insect repellants

Insect repellants are a feature of life in many areas of the country. Young children often have distressingly large reactions to insect bites; the best treatment is prevention.

Despite some concerns about nervous system toxicity, DEET (diethyltoluamide) is generally regarded as safe in children if used in concentrations below 10%. It is very effective against many types of flying and crawling insects. Products containing less than 10% DEET include

Repel®
Skeedaddle®
OFF! Skintastic for Kids®

Permethrin 0.5% aerosol spray is excellent against ticks. It should be sprayed on the clothing, not the child. Use the spray on the clothing combined with a DEET repellant on your child for very good protection against ticks - a useful fact to know in Lyme disease endemic areas.

Bite Blocker® is a soybean oil product and should be nontoxic. I am not familiar with it and it is too new to have any controlled studies I can find in the medical literature.

Citronella is a natural plant oil which is said to have repellant properties. Citronella products are widely used, but scientific results have been disappointing. It is available as candles for indoor and outdoor use as well as topical skin products such as Avon Skin-do-Soft® (which my US Marine friends at Camp Lejeune used to swear by), Nutrapel®, and Buzz Away®.

Other repellants that have been recommended by the CDC as DEET alternatives include Picaridin (KBR 3023) and oil of lemon eucalyptus (PMD). These are similar in efficacy to DEET. PMD at 30% strength is roughly equivalent to 20% DEET. It requires more frequent reapplication and is not recommended for children under three years old.

One bit of advice about combination sunscreen/repellant products: do not use them. DEET is usually the repellant ingredient; it degrades sunscreen. Also, sunscreen should be reapplied every 1-2 hours. DEET should only be applied once or twice a day.

Children should be washed to remove repellants when they return indoors, and any clothing that has been sprayed should go in the washer before being worn again. Never apply repellants over cuts or scrapes or irritated skin.

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