“Quick, get the bug spray, I think it went that-a-way!”
This line from a children’s song about bug bites always comes to mind when I hear the first mosquito of the season buzzing around my head as I walk in the Bosque.
While we are fortunate not to have too many mosquitoes around Albuquerque, they are present, and they carry diseases that can be harmful to all of us. The choices of insect repellents are staggering, and it can be difficult to determine which ones are both safe and effective, especially as we become more wary about chemicals in our environment. As a pediatrician, I am frequently faced with the question of what to use for infants and children.
There are three common ingredients that are deemed safe and effective in insect repellents that are approved by the Environmental Protection Agency (EPA). These are DEET, picaridin, and oil of lemon eucalyptus.
DEET offers protection against mosquitoes and is available in different concentrations which indicate how long the spray is effective for. For example, 10% DEET lasts about 2 hours, whereas 30% DEET lasts about 5 hours. Anything over 50% doesn’t offer any more protection. It is important to remember that higher concentrations can lead to skin irritation, although this is rare. For infants 2 months old and up to children under 2 years of age, it is best to apply DEET on the clothes and sparingly on exposed skin.
Picaridin protects against both mosquitoes and ticks and is also available in concentrations that indicate length of protection.
Oil of lemon eucalyptus products protect against mosquitoes, ticks, and other biting insects. It must only be used in children 3 years and older. As with DEET and picaridin, these come in varying concentrations.
With all these repellents, it is important to look for EPA-registered products that have been tested for chemical content and safety.
There are a few important do’s and don’ts when it comes to insect repellent and children:
• DO use a stick, lotion, or unpressurized spray to minimize the chance of getting it in their eyes or airways.
• DO apply it only to the clothes and sparingly to exposed skin and not the skin covered by clothes.
• DO apply a small amount to your hands and then put it on their faces, rather than spraying their faces.
• DO wash infants and children with soap and water when they come indoors and wash clothes before they wear them again.
• DO consider using a mosquito net over strollers and carriers for protection.
• DON’T use repellent on hands since they often put their hands in their eyes and mouth.
• DON’T use combination sunscreen and insect repellents since sunscreen must be reapplied every 2 hours, which leads to too much exposure to the insect repellent.
• DON’T use sprays in unventilated areas.
Natural repellents: Finally, a few words about natural insect repellents. Plant-based products such as citronella, geranium and peppermint, while safe, have not been proven to be effective. They frequently cause skin irritation. In addition, these products are commonly uncontrolled and so may contain higher-than-stated concentrations of ingredients than advertised or ingredients that are unlisted that may cause a serious reaction.
Protection from mosquito bites is an important part of our summer fun. As we have seen most recently with the Zika virus and the West Nile virus, mosquitoes can cause serious illness in addition to the misery of all the itching. So please, keep yourself and loved ones safe, and if you have any questions, please ask your pediatrician!
Alex Cvijanovich is a general pediatrician with Presbyterian Medical Group in Albuquerque.