Summer is already here, and with it the less welcome guests: Mosquitoes. For many parents, the sight of a large, red swelling on their child's skin after a bite can be very stressful. But before panicking, it is important to understand what happens in our children's bodies and how they can be helped.
Mosquito bites are a very common phenomenon in children, and it is important to remember that in most cases they are not dangerous. The familiar reaction, a small swelling, redness and itching, is caused by saliva that the mosquito injects into the skin during the bite.
What happens during the bite?
When the female mosquito bites, she injects a little of her saliva into the skin. The proteins in this saliva are recognized by the body as "invaders" and activate the local immune system in the skin so that substances such as histamine and other inflammatory substances are released, among others, causing itching, redness and swelling to appear. The typical reaction occurs in two stages:
The immediate reaction: Within a few minutes, a small, red swelling appears that is very itchy, and reaches its peak within about 20 minutes.
The delayed reaction: In some children, a later reaction also appears (after about 24 to 36 hours), presenting as a hard bump and sometimes also an itchy blister that can remain for several days.
In certain children, the reaction can be larger and more impressive: Significant swelling, redness, local heat and itching, and sometimes even a body fever or enlargement of nearby glands. This condition is sometimes called Skeeter syndrome – an increased local allergic reaction to a mosquito bite. Important to know: Although the appearance can be frightening and sometimes resembles a skin infection, this reaction usually appears within hours of the bite, whereas a bacterial infection tends to develop more slowly. It usually resolves within 3 to 10 days.
Many parents fear that "the child is dangerously allergic," while in practice a large local reaction to a mosquito bite is usually not dangerous, even if it looks dramatic. Severe general reactions such as a drop in blood pressure, fainting or anaphylaxis following a mosquito bite are very rare (less than 30 cases have been reported worldwide!).
How to treat and soothe?
Prevention is the most important treatment: Long and thin clothing during hours of mosquito activity, screens on the windows, drying up stagnant water sources and the wise use of repellent products suitable for the child's age.
Treating the itch: One can use allergy syrup or pills (second-generation antihistamines) that have been proven to significantly reduce swelling and itching in children.
Local treatment: Ointments containing steroids (with a doctor's prescription) are very effective in soothing the inflammation and itching.
Cooling: Cold compresses can provide immediate relief from the feeling of itching.
When should you consult an allergy doctor?
Although in the absolute majority of cases, mosquito bites are not dangerous, if the child suffers from very large local reactions that disrupt their quality of life, or if there is concern about a multi-system reaction, it is advisable to come for a consultation in order to tailor a personal prevention and treatment plan.
Dr. Anna Brameli is a senior physician at the Institute of Immunology and Allergy at the Schneider Children's Medical Center of the Clalit Group