Is It Safe To Use Bug Spray?

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Tom Collins, MD

Your question:
My daughter is 10 1/2 months old. I'm wondering if it's okay to use bug spray on her (with DEET). Obviously I try as much as possible to keep her in the house but at times I'd like to have that added protection. Is it safe to put this on a child so young?

The pediatrician answers:
What a timely question, and a great chance to review guidelines for insect repellants. Your concerns about DEET are shared by lots of parents and pediatricians.

DEET is a very effective insect repellent, and repels, but does not kill, all insects and many ticks. It is available in many formulations, with concentrations from 5 to 100 percent. It is well absorbed across intact human skin; its penetration is enhanced when it is dissolved in 30 to 40 percent ethanol.

In a 2000 study, Jensen compared 22 percent DEET to other products, including DEET-impregnated wristbands, citronella candles, mosquito smoke coils, an ultraviolet insect-killing grid, a sonic mosquito repellent, and the mosquito plant, Pelargonium citrosum. DEET outperformed all the other tested products, as measured by number of mosquito bites as well as mosquito-landing rates. (The wristbands provided some beneficial effects, but did not protect other areas, such as the face and neck.)

Fradin found, in a 2002 study, that an increase in the concentration of DEET correlated with the duration of repellent effect. 4.75 percent DEET had a mean complete protection time of 88 minutes. 6.65 percent lasted a mean of 112 minutes. 20 percent worked for 234 minutes, and 23.6 percent had a mean protection time of 301 minutes ( range 200-360 minutes).

All of the above implies that DEET is effective but none of it implies that it is danger-free. In 2001 and 2002, there were more than 5,300 annual reports of DEET exposure and subsequent adverse effects. There have been no DEET-associated deaths reported in the last seven years. (These figures from the American Association of Poison Control Centers Toxic Exposure Surveillance System.) So, DEET is effective but needs to be used carefully. The following recommendations are from the American Academy of Pediatrics:

  • DEET should not be used on infants less than two months old.
  • Young children should not apply DEET to themselves.
  • Wear long sleeves and pants where possible, and tuck them in. The repellent can be sprayed on the clothes.
  • Apply DEET sparingly only to exposed skin, and do not apply under clothing.
  • Do not use DEET on the hands of young children. Avoid the eye and mouth areas. (A hat sprayed with DEET might help.)
  • Do not apply DEET over cuts, wounds, or irritated skin, as this could dramatically increase its absorption.
  • Use products with 10 to 30 percent DEET, depending on the length of protection needed. (For example, if only 1-2 hours of protection is needed, a 10 percent product should prove sufficient.)
  • Apply DEET only once a day.
  • Avoid using sprays in enclosed areas or near food.
  • Wash treated skin with soap and water upon returning indoors. Wash treated clothing.
  • Avoid products that combine DEET with sunscreen due to the need for frequent sunscreen application.

    Take a few minutes for some precautions, and enjoy the summer.

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