bumps appear about 24 hours later. This is the most common reaction in young children. After many more bites, a pale, swollen hive, or wheal, begins to appear within minutes after a bite — followed by the red bump 24 hours later. This is the most common reaction in older children and adolescents.

With repeated mosquito bites, some people begin to become insensitive again, much as if they had allergy shots. Some older children and adults get no reaction to mosquito bites (unless they go for a long time without being bitten — then the process can start again). Other people, like your daughter Lauren, become increasingly allergic with repeated stings. They can develop blistering, bruised, large inflammatory reactions. For these people, avoiding being bitten is a particularly good idea.

Mosquitoes are attracted to things that remind them of nectar or mammal flesh. When outdoors, wear light clothing that covers most of the body, keeping as much of the skin and hair covered as practical. Avoid bright, floral colors. Khaki, beige, and olive have no particular attraction for mosquitoes. They are also attracted by some body odors, and for this reason they choose some individuals (me!) over others in a crowd. Avoid fragrances in soaps, shampoos, and lotions. All other things being equal, mosquitoes will choose children as their victims rather than adults. Many species of mosquito prefer biting from dusk until dawn. The problem is worse when the weather is hot or humid. Avoid playing outdoors during the peak biting times in your area. It would, of course, also help for one to stay away from still water. People who are highly allergic should avoid vacationing in the Everglades.

The Centers for Disease Control and Prevention (CDC) recommends using an insect repellent on exposed areas of skin. The most effective compounds are DEET (N,N-diethyl meta-toluamide), picaridin, and oil of lemon eucalyptus (Repel). I prefer the safe, non-toxic, plant-based oil of lemon eucalyptus. It does cause irritation if it gets in the eyes, but has otherwise proven safe. It has not been tested, though, on children under age 3. DEET-containing products should not be used on children under 2 months of age. Don’t apply repellents under clothes, or too much may be absorbed. Also, avoid applying repellent to portions of the hands that are likely to come in contact with the eyes and mouth.

30% is the maximum concentration of DEET recommended for infants and children. Lower concentrations have not been shown to be safer. The concentration of an insect repellent affects how long it will last, not how effective it will be when applied.

I prefer gentler insect repellents for children.

Other ingredients, such as IR3535 (Avon-Skin-So-Soft) or combinations of plant oils (Bite Blocker Xtreme or Burt’s Bees All Natural Herbal) can prevent bites, but not as effectively as DEET, picaridin or oil of lemon eucalyptus.

Repellents may not stop mosquitoes from landing — only from biting. If you see mosquitoes on Lauren, the repellents may still be working. If, however, Lauren is being bitten, they are not working.

Some studies suggested that taking thiamine (vitamin B1) 25 mg to 50 mg three times per day was effective in reducing mosquito bites. This safe vitamin was thought to produce a skin odor that is not detectable by humans, but is disagreeable to pregnant mosquitoes (Pediatric Clinics of North America, 16:191, 1969). It seemed to be especially effective for those people with large allergic reactions. Thiamine takes about 2 weeks before the odor fully saturates the skin. Subsequent studies have not found this to be effective. Some say that garlic may work in the same way (except, of course, the odor is detectable by humans), but I have seen no scientific studies supporting this. One recent study was unable to demonstrate that garlic was an effective mosquito repellant (Med Vet Entomol, 2005, 19(1)84-9.)

Once bitten, the mainstays of treatment are cool compresses, antihistamines, anti-itching compounds, and anti-inflammatory medicines. For a cool compress, apply an ice pack wrapped in a towel or soak a washcloth in cold water and press it on the bite. Ask your pharmacist to help you select an appropriate antihistamine for your child. Some are available by prescription only. You might have to balance strength versus drowsy side effects. Zyrtec, a newer antihistamine for children (available over the counter), usually works very well while not being very sedating. Of course, sometimes sedating is not such a bad thing…

The simplest anti-itching compound is a paste made of baking soda and water. Use just enough water to make a sticky paste, and spread it on. Calamine lotion works in a similar way, and usually the effect lasts longer. Other children prefer a menthol lotion such as Sarna. A topical anesthetic containing pramoxine (such as the prescription PrameGel or the over-the-counter Caladryl) can take away the pain and itching.

For the anti-inflammatory part of treatment, ibuprofen (Motrin or Advil) or naproxen (Aleve) can reduce redness, pain, itching, swelling and fever. Topical steroid creams of various strengths can also be useful. Occasionally, reactions to mosquito bites can be severe enough to warrant systemic steroids.

