We are in the throes of mosquito season and with concerns about Zika, West Nile Virus and ckikungunya it is a good time to revisit insect repellents. The mosquito threat from Aedes mosquitos is especially relevant in the southern and southeastern parts of the United States as these are the mosquitos which carry both Zika and chikngunya. The Culex mosquito species which carries West Nile Virus has been found in all of the continental United States.
One of the best way to prevent disease is by controlling the mosquito population which means eliminating areas where mosquitoes breed. This means draining standing water!! I find myself outside draining flower pot saucers after watering or an unexpected summer thunderstorm. I am also always changing the dogs water bowl. I am trying to be vigilant about eliminating standing water.
It is also important to try and limit exposure to mosquitos during dusk and dawn which is the prime time for getting bitten, but with that being said, the Aedes mosquitoes seem to be around all day. Wearing protective clothing which is light in color with long sleeves and long pants is helpful, but is hard to do when it is over 100 degrees everyday and your children want to play outside.
So, insect repellents are an important part of protecting your children from bites and possible disease exposure ( although children typically do better with these mosquito born viruses than pregnant women, adults and the elderly). There are many products out there to choose from but the insect repellents with DEET have been studied for the longest period of time.
When picking an insect repellent you want to make sure they have been proven to work (efficacy), they should be non-irritating and non toxic and preferably won’t stain your clothes. Cost is also an important consideration.
DEET has been the most widely used ingredient and has been studied and has good safety and efficacy data. DEET works not only against mosquitoes but also ticks, chiggers, fleas, gnats and some biting flies. Repellents contain anywhere from 5 - 100% DEET, but the AAP recommends that children use products containing up to 30% DEET. There is no evidence that DEET concentrations above 50% provide any greater protection. DEET has also been shown to be safe when used in pregnant women which is particularly important with possible Zika exposure.
Picardin is another repellent that has been widely studied. It comes in concentrations of 5-20% and is odorless, does not damage clothing and has low risk for skin irritation. The AAP recommends using products for children that contain up to 10% picardin.
Oil of eucalyptus has been shown to be effective in preventing mosquito bites but it is not approved for use in children under 3 years of age.
Citronella and other oils have shown very little efficacy against mosquito bites and are not recommended.
So, when choosing a product I would start with a lower DEET or picardin concentration depending on your child’s exposure and go up in concentration as needed. Typically, the higher the concentration of DEET or picardin the longer the protection. As you know, some people seem to be bitten more often than others (all sorts of hypothesis about this) so you may use different products on different family members depending on age, frequency of getting bitten and expected exposure ( i.e.. playing in the yard vs a camping trip).
Once again, start reading the labels and then apply the repellent to skin and clothing. Do not use a combination insect repellent and sunscreen, they should be applied separately. After the kids come in from playing at the end of the day a good bath with soap and water is important to wash off the repellent.