Mosquito bites can lead to more than diseases such as Malaria and Dengue. They can become infected, fester and lead to blood poisoning and cellulitis.

The obvious: I’m not a doctor and this is not medical advice. Just precautions I take based on personal experience. 

Mosquitoes that bite in the night can carry malaria parasites. You can check the CDC website to see if the area you’re travelling to has a risk of malaria, because it’s not an issue everywhere in SE Asia. The same with dengue, which is transmitted from a different kind of mosquito that bites during the daytime (I know…can’t catch a break!).

What you may not be aware of is that in this damp, warm and let’s face it, dirty, environment, minor wounds of all kinds can quickly become infected — faster than you’d imagine. And if that infection isn’t treated and knocked out right away, it can lead to cellulitis and sepsis. This goes for any break in the skin, but applies especially to hands, feet and ankles — as these are regularly exposed to more germs than say, your shoulder or upper thigh.

And guess what? Mosquitoes love to bite your feet and ankles, particularly.

There’s been a huge increase in Dengue Fever this year in Southeast Asia.

Dengue isn’t usually a big concern in Bangkok, but this year there’s been a big upswell and it’s become a real concern. This is also the case in Vietnam, where dengue cases have trebled, causing the government to make a concerted effort toward abatement, and also early diagnosis for those infected. There’s no treatment for dengue, and it can be fatal. Even when it’s not fatal, it’s really a very painful and horrible illness.

Step one: prevention

Obviously, the best thing to do is not get bitten. Let’s face it, this is a nearly impossible task. Even inside my apartment, which has screens on the windows, I still get bitten — in my own house!

Ideally, you don’t let mosquitoes get in your house. Sometimes this is possible, other times it seems not. If they are in your house, sleep under netting. If this is not possible, sleep with a fan blowing right on you. It’s not 100%, but it does seem to help, since it’s harder for them to fly around you with a fan blowing.

When you go out, day or night, it’s best to use a good bug repellent. As much as I hate slathering on pesticide, it’s better than the alternative. I focus especially on my feet (even the bottoms and between toes, if I’m in sandals), ankles and up to my knees. In the evening I try to wear pants or something that provides coverage, but realize mosquitoes can bite right through thin material.

If it’s raining, or likely to, and I’m going out, I take a tube of bug repellent in my pack in case I need to reapply. I use UltraThon. I love this stuff. It goes on easily, a little goes a long way, it works, and it doesn’t smell as strong as some repellents. In the past I’ve tried so many natural, local repellents — stuff made from all kinds of things like lemongrass and citronella. I was absolutely massacred by mosquitoes. I love the idea, but I think some blood types (maybe?) are just tastier to mosquitoes and they’ll risk a little citronella to get at the tasty goodness in my veins. It’s not worth it.

Reality: you’re gonna get bitten

Yep. No matter what, unless you have lead in your blood, you’re going to get bitten. Even taking precautions, I still get bitten. And when I do, I go into Avoid Sepsis mode.

So, this is a bit super human, it’s asking a LOT, I know. But don’t scratch. Not even once. Once you scratch, it just inflames the area and it’s that much harder to get under control. As soon as I notice a bite, I take a deep breath, avoid the urge to touch it (you just want to, reflexively, just a little, just once…don’t), and immediately put some cortisone cream on it. Yep, the old anti-itch. And after that I breathe breathe breathe, and don’t touch it. It’s terrible!

I wash my feet and ankles throughout the day, reapply the anti-itch cream and make sure I don’t break the skin. It’s so weird what can happen to mosquito bites on your feet in this climate! I had a bite on the instep of my foot, and it turned rock hard, swelled to a ridiculous huge lump, was burning hot and bright red! And I didn’t even scratch it! It was really awful. I was really careful about keeping it clean and not scratching it. It took about four days for it to shrink down to a “normal” mosquito bite. Insane.

What if you do break the skin? Be careful not to get cellulitis.

Whether it’s a bug bite or something else, even the smallest break in your skin anywhere on your feet or ankles needs to be carefully tended to and watched. I clean it regularly and use an antibacterial cream. You might use neosporin or something similar. I personally prefer a silver infused ointment instead. At home I always have a liquid colloidal silver in my medicine cabinet, but liquids are hard to travel with, so a silver ointment or gel is the next best.

A great excuse to take really good care of your hands and feet!

Not that you need one, but this is a really good reason to be diligent about grooming and pampering your hands and feet. Dry cracked heels or hands can create openings in your skin that easily get infected in this climate. Hangnails and ripped up cuticles are also infection portals. Your skin is your first line of protection, so keep it in top shape, avoid bug bites, don’t scratch the ones that you do get (so hard, I know) and keep an eye on any wounds or weird happenings below the knees. If you have any signs of infection, take it seriously. It can turn so quickly in this environment, so it’s best to get yourself to a clinic asap.