Studies suggest that some natural anti-inflammatory remedies are very effective in some people: oral evening primrose oil (Lancet, 2:1120, 1982) and papaverine (Journal of the American Academy of Dermatology, 13:806, 1985). You might find both of these in a health food store.

Stronger, experimental treatments include thymic hormones, recombinant gamma interferon, ultraviolet radiation, various chemotherapeutic agents, and immunotherapy with mosquito extract (Clinical Pediatric Dermatology, Saunders 1993, Ann Allergy Asthma Immunol, 2007 Sept:99(3):273-80), but I would only consider them if Lauren’s reactions get much worse. Probably they will instead get better over time.

It’s tempting to view mosquitoes as nothing but pests. But as my dear friend Christine Du Bois-Buxbaum reminded me, there are species of fish in the Everglades that need mosquito eggs for their diet. These fish are in turn important to the food chain in their own ways. So, although mosquitoes have been a health problem for centuries, they are also an important part of the Everglades ecosystem and of other natural habitats. Widespread destruction of mosquitoes isn’t necessarily the answer.

Still, buzzing mosquitoes are the bane of warm summer evenings. I’ve given you a lot of different solutions. You won’t need to use them all, but you may need to try several before you find what works best for Lauren. I trust you’ll soon be able to enjoy outdoor time together this summer. And autumn is just around the corner.

Medical Review on: September 18, 2014
About the Author
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Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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Recent Comments

My son also gets immediate swelling after a bite. He knows almost as soon as he is bitten because the skin will start to rise, not in the regular circle shape that my bites do, but in an irregular shaped, usually about the size of a half dollar coin. Within the day it will then blister. The swelling and blistering are so severe that he doesn’t feel well and will generally be out of school for 2-4 days. As a side note, the blisters he gets do leave a mark for weeks after, but they do slowly go away. He has had this since he was 2 and he is 7 years old now. We have talked to pediatricians, primary care doctors, allergist and immunologists and all of the things Dr. Green mentions above are what we arrived at as well and have become our standard of care. The only thing that we have found that actually makes an impact on the severity of the reaction is Apis Mellafica, which is a homeopathic remedy made by Boiron and available at Whole Foods and other natural food stores. A friend recommended this and we honestly wouldn’t have tried it if we hadn’t already tried everything else. If my son takes it immediately after the bite and then 3 times a day until symptoms are gone, it eliminates the blistering and reduces the swelling.

Whenever a mosquito bites me it gets swollen, itches then it becomes a sore what should i do, DR. GREENE

DR. GREENE, am a boy of 21 years and have been encountering some little problems in body. When ever a mosquito bites me it gets swollen, itches and then it becomes a SORE and when that happens it a longer time to cure that sore, there are always BLACK SPOT on my body whenever that happens.. Please help me on this or if anybody has a little idea of it, He/she should also help…. THANK YOU

I got out of my pool last night hour later I seen three welts which are the same as mosquito’s I get well this morning those same exact bites which turned to welts have no this morning turned to black and blue marks

weve recently got asian tiger mosquitos the past 2 or 3 years. these are the most vicious annoying things i ever have encountered in my life. they VICIOUSLY attack you and will not stop. they got in my moms house and infest everywhere outside. if your near a bush, flower, or tlal grass you will be mauled. take the dog out, and end up with 10 bites. first my dog was knawing her paws and shaking her head alot then i noticed they were landing on her and biting through her fur while we were outside! then my mom broke out in some serious blistering hives that were white. and lasted forever she was going nuts the drs couldnt do anything. next i got bit the opposite side of my elbow and then twice on my wrist. these developed into a red rash. then i started getting random hives. making the mistake of itching them will make your skin have dark red dots underneath the skin almost like a red tatoo. and it spreads. im getting hives randomly pop up on differnt parts of my body each day. first it was one lower arm. then both lower arms. then chest. then left leg. now upper right arm. and now right lower leg. and a hive just popped up on my pper left arm. its like running its course through my entire body. hot water or water will irratate it. and even when i put the cream on it irratates it at first and flames up. i keep popping benedryl its the only thing besides the cream semi working. when i wake up everything is calmed down a bit but then acts up again. i wont even leave the house because im afraid to get bit again while im in this outbreak. its getting ridiculous everytime i scartch a hive it spread like crazy to that area. i HATE ASIAN TIGER MOSQUITOS!!!

