Skeeter syndrome and cellulitis are both skin conditions that share a few similar symptoms. However, their causes are entirely different. Skeeter syndrome is an inflammatory reaction triggered by mosquito bites, and cellulitis is a bacterial skin infection.

Skeeter syndrome primarily affects individuals with a hypersensitivity to mosquito saliva, whereas cellulitis can occur in anyone.

Treatment approaches also vary. Typically, a person can manage skeeter syndrome with antihistamines and topical treatments, but cellulitis typically requires antibiotics to resolve the bacterial infection.

This article provides further insight into whether a skin reaction is skeeter syndrome or cellulitis, looking at each condition’s specific symptoms, causes, and risk factors, and how healthcare professionals diagnose them.

A person rubbing lotion into their legs to help alleviate itching due to Skeeter's syndrome -1.Share on Pinterest
Ziga Plahutar/Getty Images

Skeeter syndrome is a relatively rare inflammatory reaction to a mosquito bite. More specifically, a person experiences a reaction to the proteins in mosquito saliva.

These proteins are antigens, which are markers that tell the body something is foreign. When a person has skeeter syndrome, their body has an exaggerated response to that foreign substance.

After a mosquito bite, a person can develop a small local immunologic response hours after the bite. The reaction peaks at around 24 hours and resolves within a week. A few people will experience a large local allergic reaction with itchy, painful, swollen areas that persist for weeks. This is skeeter syndrome.

Cellulitis is a potentially serious bacterial infection that affects the deeper layers of the skin, causing inflammation, swelling, and tenderness.

Common bacteria that cause cellulitis include Streptococcus pneumoniae (strep) and Staphylococcus aureus (staph).

It is important to monitor any cuts or breaks in the skin for signs of infection and seek medical attention as soon as possible. Without treatment, cellulitis can lead to severe complications, such as amputation, shock, and even death.

There are a few key differences to look for when trying to determine whether a person has skeeter syndrome or cellulitis.

Skeeter syndrome

Symptoms of skeeter syndrome include:

  • a large area of swelling, localized to the area of skin that was bitten
  • skin that is warm to the touch
  • skin inflammation
  • itching
  • pain


Someone with cellulitis may experience:

  • skin inflammation
  • skin that is warm to the touch
  • swelling that expands beyond the initial infection site

The Centers for Disease Control and Prevention (CDC) notes that the skin can appear pitted, similar to an orange. Blisters can also appear on the skin. Cellulitis may lead to systemic symptoms such as fever, chills, and enlarged lymph nodes near the infected area.

Although it can appear anywhere on the body, it most commonly affects the feet and legs.

While both conditions involve skin inflammation, skeeter syndrome results from an allergic response to mosquito saliva, whereas cellulitis stems from bacterial infection.

Skeeter syndrome

Skeeter syndrome is more likely to develop in:

  • children
  • those with a genetic predisposition to being sensitive to mosquito bites
  • those who work outside
  • those with a weakened immune system


Someone may develop cellulitis or be more susceptible to it if they:

  • develop a bacterial infection, such as those due to Streptococcus or Staphylococcus bacteria
  • get breaks, cuts, wounds, or insect bites that allow bacteria to enter
  • have a condition that compromises skin barrier integrity, like eczema or dermatitis
  • have a chronic condition such as diabetes or peripheral vascular disease
  • have a weakened immune system due to medical conditions or immunosuppressive medications
  • have a history of cellulitis episodes
  • are middle-aged or older
  • have obesity or overweight

Diagnosing either condition typically involves a healthcare professional conducting a thorough evaluation of the person’s symptoms and medical history.

Skeeter syndrome

Diagnosing skeeter syndrome relies on a doctor recognizing the characteristic signs and symptoms of an allergic reaction to mosquito saliva.

The doctor will likely start by performing a physical examination of the affected area following the mosquito bites. They may then talk with the person about their medical history, including asking about any previous reactions to mosquito bites.

Skeeter syndrome can be misdiagnosed as bacterial cellulitis. When a diagnosis is unclear, the doctor may try diagnostic tests such as skin prick testing or allergy testing to confirm whether an allergic reaction to mosquito bites is present.

Ruling out other potential causes of skin irritation or infection may be necessary to establish a definitive diagnosis of skeeter syndrome.


