I’m allergic to mosquito bites. The bitten area swells up and becomes itchy. Scratching results in bleeding and later that part becomes dark in colour. I’ve many such scars all over my body. Please help.

Allergic reactions to insect bites, including to mosquitoes, are medically known as papular urticaria. This type differs from common urticaria primarily in shape and duration of the lesions. The usual urticarial lesions which are commonly known as hives appear as circular pale-red coloured, severely itchy patches or raised plaques on different body areas. These lesions usually disappear within 24 hours of their onset; however, new lesions can continue appearing if the exposure to the allergen is not eliminated or the condition remains untreated.

In case of papular urticaria, the lesions are mostly papulo-nodular in shape with a central punctum representing site of the bite. The vigorous scratching of these nodular lesions stimulates the pre-existing inflammation leading to their persistence for longer period, which is true in your case as well.

Part of the first-line treatment of the nodular type of insect bites is use of topical potent steroidal preparations together with oral anti-allergic tablets or syrups.

If there is no improvement in one week, then a short course of oral steroids or treating the individual lesion with intralesional steroidal injections can be considered.

The dark marks on your skin are medically known as post-inflammatory hyperpigmentation. The Asian skin in general and the subcontinental skin in particular, has been seen to be extremely prone to this post-inflammatory sequel.

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Over-the-counter (OTC) skin lightening creams containing hydroquinone can be used as an initial treatment to see the response. In persistent, non-responsive cases, professionally formulated, higher-concentration anti-pigmentation topical treatments usually do the job. However, in rare resistant cases, a suitable chemical peel alone or together with pigment-lightening-lasers can be an effective therapeutic option, depending on assessment ability, experience and skill of your treating dermatologist.

Dr Ikramullah Al Nasir is a Dubai-based dermatologist. Got a problem? Our fantastic panel of renowned experts is available to answer all your questions related to fashion, well-being, nutrition, finance and hypnotherapy. Email your queries to friday@gulfnews.com.