Hey Dr.Green I been bit by a mosquito bite after a few day my arm is big and it a little hot not extreme and it hurt,ache and feel heavy. I was wondering if it was allergys or if I get it check by my doctor.

It’s called skeeter syndrome.

My 8 year old came home from school
today with a mosquito bite the size of a lemon. Is she allergic and that is why the bite is so big. I’d post a picture of her leg but that option is not on here.

My daughter is 5 and when she gets bitten by mosqiutos they turn into blisters. They make it painful for her and they get really big. In somecases they get about 2inchs in diameter. What is making this happen to her?

Hi William,

Dr. Greene wrote about this in an answer to another reader — Preventing and Treating Severe Mosquito Bites.

Hope that helps,
Co-founder & Executive Producer,

My seven year-old son has had severe reactions to mosquito bites since about the time he was 3 or 4. He gets blistering and severe swelling. The swelling can last a week. If there is one mosquito in the house, it will find him. He use to wake up with bites on his face and ears after being the victim of a nigh time mosquito visitors. We bought him a mosquito net for his bed and it has completely eliminated those night time threats.

Dear dr Greene three months before i went to a garden area for picnic unfortunately i bitten by mosquito from over the cloths…it was normal till a hour but after that it shown itself abouts 5×5cm over my hand. I got to doctor and used several creams and anti allergic pills but got uselesdo.once i put out awhite egg also from like there is several eggs inside…i am seeking your help what to do.

I have found toothpaste (not gel) to be effective in calming itchy mosquito bites.

I’ve always been extremely allergic to mosquito bites. When I was little and got bit, my entire limb would swell, get hot, hard and itch like crazy. Once I got bit on my calf and it traveled to the tips of my toes all the way up my thigh. I wasn’t able to wear shoes and my feet would barely fit into slippers. The doctors didn’t have any treatments other than cool compress and anti itch creams. They usually lasted a week. As I’ve grown older, my reactions to the bites have become less and less extreme with normal sizes as big as my palm. Recently, a mosquito found its way into the bedroom and, but the bruising and the hardness of the area is still there. Then 2 nights ago that darned mosquito found its way into the bedroom again and I got bit another 2 times. This time they are blistering, but are no bigger than my pinky nail. Why is my reaction to these bites so different? I’ve never blistered before. How should I treat them?

I’ve always had problems with the little buggers! The latest bites have been the worst yet. One site is bigger than a silver dollar with an angry look to it, and the second one is about the size of a quarter(with the same look and blister)! It’s passed the “itchy” stage and into the painful and stiff stage!

I always find it funny when they tell you to wear more clothes. I’ve been wearing pants and still had my legs covered in bites,even on my rear end and I had on underwear and pants. I don’t know how they do it but they do. They love my legs for some reason. I have 5 awful bites on my thighs right now. They blistered up and are angry looking which I’ve never experienced before. And again I was wearing pants. I had a tank top on but no bites anywhere but my thighs. I hate mosquitoes.

They bite through my clothes too and seem to prefer my legs and feet. I get nasty reactions- huge welps, bruising, rashes- from the bites but mostly on my lower body. The bites on my upper body are itchy but don’t bruise or erupt nearly as much; I have no idea why. I can hardly bare my legs in the summer because they look like I have the pox from all the ugly, angry bites. I wish there was a cure or repellent that worked reliably but nothing so far.

Wow. Those are some determined mosquitos.

This is very interesting as my daughter has been getting these since she was 2 (she is almost 8). They (dr’s) have thought it was a large # of different things before settling on bug bite reaction. She even had a biopsy of one of them She came in from outside with 5 marks on her legs that last night, looked like a normal bug bite. I put some lavender oil on them and decided to just wait and see if maybe she had outgrown this reaction yet. No such luck. Today she has got 5 red, hot, swollen, itchy and painful hard lumps with blisters in the center, of varying sizes on her legs. 2 years ago she was given Fluocinonide ointment and based on last year and part of the year before, it seems to limit the swelling and blister phases if applied right away. But they last forever and leave discolorations that take months to completely fade. I feel so bad for her. We currently live in Virginia (near the Dismal swamp) but they manage to control the mosquitos somewhat, I am nervous about a year from now when we will be back to living in Maine. Ugh.

