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ASK THE DOCTOR: To DEET or not to DEET?
By DR. JIM MITTERANDO
For The Patriot Ledger

Q Can I use a bug repellant with DEET on my 4-month-old daughter? Is DEET dangerous? What are other alternatives?

A The Centers for Disease Control recommends DEET as the best insect repellant. DEET is safe for infants older than 2 months, children, adults, including pregnant and breastfeeding women.

DEET is a repellant not an insecticide. It is effective against mosquitoes, biting flies, chiggers, fleas, and ticks. DEET has been widely used and tested for more than 50 years. Products containing DEET are very safe when used according to the directions. DEET can be toxic if ingested.

DEET is available in concentrations from 5 percent to 100 percent. Higher concentrations of DEET generally last longer on your skin, but concentrations of more than 50 percent DEET rarely are necessary. Products containing 25 percent DEET (Cutter Backwood or Off! Deep Woods) provide an average of five hours of complete protection from mosquito bites.

Those containing 20 percent DEET provide four hours of protection; 7 percent DEET (Cutter All Family, Cutter Skinsations, Off! Skintastic) provide two hours of protection. Products with 5 percent DEET (Off! Skintastic Family) provide roughly 1½ hours of protection. The American Academy of Pediatrics recommends products up to 30 percent DEET for children. For infants over 2 months use 5 or 7 percent. Infants 2 months or younger should be protected with netting and clothing. Apply DEET or permethrin (Cutter Outdoorsman Gear Guard or Permethrin tick repellant) to the netting or clothing when mosquitoes are quite abundant. Permethrin is an insecticide that kills insects that land on clothes.

When using insect repellant on a child:

  • Apply it to your own hands and then rub on your child.
  • Do not apply repellant to children’s hands since they tend to put their hands in their mouths.
  • Do not allow young children to apply insect repellant to themselves; have an adult do it for them.
  • Keep repellants out of reach of children.

Other tips:

  • Do not apply repellant to skin under clothing.
  • Do not apply DEET to cuts, wounds, irritated or eczematous skin.
  • DEET can damage plastics, synthetic fabrics, leather and painted or varnished materials, so be careful not to get it on such things as eyeglasses, watch crystals, walls or furniture.
  • DEET does not damage nylon or natural fibers, such as cotton or wool.

Good alternatives

Insect repellants that do not contain DEET do not offer the same degree of protection. Non-DEET repellants that are marketed a ‘‘natural’’ or ‘‘herbal’’ have not been as thoroughly studied as DEET, and may not be safer for use on children or pregnant women.

Alternatives to DEET include:

  • 2 percent soybean oil (Biteblocker for kids with soybean oil) provides roughly 1½ hours of complete protection.
  • Citronella products (Herbal Armour or Natrapel) provide 20 minutes of protection
  • Most Skin-So-Soft products only provide maximum protection for 10 minutes.
  • Citronella candles are only somewhat more effective than ordinary candles in reducing mosquito bites and only half as effective as wearing insect repellant.
  • Wristband repellants do not provide protection.
  • Backyard bug zappers are not effective with mosquitos and mostly kill other insects.

Once bitten

Treat insect bites with cortisone creams to decrease inflammation and itch. Oral antihistamines - Claritin, Benadryl, Chlortrimeton and Allegra - can help reduce the itch and swelling. Avoid topical antihistamine (Benadryl) creams and numbing benzocaine sprays and creams because they can cause allergic skin reactions.

Dr. Jim Mitterando is a family doctor at Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.

Readers should send questions to: Ask the Doctor, The Patriot Ledger, P.O. Box 699159, Quincy, MA 02269-9159, or by E-mail to his attention at features@ledger.com.

Questions of general interest will be answered in this column. The information in this column is not intended to diagnose individual conditions, and individual replies are not possible. Readers should see their own doctors about specific problems.