Writ­ten 5/28/24, Updat­ed 8/19/24

Foreword

Hel­lo! I suf­fer from skeeter syn­drome! I’ve had it since I was a kid, and while mine can get pret­ty bad, my sis­ter has it worse than I do! I’ve had sev­er­al humdingers over the years well into my 20s. Then all of the sud­den in my 30s, they quit pop­ping up as much. In fact, a few years ago, I got — I’m NOT jok­ing — at least 100 mos­qui­to bites from play­ing with my dog at my grand­par­ents’ house with­out bug spray or long cloth­ing and not a sin­gle one of them got larg­er than a dime. They even cleared up with­in 4 days. I thought I was cured at least for the local mos­qui­toes. Leav­ing the area would net me some nasty ones, but none ever larg­er than about 3 inch­es in diam­e­ter. I quit wor­ry­ing about it until May of 2024 when chop­ping down some over­grown tree limbs blessed me with 4 bites from some mys­tery bugs (not ticks). All 4 of them blew up almost instant­ly and proved that I am not immune!

This post is to chron­i­cle my larg­er cas­es so that oth­ers don’t have to feel alone or just to sate some curios­i­ty.

Skeeter Syndrome

What is it?

Accord­ing to The Cleve­land Clin­ic Skeeter syn­drome is “a large local aller­gic reac­tion to mos­qui­to bites marked by sig­nif­i­cant inflam­ma­tion.” It’s a hyper­sen­si­tiv­i­ty reac­tion to the polypep­tides in the female mos­qui­to’s (males don’t bite) sali­va. In short, it’s when your body reacts severe­ly to a bug bite.

Symptoms

Large wheal forms with­in min­utes to hours of con­tact, with heat, swelling, red­ness, itch­ing, and pain that appears sim­i­lar to cel­luli­tis. It often pro­duces blis­ters around the hard bump of the bite site, inflamed lymph nodes, swollen joints, and can induce fevers/malaise. Large lesions may cause move­ment dif­fi­cul­ty.

**Stop read­ing and seek med­ical atten­tion imme­di­ate­ly if you expe­ri­ence dif­fi­cul­ty breath­ing, severe headache, nausea/vomiting, con­fu­sion, or unusu­al mus­cle weak­ness (espe­cial­ly if it’s only on one side of the body)**

Treatment

Prevention

Does it Get Better? Or will it Always Be Like THAT?

It is under­stood that this type of reac­tion hap­pens when they indi­vid­ual comes in con­tact with a species of mos­qui­to that the body has not yet encoun­tered. That may explain why I had a peri­od of time where I was­n’t react­ing heav­i­ly to any­thing local, just out­side of the area.

My Memorable Cases — With Pictures

Stan­dard Process:

1. Ini­tial bite
2. Spread­ing of inflam­ma­tion, pos­si­bly sev­er­al lay­ers of expan­sion (usu­al­ly 2–3 for me)
3. Pro­duc­tion of a small, raised bump that’s insane­ly itchy (inevitably, it pops from fric­tion or just on its own)
4. 24–36 hours: THIS is where if any sign of headache, fever, and malaise occurs, SEEK MEDICAL ATTENTION
5. Lymph nodes may become enlarged and itchy/hot
6. Lesion cycles through weep­ing and hard­en­ing (some­times liq­uid, some­times gooey flu­id)
7. 72 hours: the worst of the inflam­ma­tion and itchiness/pain is gone. Lesion has deflat­ed to a more man­age­able size
8. Day 5: almost for­get about it. Min­i­mal itch­i­ness, flat lesion
9. 3–4 weeks: returns with a vengeance. Goes through the heal­ing process again (inflam­ma­tion, weep­ing, itch­i­ness, mul­ti­ple scabs that shed over and over) for about 2 weeks
10. Cycle repeats for sev­er­al months to years until final­ly the wound dis­ap­pears (I’ve had them around for a few years if I scratch them)

Normal Mosquito Bite Reaction

For Com­par­ison’s Sake

July 2024

*NOTE: Both loca­tions had After Bite admin­is­tered quick­ly after con­tact

Loca­tion: Right Arm

Loca­tion: Back of Thigh

Skeeter Syndrome Cases

June 2013

Loca­tion: Right Cheek

July 2013

Loca­tion: Left Tri­cep

This one was excit­ing because I’d nev­er had any of them get large enough for the ends to touch on the oth­er side of the limb. First time for every­thing! When they get large like this, it not only itch­es, but it hurts. It’s also real­ly heavy and you smack it on every­thing. Prob­a­bly should have seen a med­ical pro­fes­sion­al, but I did­n’t and just like the oth­ers the swelling went down with­in a week

October 2018

Loca­tion: Upper Left Thigh

You can see how raised it got. You can also under­stand why a med­ical pro­fes­sion­al would mis­take it for cel­luli­tis, but it’s not. That will hap­pen, where it rais­es from being flat to the skin. The right image shows the ini­tial bite lesion (red), sec­ondary inflam­ma­tion (blue), and then ter­tiary inflam­ma­tion (yel­low). This par­tic­u­lar bite only expand­ed twice.

May 2024

Loca­tion: Arms

24 Hours

48 Hours

Lines indi­cate growth (black, red, green, then black). Con­tact: ⁵⁄₂₃; Before: ⁵⁄₂₄; After: ⁵⁄₂₅

Up Close of Blis­ter­ing and Weep­ing

The blis­ters are extra itchy and as the cher­ry on top, the heat com­ing from these lesions make it feel like you’re being microwaved over and over again as the skin is so flam­ing hot that it com­bats the cool­er air tem­per­a­ture. If you’re faced with heat whether from out­side or from a hot show­er, it gets even more itchy and painful, mov­ing from itchy to painful as the heat lev­el increas­es.