After much research I now find I am the expert on mosquito bite responses…never had a problem until suddenly 3 years ago the extreme reaction at age 67 began.

I have been diagnosed and treated for Wells’ Syndrome, 4 dermatologists, and one allergist…to those commented here…the swelling..then the blistering and the horrible itching that lasts for several days…I know what so many are going through.

The place where the bite occurs that sometimes spews serum…is caused by eosinophils that are one of the 5 white blood cells, and they are programmed to rush to the site of inflammation and begin to eat up the offending inflamed cells…that is why there is often a blister, then deep sore and scab that continues to form sometimes again and again and will come off in the shower and reform.

There is new research that the color of the clothing has nothing to do with attracting the mosquitos. The enzyme that a human emits when sweating…lactose, is very much an attractant to the Culex mosquitos which have migrated from tropical areas and are populating the southern US.

From your research, how can people reduce the smell of lactose enzyme? Is it diet related? Or can it be covered with Oil of Lemon Eucalyptus?

Best article I have found on the internet. My granddaughter gets massive blisters and it is actually painful. Caladryl and Fexofenadine works amazingly well. Fexofenadine is not sedating (basically not at all). Claratine and Zyrtex is still sedating even though it claims not to be.

My son is experiencing the same as Lauren and his two. What can I do to stop it from running water and sometimes puss.

From Trinidad

I appreciate the Dr advice but I suffer from the same problem with mosquitos & the only thing that helps me is apple cyder vinegar & lemon juice. Every moring I put two tea spoons of ACV, two table spoons of lemon juice & 2oz of water in a cup mix it & knock it back. Idk why it works, but it does. I went from getting bit 15 times a day to maybe 15 the whole summer. Good luck.

That’s so interesting. I think (reminder, I’m not a doctor) mosquitos are drawn to the odor of some people more than others. When our family goes outdoors two of us are bitten far more than the others. I bet you’re changing your scent, and the mosquitos don’t like it. I’m going to give it a try the next time we’re going camping.

Just this summer I began getting lots of mosquito bites that became inflamed. I can’t even remember the last time I has a mosquito bite which I why I’m assuming I am super allergic to them now. I have gotten at least 10 huge, inflamed mosquito bites in a month and a half… crazy! One even came with a bacterial infection which was treated quickly with antibiotics. My most recent bite is 3.5 inches in DIAMETER… huge, hot, and annoyingly painful! Regular hydrocortisone creams do not work on me any more nor does it cool it… I feel it has irritated it a little more. I’ve found only 2 things that have worked for me as a 26 yr old adult:
1. My good friend introduced me to this thing called Redmond Clay. She applied a thick layer onto a bite on my hand. The bite had my whole hand swollen where you couldn’t see my knuckles. After an hour of applying the clay, the swelling went down drastically (I’d say 90%) cooled the hot inflamed area, and was therefore less painful from the swelling. It supposedly pulls out toxins. You can buy Redmond Clay on Amazon, not sure if they sell in stores. It is magic and carry it with me all the time now! Very good for mommies =]
2. My grandma swear vinegar works for all sorts of things including any kind of bug bites. I’ve read online many say only apple cider vinegar works. I never believed my grandma but I was desperate waiting for the Redmond Clay to arrive. I dunked my swollen hand into a cup of regular white vinegar (didn’t have apple cider vinegar) for a few seconds to minute (keep in as long as you like) and rinsed with cold water. Surprisingly, it helped cool the burning and itching and helped reduce the swelling. Amazing!
So I now alternate dipping bites into vinegar and applying the Redmond Clay. I love using these 2 solutions because they are way more natural than using all those medications and OTC drugs.

I get bites on my legs and i have two right now on my shin on one leg and and one on the side on the other. I’ve gotten them a long time ago andnow they are bruises, small ones. They bother me a lot and it’s so visible I don’t like wearing short pants to school because of them. They look like they have been bumped slightly, like a small scab. The bruise is still there after about 2-3 months. Any remedies that would work for this or am I stuck with it forever?

Whoa…A lot of info here! Thanks.

When I get mosquito bites it forms a wheal. Whether the wheal is popped or not it turns into black crust and gets very itchy. It last for a couple of weeks or a month. Why is that?

My daughter has the same problem as lauren but she is only 3yr old when she
Itches water kind liquid comes out and it takes around 4-5 days to cure just 1 bite its so bad