Tuesday, June 14, 2016

The Right Insect Repellent

Preventing Zika virus infection is to minimize mosquito bites. Common-sense measures to reduce bites include wearing long-sleeved shirts and long pants and keeping windows closed or screened to prevent mosquitoes from entering the home.

EPA-registered mosquito repellents. The Centers for Disease Control and Prevention (CDC) recommends using an Environmental Protection Agency (EPA)-registered mosquito repellent (Table). These repellents have been shown to be safe and effective and also are considered safe in pregnant and breastfeeding women. In addition, most of them are considered safe for children 2 months of age or older. Lemon eucalyptus oil products are typically not recommended for use in children younger than 3 years.[2-4] For children under 2 months of age, an infant carrier can be covered with netting to shield against mosquitoes.[3]In Canada, the use of picaridin products in children under 6 months of age is not recommended.[5]

Table. EPA-Registered Mosquito Repellents

IngredientProduct(s)*Duration of EffectSpecial Considerations/Comments
DEET (N,N-diethyl-meta-toluamide)OFF! Deep Woods® Insect Repellent;
Repel® 100 Insect Repellent
  • 30% concentration should provide protection for 6 hours

  • 20%-23.8% concentration provides 4-5 hours of protection

  • 6.65%-10% concentration provides about 1-3 hours of protection

  • Concentrations over 50% offer no additional benefit

  • Controlled-release products might offer a longer duration of protection even with lower concentrations

Safe for children 2 months of age and older. Children should use products containing 10%-30% DEET concentrations. Do not apply to children's hands or around eyes.
PicaridinAvon Skin-So-Soft™
Bug Guard Plus Picaridin
  • 20% concentration provides protection for up to 7 hours

  • 10% products provide protection for up to 5 hours

Known as icaridin in Canada. Canada recommends against use in children under 6 months.
IR3535 (Ethyl butylacetylaminopropionate)Avon Skin-So-Soft™
Bug Guard Plus IR3535®
  • 7.5% concentration provides about 10-60 minutes of protection

Safe for children 2 months of age and older.
Lemon eucalyptus oil (para-menthane-diol)Cutter® Lemon
Eucalyptus Insect Repellent; Repel®
Lemon Eucalyptus Insect Repellent
  • Protection for up to 2 hours

Lemon eucalyptus oil is not recommended for children younger than 3 years.

*Products are representative examples; this is not a complete list.
Data from Centers for Disease Control and Prevention[2]; Nasci RS, et al[3]; Fradin MS, et al[4]; Government of Canada[5]; Health Canada.[6]

An important caveat in understanding the effectiveness of mosquito repellents is that higher-concentration products are not necessarily more effective; however, higher concentrations typically result in a longer duration of protection. Manufacturers often estimate the protection time provided, but these estimates may not be supported by reliable evidence.

Permethrin is recommended as an insect repellent for application to clothing and gear, such as pants, socks, boots, backpacks, and tents. Permethrin-treated items should retain mosquito repellent properties through several washings.[3] Although approved by the US Food and Drug Administration for topical use as a scabicide, permethrin should not be applied to the skin as an insect repellent.

Natural mosquito repellants. A variety of natural mosquito repellants that are not registered by the EPA are on the market. People often turn to these products with the assumption that they are safer than other products. However, these products may not work as well as EPA-registered products, or they may have unknown safety or effectiveness when applied to the skin. Natural plant oils, such as citronella oil, cedar oil, geranium oil (or geraniol), and lemongrass oil, are not generally recommended for reliable protection against mosquitoes. In fact, a test by Consumer Reports found that products containing one or more of these ingredients provided protection for only up to 1 hour or not at all.[7] Products including vitamin B1 or garlic, wristbands, and ultrasonic devices are also not recommended owing to a lack of supporting evidence.

Application dos and don'ts. To maximize the safe and effective use of repellents:

  • Don't apply repellents underneath clothing or over wounds or irritated skin.

  • Don't spray repellents on the face; instead, spray onto hands and then rub onto the face. Avoid contact with the eyes or mouth.

  • Don't let young children apply repellents.

  • Reapply the repellent if mosquito bites occur after the first application; in some cases, use of a different type of repellent may be needed.

  • Keep in mind that low-concentration repellents (eg, DEET 10%) may only provide protection for 1-2 hours.

    Play outside yet stay protected!

    "One more caveat that I would add is that taking a shower once you have retreated to the indoors is a smart game plan

    as chemicals can cross the skin barrier." 

    #drshawnie #insect_repellents #DEET

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