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The best way prevent bug bites is to avoid them when you can.

However, this is easier said than done. There are times that the only way to prevent bites in areas with a high concentration of bugs is to use repellent.

What is a repellent?

Insect repellents work by masking the chemicals given off by our bodies that attract biting insects. They don't kill insects but repel them for a certain amount of time. They will deter biting insects such as mosquitos, ticks, chiggers and fleas, but will not deter stinging insects like bees, wasps and hornets.

Repellents can be found in different forms such as aerosols, sprays, sticks, liquids or creams. Though they are generally considered safe to use, they are not recommended for children under the age of 2 months.

Insect Repellent Types

There are many options if insect repellents on the market. The most effective repellents contain one of three active ingredients:

1. DEET (N, N, N-Diethyl-3-methylbenzamide)

Repellents with DEET will usually last about 2 to 5 hours, depending on the concentration. These are considered the best repellents for biting insects and have been shown to be safe for use since it was made available to the public in 1957. Repellents typically contain concentrations of DEET ranging from 10-30% or more. The higher the percentage of DEET, the longer the protection — up 30%. Greater than 30% DEET has shown no additional length of protection.

The American Academy of Pediatrics recommends that children use no more than a 30% concentration of DEET and children younger than 2 months should not use at all.

2. Picaridin

Repellents with Picaridin usually last about 3 to 8 hours, depending on the concentration. Picaridin is a compound made to resemble the natural properties of piperine which is found in plants that are used to produce black pepper. Picaridin has been used as a repellent in Europe and Australia since 1998, but was only made available in the US in 2005. Picaridin is non-greasy and odorless, differing from DEET.

Like DEET, picaridin is sold in percentages. Concentrations of 5-10% picaridin lasted a couple hours. A concentration around 20% lasts 4-5 hours and concentrations of 50% or more lasted only marginally longer. There are slow release formulas that can extend protection to 8 hours or more.

3. Essential Oils

Essential oils are found in plants such as citronella , cedar, eucalyptus and soybean. They usually last less than 2 hours.

Along with the CDC's approval of picaridin for use as a repellent in 2005, repellents made with oil of lemon eucalyptus or 2% soybean oil were also approved. Oil of lemon eucalyptus should not be used on children under 3 years of age.

The essential oils have been shown to be as effective as about a 10% concentration of DEET lasting about 2 hours. These are considered safe and effective, but more long term studies need to be done to be proven how well they repel ticks.

Tick Clothing Repellent

To repel and kill ticks, a chemical repellent with permethrin was developed. Permethrin kills ticks on contact. It should never be applied to skin and should only be applied to clothing or things like tents and sleeping bags. Permethrin can last on clothing after several washings.

Repellent Dos and Don'ts

Follow these dos and don'ts to use insect repellent safely.

Do:

  • Read and follow the repellent instructions closely and help children apply safely.
  • Spray in open areas to avoid breathing in repellents.
  • Apply repellent to the outside of your child's clothing and exposed skin using just enough to cover the areas. Using more repellent doesn't make it more effective. Re-apply only if necessary.
  • Wash your child's skin with soap and water when they come in and wash clothing before wearing again.

Don't:

  • Use repellents on children younger than 2 months.
  • Use oil of lemon eucalyptus on children under age 3 years.
  • Spray around foods.
  • Spray repellent in children's faces. First spray the repellent on your hands and then apply to the face, avoiding the eyes and mouth.
  • Spray permethrin-containing products on the skin.
  • Apply repellents to cuts, wounds, irritated, or sunburned skin.

Sunscreen and DEET Usage

Apply sunscreen 20 minutes before applying any repellent. Don't use products that combine DEET repellent and sunscreen. These products can make the sun protection factor (SPF) less effective, and you'll need to apply sunscreen more often than the repellent. Instead opt for applying sunscreen and repellents separately.

Repellents That Don't Work

That are many items available on the market that don't do what they claim. Save your money and avoid these items:

  • Backyard bug zappers (they may actually attract insects)
  • Ultrasonic devices that give off soundwaves to keep insects away
  • Bird or bat houses
  • Wristbands soaked in repellents
  • Garlic or vitamin B1 capsules taken by mouth

Repellent Reactions

If you suspect you or your child is having a reaction like a rash to a repellent, stop using the repellent and wash the skin with soap and water. Call your child's doctor or Poison Control at 1-800-222-1222. If you go to your child's doctor, be sure to take the repellent with you.

Margo Anderson-Fowler, MD

Dr. Anderson-Fowler enjoys caring for patients of all ages. She has a special interest in the Mind/Body/Spirit connection for health. She tries to understand her patients' family dynamics and how this may affect their health. She feels a physician should be totally engaged with the patient and see him or her as an individual. She believes every person just wants to be heard so she listens carefully to her patients' concerns and tries to offer them the best care possible so they can reach thei ...

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