Q: What are the key things I should look for when choosing a bug repellent?
A: Look beyond the brand name. The key information you want to find on the label is:
Q: What active ingredient stays effective the longest?
A: DEET — in high concentrations (30% or higher) or when used in a controlled-release formula (which typically uses a 30%-35% concentration).
DEET (Diethyl Toluamide) is a chemical. To some people, the thought applying it their skin makes them uneasy. Yet DEET has been in use since 1957 and has been repeatedly tested for toxicity. The Centers for Disease Control and Prevention (CDC) recommends its usage and considers it safe when applied according to label instructions.
DEET is the only active repellent ingredient available currently in high concentrations in the U.S. Why? Only DEET's higher concentrations have been screened extensively for toxicity (a lengthy and expensive process, costing millions). Such data is required by the Environmental Protection Agency, which regulates repellent ingredients in the U.S. Over time, newer repellents will likely be researched more extensively and higher concentrations will become available.
In lower concentrations, active ingredients (DEET included) provide shorter-term effectiveness. The duration of effectiveness will vary by active ingredient.
For example, in an often-cited study published in the New England Journal of Medicine in 2002, DEET at 6.7% was effective for 112 minutes before the first bite was registered. Citronella at 10% yielded a bite after 19.7 minutes. A 2004 study produced similar results.
What does that mean for you? Base your choice on the amount of time you plan to spend outside. If you are planning a vigorous all-day hike, choosing a high-concentration repellent makes sense — you will have less need to reapply the repellent. If you are planning just a short walk or a casual backyard activity, you could choose a low-concentration repellent — usually effective for 1 to 4 hours.
Q: What if I'm heading into a highly bug-infested area?
A: Consider wearing clothing treated with permethrin, an insecticide engineered specifically for fabrics (such as clothing or tents). You can achieve a high level of protection by using both:
Q: How can I best defend myself against West Nile virus and Lyme disease?
A: Here are recommendations from the CDC:
West Nile virus (carried by mosquitoes): Use repellents containing DEET, picaridin or oil of lemon eucalyptus and wear clothing treated with permethrin.
Lyme disease (carried by ticks): Use repellents containing DEET (in 20% or higher concentrations) and wear clothing treated with permethrin.
Q: Wearing repellent on my skin or permethrin-treated clothing is unappealing to me. Am I really at risk if I avoid using such measures?
A: Very likely, yes. West Nile virus has been detected in almost every state, with 4,261 cases (and 174 fatalities) reported in 2006. In 2005, 23,305 cases of Lyme disease were reported in the U.S. With West Nile virus, the number of cases continues to rise and the geographical distribution of the disease now reaches across the continental United States. In 1999, only one state (New York) had reported a human case.
In contrast, the health risks associated with repellents and permethrin, according to health authorities, range from tiny to nonexistent. This is why an agency such as the CDC advocates their use.
"Each year some areas of the U.S. experience intense outbreaks of West Nile virus transmission," says Dr. Emily Zielinkski-Gutierrez, a behavioral scientist with the CDC. "If you hear reports of human cases, infected mosquitoes or dead birds, it makes sense to raise your level of concern and take more precautions.
"Likewise with Lyme disease, if you live on the East Coast or an area of intensive transmission in the upper Midwest, the chance of getting infected is something to take very seriously.
"The risk of some mosquito- or tick-borne disease is present in nearly every state," says Zielinkski-Gutierrez. "Taking a few minutes to apply a repellent can prevent infection with a serious or life-threatening illness. That seems like a pretty reasonable trade-off to me."
Q: How about malaria and international travel?
A: Malaria, also transmitted by mosquitoes, is a serious and potentially fatal disease concern in some countries. To defend yourself against it, the CDC recommends:
The species of mosquito that transmits malaria is more aggressive than North American species, meaning you may need to reapply repellent more often than you would back at home.
Other mosquito-transmitted diseases include yellow fever (for which a vaccine is available; it is required for entry into some countries), dengue fever and Japanese encephalitis, making repellent an important travel accessory. Check for airlines restrictions regarding aerosol containers. For info on your travel location, visit www.cdc.gov/travel.
Q: What are my choices of active ingredients?
| Traditional (DEET, Picaridin, IR 3535) |
Natural (Plant-based formulas) |
| Pros Most effective; longer lasting Long record of safety |
Pros Derived principally from plants Won't damage fabrics or surfaces |
| Cons Chemical-based DEET may impact fabrics or surfaces IR 3535 may impact plastics |
Cons Variable duration of effectiveness Reapplications usually needed |
DEET (N,N-diethyl-3-methylbenzamide, or N,N-diethyl-m-toluamide)
Pros:
Cons:
Picaridin (KBR 3023)
Pros:
Cons:
IR 3535 (3-(N-butyl-N-acetyl)-aminopropionic acid ethyl ester)
Pros:
Cons:
Oil of Lemon Eucalyptus (natural oil is extracted lemon eucalyptus leaves and twigs)
Pros:
Cons:
Citronella (natural oil is derived from dried cultivated grasses)
Pros:
Cons:
Herb-based formulas (ingredients range from soybeans to crushed chrysanthemums)
Pros:
Cons:
Permethrin (a chemical insecticide; applied to clothing either by soaking or spraying)
Pros:
Cons:
Tip: Plan ahead. Apply permethrin to fabric well in advance of a trip and allow it to fully dry before wearing or using it.
Q: How safe is DEET?
Note: DEET and all active ingredients described in this article are registered with the Environmental Protection Agency (EPA). They have been evaluated for safety and, in most cases, efficacy when used according to label instructions. This is a key in appropriate use of insect repellents: Follow label instructions.
Q: Can children safely use DEET and other repellents?
A: According to the CDC: "No definitive studies exist in the scientific literature about what concentration of DEET is safe for children. No serious illness has been linked to the use of DEET in children when used according to manufacturer's recommendations."
Pediatricians typically suggest avoiding the use of repellents on infants younger than 2 months and advise DEET concentrations up to 30 percent. Repellents containing oil of lemon eucalyptus often carry a label warning that they should not be used on children under the age of 3.
Q: Can insect repellent and sunscreen be worn at the same time?
A: Little hard evidence on this topic exists, though it is generally accepted that applying both insect repellent and sunscreen topically (to the skin) will diminish the efficacy of both.
Our advice: Generously apply sunscreen to cool, dry skin 20 to 30 minutes before activity. Wait until insect activity demands repellent, then apply it. A few sunscreen/repellent combos exist.
Q: What do we know about mosquitoes?
A: Here are some interesting facts provided by the nonprofit American Mosquito Control Association:
Q: How do repellents work?
A: Active ingredients in repellents create a vapor barrier at the skin surface that disorients or inhibits mosquitoes. Mosquitoes have chemoreceptors on their antennae that are stimulated by carbon dioxide or lactic acid. These same receptors, it appears, are inhibited by active ingredients such as DEET.
Wearing repellent underneath clothing almost always reduces the efficacy of repellent, since clothing interferes with the vapor barrier repellents attempt to create on skin surfaces.
Q: Should I use lotions or sprays?
A: Sprays may allow active ingredients to evaporate faster than lotions, reducing the duration of their effectiveness. Sprays, though, can be useful when spraying repellents on clothing (if insects are biting you through your shirt, for example). Remember, however, that DEET (but not picaridin) can damage most synthetic fabrics. DEET does not damage cotton, wool or nylon.
Alcohol-based sprays tend to cause skin pores to open wider, possibly allowing more the body to absorb more of the repellent's active ingredient. This may not appeal to those who use a traditional (chemical-based) repellent. Water-based sprays do not have the same effect.
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