Biting insects can make children miserable and be worrisome for parents, as well as cause serious illnesses. According to the CDC, insect-borne illnesses are on the rise. Insect repellants don’t kill insects but work by keeping insects away from the person using them like mosquitoes, ticks, fleas, chiggers, and the ever so popular Florida midges known as the No-See-Ums. Remember that repellants are not effective against stinging insects like bees, hornets, or wasps, so don’t forget to update your patient’s Epinephrine prescriptions!
Here are some insect repellants approved by the Environmental Protection Agency (EPA):
- DEET (N,N-diethyl-meta-toluamide) –
- 10% DEET provides protection for about 2 hrs, and 30% DEET protects for about 5 hrs.
- DEET-containing repellents should not be harmful if parents follow directions on the label.
- DEET products can cause skin rashes especially when high concentrations are used, but these reactions are rare.
2. Picaridin – a synthetic compound first made in the 1980s. It was made to resemble the natural compound piperine, which is found in plants that are used to produce black pepper. Picaridin products can be formulated as solids, liquids, sprays, aerosols, or wipes.
3. Permethrin– first registered in 1990 for use as a repellent on clothing by the military. Permethrin 0.5% spray is often used to treat gear (such as boots, pants, socks, and tents). Permethrin-treated clothing provides protection after multiple washings. Although it is indicated for the treatment of lice, Permethrin should not be used directly on skin for the daily prevention of insect bites.
Here are some quick suggestions to share with your patients:
- Use spray repellents in open areas to avoid breathing them in.
- Wash children’s skin with soap and water to remove any repellent when they return indoors and wash their clothing before they wear it again.
- Keep repellents out of young children’s reach to reduce the risk of unintentional swallowing.
- Use mosquito netting over baby carriers or strollers.
- Never spray insect repellent directly onto the face or hands.
- Do not use products that combine DEET with sunscreen. These products can overexpose children to DEET because the sunscreen needs to be reapplied often.
- “Natural” insect-repellent ingredients include citronella, geranium, peppermint and soybean oil. These are deemed safe but have not been approved for effectiveness by the EPA.
- Other products that are NOT proven to be effective against mosquitoes include wristbands soaked in chemical repellents and ultrasonic devices that give off sound waves designed to keep insects away.
Have you ever heard of STARI (southern tick-associated rash illness)?
Like the rash of Lyme disease, STARI has been seen in humans following bites of the lone star tick, Amblyomma americanum. The bite is often described as an expanding “bull’s-eye” lesion that develops around the site of the bite. The rash usually appears within 7 days of being bit and expands to a diameter of 3 inches or more. The rash may be accompanied by fatigue, fever, headache, muscle, and joint pains. Because the cause of STARI is unknown, no diagnostic blood tests have been developed. It is not known whether antibiotic treatment is necessary or beneficial for patients with STARI. Nevertheless, because STARI resembles early Lyme disease patients are often prescribed a course of Doxycycline.
