Skeeter Syndrome: When Mosquito Bites Trigger a Serious Reaction

While most people experience only mild discomfort and itchiness after a mosquito bite, those with skeeter syndrome have a strong allergic reaction, including swelling, redness and intense itchiness that can persist for days or longer. Eli Silver, MD, a pediatric allergy and immunology specialist at University Hospitals, shares more about this relatively rare syndrome and how to recognize, treat and prevent it.

How the Body Reacts to a Mosquito Bite

Skeeter syndrome occurs when the body’s immune system overreacts to mosquito bites. Only female mosquitoes bite people and animals, using the blood to nourish their eggs. When the bite occurs, a small amount of saliva containing a mix of proteins and enzymes is injected into the skin to prevent the blood from clotting.

“In people with skeeter syndrome, the immune system interprets the proteins as harmful, triggering an allergic response that can range from mild to extreme,” says Dr. Silver. “Chemicals like histamines are immediately released to attack the protein, causing swelling, redness and intense itchiness. Instead of a small red bump that fades in a day or two, the bite becomes a large, swollen, intensely itchy area that may feel hot and painful. Rarely, it can cause blisters or bruising if the irritation is not treated properly or if it becomes infected due to persistent scratching,” he adds.

Who’s at Risk for Skeeter Syndrome?

Skeeter syndrome is most common in children due to their immature immune systems and limited prior exposure to mosquitoes. This makes them more susceptible to strong reactions when bitten. “Luckily, as they get older and with long-term exposure, most children will develop a natural desensitization to mosquito saliva,” says Dr. Silver. “In the majority of cases, I just treat the symptoms and, in time, they improve on their own.”

Older adults are less likely to experience the extreme allergic reactions associated with skeeter syndrome due to a lifetime of exposure and a weakened immune system response that often occurs with age.

Tips to Ease Discomfort

To ease the pain and itchiness of skeeter syndrome and prevent more extreme symptoms, Dr. Silver recommends the following:

• Apply ice packs to the bite to reduce swelling and itching.
• Use topical creams like hydrocortisone to reduce itching.
• Try to avoid scratching which can prolong symptoms and lead to infection.

If approved by your doctor or pediatrician, over-the-counter antihistamines like Benadryl can also help manage symptoms. If pain persists, swelling continues to spread for more than 2 days, or you experience other signs of infection such as pus, extreme warmth or a fever, you should be evaluated by a doctor.

Prevention Is the Best Medicine

There’s no guaranteed way to stop skeeter syndrome if you’re highly sensitive to mosquito saliva but avoiding mosquito bites is the best way to prevent complications. Dr. Silver recommends that everyone take the following preventive measures:

• Use insect repellant with DEET or oil of lemon eucalyptus when outside.
• Wear long sleeves, pants and socks in mosquito-heavy areas, especially at dawn and dusk when they’re most active.
• Get rid of standing water around your home where mosquitoes like to breed. Clogged gutters and birdbaths are common problem spots.
• Sleep under a mosquito net when camping.
• Keep a supply of antihistamines and topical creams handy.

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The allergy and immunology specialists at University Hospitals have the advanced training and experience to diagnose and treat a wide range of allergies and immunological disorders, including skeeter syndrome. Comprehensive care is available at convenient locations across Northeast Ohio.