Diagnosing cellulitis also relies on recognizing characteristic signs of skin infection.

A person’s healthcare professional will likely perform a physical exam of the affected area to assess the extent and severity of the infection, as well as ask about recent skin injuries or breaks in the skin barrier.

In some cases, healthcare professionals may order additional tests to support the diagnosis or rule out other potential causes of skin inflammation.

The treatment for each condition is outlined below.

Skeeter syndrome

Overall, treating skeeter syndrome involves managing the allergic reaction symptoms.

Examples include:

  • applying anti-inch creams with hydrocortisone or calamine to reduce itching and inflammation
  • taking oral antihistamines such as diphenhydramine (Benadryl) or cetirizine (Zyrtec) that may alleviate itching and other symptoms
  • applying a cold compress to the affected area to reduce swelling and discomfort
  • avoiding scratching, which can worsen symptoms and increase the risk of infection
  • taking oral corticosteroids or applying topical corticosteroid creams, which are typically reserved for severe or lasting cases

Additionally, a person may consider discussing preventive measures against future allergic reactions with their doctor.

Such measures may be as simple as wearing long-sleeved clothing and using insect repellents. Other methods include undergoing allergy testing and treatments to reduce their sensitivity to mosquito saliva.


Healthcare professionals typically prescribe antibiotics to eliminate the bacterial infection causing the cellulitis.

The type of antibiotic and duration of treatment depends on factors such as the bacteria itself, the severity of the infection, and any underlying medical conditions.

However, uncomplicated cases might call for oral antibiotics, while more severe cases may require intravenous antibiotics in a hospital setting.

Completing the full course of antibiotic treatment is critical to eliminating the infection.

A person’s doctor may also recommend supportive measures such as rest, elevation of the affected limb to reduce swelling, and over-the-counter pain relievers to alleviate discomfort.

The outlook for each condition is outlined below.

Skeeter syndrome

The outlook for people with skeeter syndrome is usually positive, and it usually resolves within a week.

A person can usually manage mild to moderate allergic reactions to mosquito bites with anti-itch medications and supportive measures. Severe cases or complications may require medical intervention.


With timely and complete treatment, the outlook for people with cellulitis is generally positive, and complications are uncommon.

However, a person’s outlook depends on factors such as infection severity, underlying medical conditions, and how quickly a person receives treatment.

Without proper care, cellulitis can cause complications, such as:

  • a blood infection (bacteremia)
  • bone infection (osteomyelitis
  • bacterial infection in a joint (suppurative arthritis)
  • swelling of the inner lining of the chambers in the heart (endocarditis)
  • swelling in a vein as a result of a blood clot (thrombophlebitis)

The following are commonly asked questions about skeeter syndrome and cellulitis.

Does a person need antibiotics to treat skeeter syndrome?

Skeeter syndrome itself does not require antibiotics. However, scratching the affected area can lead to cellulitis, which does require antibiotics.

What is a delayed reaction to skeeter syndrome?

Mosquito bites trigger immediate and delayed reactions, along with large local reactions in some people.

Right after a bite, a small bump forms, reaching its peak in about 20–30 minutes. The delayed reaction appears as itchy bumps of similar size, peaking after 24–36 hours and gradually fading over several days.

What are the stages of skeeter syndrome?

There are five stages of skeeter syndrome based on the cumulative number of bites a person experiences in their lifetime.

At stage 1, the first mosquito bite results in a small spot on the skin. At stage 2, subsequent bites only cause a delayed reaction.

At stage 3, more bites lead to both immediate and delayed reactions. At stage 4, additional bites only trigger an immediate reaction.

A person reaches stage 5 with prolonged exposure. Some individuals may not experience immediate or delayed reactions. Stage 5 may indicate potential desensitization to mosquito saliva.

Even so, some research shows significant individual differences in the progression of stages, with some people staying at a particular stage for decades at a time.

Skeeter syndrome and cellulitis share symptoms. However, they differ in their causes. Skeeter syndrome stems from allergic reactions to mosquito bites, whereas cellulitis results from bacterial infection.

While skeeter syndrome affects those sensitive to mosquito saliva, cellulitis can occur in anyone, often requiring antibiotics for treatment.