Being outside is good for children’s health: Running and playing provides needed physical activity, while time in nature reduces stress and improves mood. Warm weather might mean that your family is hiking, camping or playing in the backyard.
Just remember that you’re sharing the great outdoors with insects that can bite you and ruin all the fun.
“There are two big reasons we encourage parents to take steps to prevent bug bites,” says UNC Health pediatrician Jessica Hart, MD. “First, insect bites are uncomfortable and itchy. Second, insect bites can transmit many illnesses, which is important to keep in mind when you’re traveling or in the summer months when mosquitos and ticks are prevalent.”
You can prevent bug bites by dressing your child in long sleeves and pants, reducing the amount of exposed skin for mosquitos and other biting bugs to find. But when it’s hot outside, long clothes are probably not feasible, leaving insect repellent as a viable option.
Dr. Hart explains what to look for when you’re shopping for a bug spray or lotion for your kids.
Safe and Effective Bug Spray Ingredients
Dr. Hart recommends insect repellents with active ingredients that are registered by the Environmental Protection Agency (EPA). The label should have an EPA registration number, though it may be small.
The most common EPA-approved ingredients are DEET, picaridin and oil of lemon eucalyptus. Note that oil of lemon eucalyptus should not be used on children younger than 3 years old. The others may be used without age restriction but should be used sparingly and in low concentration on children younger than 2. If you have a newborn or infant, you may want to consider other bug-bite prevention methods, such as long sleeves and pants or netting or a screen on a stroller.
The product label will include the concentration of the ingredient, which is an indication of how long the product will protect you. “It’s good to consider the length of time that you need protection and pick the concentration or plan to reapply accordingly,” Dr. Hart says.
The American Academy of Pediatrics offers this guidance:
- DEET: 10 percent concentration is effective for about two hours, and 30 percent protects for five hours. Although a higher percentage typically indicates longer effectiveness, Dr. Hart says there’s no need to go beyond 50 percent DEET, as those formulations have not been shown to extend protection.
- Picaridin: Products with 5 percent protect against bugs for three to four hours, and 20 percent can provide coverage for up to 12 hours.
- Oil of lemon eucalyptus: 8 to 10 percent concentration is effective for two hours, and 30 to 40 percent covers for six hours.
These ingredients repel but don’t kill insects that bite, including mosquitos, ticks, gnats, biting flies, chiggers and fleas. They don’t protect against insects that sting, such as bees or wasps.
Permethrin is an effective way to keep ticks away, but it’s not meant to be used on skin. If your family is camping, it can be sprayed on clothing, sleeping bags and tents.
Some repellents contain natural ingredients, usually essential oils, but these sprays or lotions have not been shown to be as effective as DEET or picaridin.
“Natural products don’t work as well, and they use a lot of oils that can cause skin irritation,” Dr. Hart says. “Products that use sound waves, like wrist bands, are not proven to work either.”
EPA-registered repellents are considered effective and safe, though Dr. Hart understands why a parent might be concerned about using them.
“Whenever we use a chemical or prescribe a medication, there are risks and benefits to consider,” she says. “When you apply these products as directed, the risk of using them is very low, while the benefit is that you’ve reduced the risk of serious illness.”
Tips for Applying Bug Repellent
Dr. Hart recommends buying insect repellent in the form of lotion, stick or unpressurized spray. Avoid aerosol sprays, as children might breathe in some of the droplets, and these products should not be inhaled or swallowed.
If you’re getting ready for an afternoon hike, sunscreen goes on first, then repellent. Use only as much of the bug spray or lotion as is necessary to cover exposed skin. Repellent shouldn’t be applied under clothing or onto cuts or wounds.
“If you’re using a spray, spray it on your own hands first and apply it to the child that way” to ensure proper coverage, Dr. Hart says. “Be careful it doesn’t go in the eyes or mouth.”
Don’t apply bug spray to the front or back of the hands of smaller kids, as they may put their hands in their mouth or on their eyes.
Insect repellent does not need to be reapplied as often as sunscreen; just keep in mind how many hours of protection the product provides and consider whether water or sweat may have washed off the product.
Treating Bug and Tick Bites in Children
After a day of outdoor fun, it’s a good idea to rinse your child’s skin and change their clothes to remove insect repellent, which can help avoid accidental swallowing. That’s also a great time to check for any bites or stings.
“I want to stress the importance of checking the child’s skin once they’re inside,” Dr. Hart says. “Even with insect repellent, ticks can hide in clothes. Check for bites head to toe, including the scalp or hair.”
If you see a tick on your child, Dr. Hart recommends taking a photo of it, which will help doctors identify the type of tick and possible illnesses. You can remove a tick by using tweezers and pulling it straight up off the skin. Then, wash the wound with soap.
“Don’t panic, but reach out to your pediatrician, especially if the exposure is followed by flu-like symptoms, a fever or a rash, or if you see any signs of infection, like redness or draining from the wound,” Dr. Hart says.
If you notice other bites on your child, wash the skin with soap and water. You can put ice on the skin to help with swelling and itching, but before you apply a medication for the first time, you should reach out to your pediatrician.
“It’s not common for kids to have severe reactions to bites, but your pediatrician can help identify the best way to treat them,” Dr. Hart says.
For more recommendations to keep your child healthy and safe, talk to their doctor. Need a doctor? Find one near you.