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
- Oral and topical antihistamines (e.g. loratadine, cetirizine, diphenhydramine, etc.)
- Oral and topical corticosteroids (e.g. prednisone, methylprednisolone, hydrocortisone) for severe cases to reduce inflammation
- Over-the-counter lotions, soaks, and creams (e.g. calamine lotion, aloe gel, oatmeal baths, aluminum acetate, etc.)
- Cold packs
- Pressure (not scratching, just pressure, like tying some cloth around the wound)
- Antibiotics will NOT help an allergic reaction. Only useful if the wound (e.g. by scratching) were opened and became infected
Prevention
- Bug Spray – Off Deep Woods works well for me
- Eliminate Stagnant/Standing Water – You can use the mosquito pellets and/or aeration if you have a pond. Moving water kills mosquito larvae. They only need a little bit of water to reproduce!
- Wear Light Colored Clothing – Mosquitoes can favor certain colors, while not being fans of other colors*
- Wear Long Sleeved Clothes and Closed-Toed Shoes – beware any flappy sleeves or that gap between your shirt and pants!
- Avoid Perfumes
*More on this at the end of the post
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:
- Initial bite
- Spreading of inflammation, possibly several layers of expansion (usually 2-3 for me)
- Production of a small, raised bump that’s insanely itchy (inevitably, it pops from friction or just on its own)
- 24-36 hours: THIS is where if any sign of headache, fever, and malaise occurs, SEEK MEDICAL ATTENTION
- Lymph nodes may become enlarged and itchy/hot
- Lesion cycles through weeping and hardening (sometimes liquid, sometimes gooey fluid)
- 72 hours: the worst of the inflammation and itchiness/pain is gone. Lesion has deflated to a more manageable size
- Day 5: almost forget about it. Minimal itchiness, flat lesion
- 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
- 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
Minutes After Contact
72 Hours
8 Days
Location: Back of Thigh
Minutes After Contact
48 Hours
9 Days
Skeeter Syndrome Cases
June 2013
Location: Right Cheek
Bite on Cheek
Swollen Lymph Node in Neck
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
Day 1 – 1 Hour
Day 2 – 24 Hours
Day 2 – 36 Hours
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
Right Forearm
Left Forearm
Left Tricep
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
20 Days
24 Days
26 Days
28 Days (4 Weeks)
30 Days
35 Days
Day 42 (6 Weeks)
Day 49 (7 Weeks)
Day 105 (3.5 months)
August 2024
Location: Face Next to Ear with Lymph Node Involvement
24 Hours
48 Hours
72 Hours
5 Days
9 Days
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
According to researchers at the University of Washington:
Mosquito species: Aedes aegypti (aka the Yellow Fever Mosquito)
Color Attraction: red, orange, black, and cyan
Color Deterrents: green, purple, blue, and white
- 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
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
