Guide to Insect Repellents in Kids

Children love to play outside, and they should as much as possible. But with playing outside come several risks, especially in the summer, including biting and stinging insects and arachnids such as chiggers and ticks. Most insect bites are mild and simply annoying; however, they can also transmit dangerous diseases including West Nile virus and other forms of encephalitis, Rocky Mountain spotted fever, Lyme disease, and others. There are several ways to protect your child from insect bites, including insect repellents.

General guidelines for insect repellents

• Read and follow the instructions on the label. These chemicals may not be safe when not used correctly.
• Do not use insect repellents in children less than 2 months old.
• Do not use products with more than 30% DEET in children.
• Do not spray it directly on the face, but on the hands first then rub on the face. Avoid the eyes and mouth.
• Use sprays only in an open area. Do not put it on the hands of young children who will put their hands in their mouths.
• Do not let young children apply it themselves and supervise older children. Teens may apply themselves if mature enough.
• Wash repellent (DEET) off when coming inside.
• Do not apply products with Permethrin on the skin but only on clothes.
• Do not use oil of lemon eucalyptus (PMD) on children less than 3 years of age.
• Do not apply to cuts, wounds or irritated skin.
• Insect repellents work on mosquitoes, flies, midges, chiggers and ticks. They will not work on stinging insects such as bees and wasps.
• Avoid combination sunscreen-insect repellent products.

Types of repellents

• DEET is the most effective insect repellent. Products contain between 10% and 30% DEET. A higher percentage will work longer, but there is no benefit beyond 50%, and a concentration more than 30% may not be safe in children. DEET should not be used at all in children less than 2 months old.
• Picaridin was developed as an alternative to DEET and has been in widespread use since 1998; it became available in the U.S. in 2005.  It is very common in Europe and Australia, and the World Health Organization feels it is the most effective at preventing malaria. It keeps the insects from smelling you. It does not have to be washed off may be less toxic than DEET, but may not be as effective or last as long as higher concentrations of DEET. It is also odorless and cleaner feeling.
• Permethrin is a naturally occurring pesticide and repellent. It kills ticks on contact. It is applied to clothes and shoes, not to the skin. It can also be applied to tents, sleeping bags, and other gear. It usually lasts through several washings. Some products are pre-treated with it.
• Oil of lemon eucalyptus (PMD) is also a naturally occurring repellent. In 2005, the CDC stated that this may work as well as DEET, though more studies are needed. It probably works as well as low concentrations of DEET, which means it would probably work for 2-4 hours. It is not labeled for use in children under three.
• Clip-on repellents seem to be somewhat effective.

Things that don’t work

• Wristbands soaked in chemical repellents, ultrasonic devices, and vitamins or garlic, etc. do not work.

Other ways to prevent insect bites

• Wear long pants and long sleeves when possible.
• Avoid brightly colored clothes and any perfumes or hair spray.
• Avoid areas where there are a lot of insects, such as standing water. Mosquitoes are more active in the early morning and evening hours.
• The symptoms of Rocky Mountain spotted fever are fever, a rash all over the body (often including the hands and feet), vomiting and feeling ill. Medical attention is required right away.

Insect Repellent Chart

Repellent	Effectiveness	Duration	Precautions
DEET	Most common, very effective. Look for 10-30% products.	Around 2-5 hours, depending on the concentration used.	Do not use more than 30% in children, or in children less than 2 months old. Do not get in nose or mouth.
Picaridin	Alternative to DEET, effective especially against mosquitoes. Cleaner feeling than DEET.	Around 4-8 hours, depending on concentration.
Oil of lemon eucalyptus	About as effective as 10% DEET.	Around 1-2 hours. Has to be reapplied frequently.	Not labeled for use in children under three.
Permethrin	Highly effective against ticks; kills ticks as well as repelling them.	Lasts a long time, even through washing clothes.	Cannot be used on skin, only on clothing and gear.