For this par­tic­u­lar case, they became so unbear­ably itchy that I went to see my PCP who pre­scribed a Medrol dose pack (methyl­pred­nisolone). I think I had a fever by the end of day 2 and over­all malaise which is not some­thing I’ve endured before, and that pushed me to seek help. By the time I got in to see them (72 hours post-con­tact) it was already start­ing to come down. What I did­n’t know at the time, was that brew­ing under­neath and in the same area was my first ever aller­gic reac­tion to poi­son ivy which end­ed up being incred­i­bly bad (that’s a dif­fer­ent post). So, were the two influ­enc­ing each oth­er? I don’t know.

10 Days Since Con­tact

At the 72-hour mark, the bites decreased in size and symp­toms dras­ti­cal­ly. Then again, it might have been because I had a more seri­ous issue to deal with (as you can see), but usu­al­ly after the major inflam­ma­tion goes down, you most­ly for­get that you have them

*Ignore the Poi­son Ivy lesions*

Resurgence/Healing

This is when it start­ed get­ting real­ly itchy, hot, and inflamed again. You can see how it gets red, then starts to bleed, weep (can weep to the point of soak­ing through bandaids), and scab on its own, then the skin starts to peel in lay­ers. Then the cycle keeps repeat­ing with the itch­ing, bleed­ing, scab­bing, peel­ing.

**This is where if you scratch it (because you’re going to want to, it’s so itchy), the cycle will keep going for a very long time, months, even pos­si­bly years. And there’s a high pos­si­bil­i­ty for it to get infect­ed as evi­denced by a red streak/line com­ing from the bite. So, DON’T SCRATCH IT!**

Loca­tion: Left Fore­arm

August 2024

Got this from rak­ing up years of dead leaves. It was the only part of me uncov­ered (fig­ures). Lymph node involve­ment with­in 24 hours, very painful to touch for about 6 days. Dimin­ished and asymp­to­matic by Day 9. Lesion spread behind ear in 72 hours, imped­ing hear­ing by par­tial ear canal occlu­sion due to inflam­ma­tion for 24 hours, con­tin­u­ous weep­ing by Day 5 and also peel­ing. Face lesions usu­al­ly heal quick­ly

The Science Behind Mosquito Bites

SOURCE

Accord­ing to researchers at the Uni­ver­si­ty of Wash­ing­ton:

• Mos­qui­toes can smell CO2 (car­bon diox­ide)
• Once they smell the CO2, then their visu­al sens­es acti­vate (like you smelling the aro­ma of good food while walk­ing down the street and then look­ing to see where it’s com­ing from)
• With­out smelling the CO2, mos­qui­toes don’t care about humans much. It’s only when they catch the scent
• Mos­qui­toes can smell up to 100ft away yet can only see about 20ft
• CO2 can trav­el far dis­tances
• Orange-red col­ors in the skin allow mos­qui­toes to locate a host
• Mos­qui­to detec­tion sys­tem: Smell CO2, look for red col­or, detect heat, is that sweat? Oooo body vapors!
• Study was con­duct­ed on 1.3 mil­lion mos­qui­toes in a large wind tun­nel which allowed for a con­trol­lable envi­ron­ment sim­u­la­tor
• Con­clu­sion: by under­stand­ing mos­qui­to neu­ro­science then humans can turn them­selves vir­tu­al­ly invis­i­ble to mos­qui­toes

SOURCE

Researchers at Johns Hop­kins

Mos­qui­to species: Anophe­les gam­bi­ae (trans­mits malar­ia)

• Mos­qui­toes can dis­crim­i­nate amongst mul­ti­ple peo­ple in an open area
• Despite many dif­fer­ent com­plex odors, some peo­ple real­ly do attract mos­qui­toes more than oth­ers
• Dif­fer­ent con­cen­tra­tions of 15 air­borne com­pounds pro­duced by sub­jects in the study seemed to attract mos­qui­toes more
• Mos­qui­toes real­ly like car­boxylic acid (fat­ty acid class in sweat pro­duced in sebum and also by ben­e­fi­cial microbes on skin that smells like ran­cid but­ter or cheese), and ace­toin (pro­duced by skin microbes)
• There­fore: skin micro­bio­me is impor­tant in attrac­tive­ness to skeeters
• Researchers test­ed 4 soap brands’ abil­i­ty to pre­vent attrac­tion, where 3 of 4 seemed to ampli­fy attrac­tive­ness, but over­all, the results are not straight­for­ward
• All soaps con­tained limonene, a known repel­lant, so the con­clu­sion is that it’s not nec­es­sar­i­ly the brand of soap but the con­cen­tra­tion of ingre­di­ent and how it inter­acts with an indi­vid­u­al’s skin chem­i­cals
• More diverse micro­bio­mes tend to attract mos­qui­toes less than less-diverse micro­bio­mes
• Mos­qui­toes have evolved over time to adapt to human inter­ven­tion as they rely heav­i­ly upon human blood to breed. For exam­ple, to over­come the use of bed nets, they have begun to feed ear­li­er in the day.
• Con­clu­sion: mos­qui­toes have a com­plex sys­tem to iden­ti­fy humans that does­n’t’ rely on just one sig­nal path­way. Each human has a par­tic­u­lar, per­son­al odor and per­haps the key to pre­vent attrac­tion is find­ing what mix of repel­lents is best for the indi­vid­ual. DEET is still the best, and nat­ur­al repel­lents, while they work, are not as effec­tive and require repeat­ed reap­pli­ca­tions