Jun 30, 10 | Posted by: Kristin Bencik Boudreau, D.O.

Ah, Summer- If only there were no Bugs!

Yeah, the heat is finally on in Milwaukee! Unfortunately, that also means the bugs are out. I just returned from a vacation in Michigan where you couldn’t walk out the door at dusk or dawn without being swarmed by mosquitoes. My kids spent the weekend at the cabin (with the grandparents) and their faces were covered in bites. So, what can you do? Well, common sense things like long sleeve pants and shirts if you are going to be outside at those heavy bug times. Avoid areas with standing water like ponds and pails of water. Insect repellent is highly recommended, not only are those bugs a nuisance, they also can carry diseases like West Nile Virus or get secondarily infected. So, what kind of insect repellent should you use? The AAP recommends an insect repellent with DEET (N,N-diethyl-m-tolamide) be used. I generally recommend one of the family insect repellents, like Off  Skintastics or Cutter Family Repellent. I recommend not exceeding 15% DEET, and generally try and stay in the 10% range. With infants 2 months to 12 months, use 7.5% DEET. Larger amounts of DEET only increase the length of protection, they do not increase the efficacy. With kids, try and spray their clothes heavily, and then lighter on the skin. There are new OFF wipes that allow you to put repellent on the face, just avoid the eyes and mouth. I do not recommend repellent for infants under 2 months- put them in long clothes and spray the stroller and use mosquito netting. After you come inside, wash off the repellent with soap and water. Never use a sunscreen- insect repellent combination, because sunscreen should be reapplied often and that would be too much DEET exposure. Picardin is another repellent that can be used, but not in kids less than 2 years. Products with oil of lemon eucalyptus should not be used in kids younger than 3 years.

Now, you have used the repellent but they still get bit- what do you do? Kids and mosquito bites are always very impressive. Many kids will form a large welt that looks like a hive. These are NOT allergies, but intense local inflammatory reactions. I recommend a topical anti-itch like afterbite or hydrocortisone cream, and oral Benadryl. It is important to monitor the bites. If it appears that the redness is increasing rapidly 2-3 days after the bite or any pus develops in it, bring them in for a check. Bites can get secondarily infected from all the scratching. Also, it is important to check your kids for ticks, especially if they have been playing in wooded areas or high grass. If you see a tick, use tweezers to pull it out and make sure the head comes out. If a target looking lesion appears, please call your doctor.

Have a great summer!

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