Mosquito prevention and treatment: A quick guide for families

The Pediatric Insider

© 2017 Roy Benaroch, MD


Mosquitoes are more than an itchy nuisance. Though uncommon, serious diseases such as West Nile Encephalitis and dengue fever can be spread by mosquito bites in the USA. Our newest worry, Zika virus, is especially dangerous to pregnant women and their unborn babies — and there will almost certainly be US cases this summer.  Itchy mosquito bites can be scratched open by children, leading to scabbing, scarring, and the skin infection impetigo. Prevention is the best strategy.

Try to keep your local mosquito population under control by making it more difficult for the insects to breed. Empty any containers of standing water, including tires, empty flowerpots, or birdbaths. Avoid allowing gutters or drainage pipes to hold water. Mosquitoes are “home-bodies”—they don’t typically wander far from their place of birth. So reducing the mosquito population in your own yard can really help.

Most biting mosquitoes are active at dusk, so that’s the most important time to be vigilant with your prevention techniques. Light colored clothing is less attractive to mosquitoes. Though kids won’t want to wear long pants in the summer, keep in mind that skin covered with clothing is protected from biting insects like mosquitoes and ticks. A T-shirt is better than a tank top, and a tank top is better than no shirt at all!

Use a good mosquito repellent. The best-studied and most commonly available active ingredient is DEET. This chemical has been used for decades as an insect repellant and is very safe. Though rare allergies are always possible with any product applied to the skin, almost all children do fine with DEET. Use a concentration of about 10%, which provides effective protection for about two hours. It should be reapplied after swimming. Children who have used DEET (or any other insect repellant) should take a bath or shower at the end of the day.

Other agents that are effective insect repellants are picaridin, oil of lemon eucalyptus, and IR3535 (also known as ethyl butylactylaminopropionate. Tasty!) These are probably not more effective than DEET, but some families prefer them because of their more pleasant smell and feel. Other products, including a variety of botanical ingredients, work for only a very short duration, or not at all. The CDC has extensive info on these products here.

There are also yard sprayers or misters, devices that widely spray repellants or pesticides. I couldn’t find much in the way to independent assessments of these products, but there’s no reason to think they wouldn’t work. Still, I’m leery about the idea of spraying chemicals all over the place, when we know that DEET sprayed on your child is effective and safe for both child and environment.

About “Organic” or “Natural” insecticides or repellants – those are just  marketing words. Organic compounds are no more or less likely to be dangerous to people or the environment than non-organic compounds; likewise, “natural” in no way implies that something is safe or effective (or even “natural” in the sense that most people mean that term.) These words are tossed around as part of the typical salad of meaningless marketing-speak on labels. Ignore them.

There are also devices that act as traps, using chemicals or gas to attract the mosquitoes from your yard. Although I don’t have much independent confirmation that these work, they are probably environmentally friendly and safe.

Some children do seem more attractive to others to mosquitoes, and some children seem to have more exaggerated local reactions with big itchy warm welts. To minimize the reaction to a mosquito bites, follow these steps:

  1. Give an oral antihistamine like Zyrtec or Claritin, or old-school oral Benadryl (do NOT use topical Benadryl. It doesn’t work, and can lead to sensitization and bigger reactions.)
  2. Apply a topical steroid, like OTC hydrocortisone 1%. Your doctor can prescribe a stronger steroid if necessary.
  3. Apply ice or a cool wet washcloth.
  4. Reapply insect repellent so he doesn’t get bitten again.
  5. Have a Popsicle.
  6. Repeat all summer!

Updated and adapted from previous posts. Reduce reuse recycle!

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4 Comments on “Mosquito prevention and treatment: A quick guide for families”

  1. Cara Finn Says:

    Please do not use Oil of Lemon Eucalyptus repellents on children younger than 3. The CDC states that in several places, including on this website (scroll down):

    I work for EPA’s Office of Pesticide Programs. I use DEET and permethrin-treated clothing on my young children to protect against both mosquitoes and ticks, both prevalent in my area. I will not use a product for public health pests that has not been registered with the US EPA, as it has not had to prove efficacy. Products registered with the US EPA have to have efficacy data to support their registration, if they’re for use against public health pests.


  2. Dr. Roy Says:

    Thanks very much for this info!


  3. wzrd1 Says:

    Aedes aegypti is a day biting mosquito. That means that the mosquito is most active during daylight, for approximately two hours after sunrise and several hours before sunset.
    We have that species where I live in NW Louisiana and they’re active in full daylight. To add to my joy, we have a drainage bayou behind the house, which if it hasn’t rained for a while, then goes stagnant and provides an excellent breeding ground for the little buggers.

    I’m with Cara on DEET and permethrin-treated clothing, I used the same precautions while in the military and avoided bites.
    I’ve also noticed that some mosquitoes seem to avoid people who consume significant amounts of garlic, probably due to sulfurous compounds present in perspiration (one can actually smell it in perspiration), but I’d not consider that a reliable solution, as the effect is variable and not all species of mosquito is repelled that way.

    There are treatments for bodies of water one cannot drain, which would either create a bacteria culture that is harmful only to mosquito larvae or several species of freshwater shrimp, which eat mosquito larvae. Both have proved equally effective in reducing mosquito population numbers in many national and state level programs.


  4. Suz Says:

    Maybe this goes without saying, but clothing does not protect the tastiest people from bites. I’ve been bitten through thick wool socks, jeans, t-shirts… Fabric that is thick and does not lie tight against the skin works pretty well, but if you’re wearing yoga pants you might as well be naked.


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