Mosquito Repellents | A must-have skincare essential for summer

Mosquito repellents work by making us less attractive to mosquitoes. They work by repelling insects, not killing them. There are a number of options available to consider. Read more...

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Topics

• Why do we need insect repellents?

• Which types of bugs do insect repellents repel?

• How do insect repellents work?

• Let's talk insect repellent options. What is available and how do they work?

• Starting with topicals for your skin, what are the ingredients available, how are they used, and are there any risks to using them?

• Are there any foods or drinks in our diet that make us more attractive to mosquitoes?

• Are there other means of protecting from insects that do not require the use of a repellent on our skin?

• Are insect repellents safe to use for children? Are insect repellents safe to use while pregnant?

• Where does insect repellent fit in the steps of my skincare routine?

• Does sunscreen interact with insect repellents?

• Are there other means of protecting from insects that do not require the use of a repellent on our skin?

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Photo: Wix

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Why do we need mosquito repellents?

Repelling insects is not just about the nuisance factor of having them fly or buzz around us when we are trying to enjoy our time outdoors. Some insects can play a role in transmitting disease. These diseases are referred to as vector-borne illnesses. These illnesses are first acquired when insects that take a blood meal to complete their cycle of laying eggs feed on an infected person or mammal. They then acquire the parasite or virus from the infected individual and then land on another unsuspecting animal or human, taking another blood meal while transmitting the disease acquired.

The most common diseases that tend to be targeted by insect repellents are Malaria, Zika virus, West Nile virus, Dengue fever, and Lyme disease.

Video: Techei

Which types of bugs do insect repellents repel?

The use of insect repellents is primarily to prevent insects from biting our skin given the risk of transmitting disease. In fact, the earliest insect repellents, such as DEET, were formulated for the US military to protect military personnel from vector-borne illnesses such as malaria, yellow fever, and dengue.

The primary focus of most repellents from a development perspective was the Aedes aegypti mosquito and the Anopheles mosquito. This particular Aedes species is a known vector of chikungunya, yellow fever, dengue, and Zika virus. The Anopheles is a known vector for a parasite of the Plasmodium genus that can cause malaria.

It has been noted that insect repellents can work against mosquitoes, fleas, ticks, biting flies, and chiggers depending on the concentration.

What makes it challenging for consumers to understand insect repellents is assigning the broad name "insect" to a product that was technically designed to address mosquito-borne illness. We have expanded the concept in recent years given the need to address ticks and other hematophagous bugs (blood-feeding) but the research was specifically focused on mosquitos. The repellents themselves are focused on the olfactory receptors in mosquitos.

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How do insect repellents work?

So it’s true there are people that are just more attractive to mosquitoes than others. I’ve always considered myself a "mosquito magnet" wherever I go. Research seems to suggest that there are a number of factors that can attract these insects that draw them in such as carbon dioxide that is exhaled, body heat, carboxylic acids in our skin, and skin odor. Although some reports have attempted to link blood type (ABO) to the tendency to be bitten, there is little data to support this.

Insect repellents generally work by deterring insects from our skin based on recognizing the scents that they favor and dislike to make them less like to land and bite.

Let's talk insect repellent options. What is available and how do they work?

Insect repellents come in lots of different varieties and forms. It's important to know how each works to find your best option based on intent- is your goal to prevent vector-borne illness or just to get rid of some flying critters in your outdoor space because you find them annoying? You will find topical lotions and sprays for your skin, sprays for your clothing, sprays for your yard, electronic devices, candles, torches, zappers, wearable bands, and more. If I do not cover something, drop me a message and I will update the article!

Starting with topicals for your skin, what are the ingredients available, how are they used, and are there any risks to using them?

The following ingredients are registered with the Environmental Protection Agency (EPA) as safe and effective when used as directed according to the CDC.

Synthetic

• DEET

• Picaridin (known as KBR 3023 and icaridin outside the US)

• IR3535

Natural

• Oil of lemon eucalyptus (OLE) (or synthetic version Para-menthane-diol (PMD))

• Citronella

• 2-undecanone

Ingredient	How it works	Targets	Duration of Action	Risks
DEET	​Interacts with Odorant Receptors on Mosquitos to divert them away	Mosquitoes Biting flies Gnats Chiggers Ticks	5% : 2 hours of protection 10% : 3 hours of protection 15% : 5 hours of protection 30% : 6 hours of protection	Encephalopathy Contact Urticaria Vesiculobullous eruptions at 50 to 70% seen Can damage Vinyl Plastics Acetate Rayon Leather Spandex Risk of increase absorption when used with sunscreen - can increase absorption of both DEET and sunscreen.
Picaridin	Stimulates sensory receptors on Mosquito antennae to make the mosquito not able to detect its host.	Mosquitos Biting flies Chiggers Ticks Fleas	Comparable to DEET depending on concentration 9.3% : 6 hours of protection (80% effectiveness) 19.2% : 9 hours of protection (90% effectiveness) 25% : 5 hours of protection (90% effectiveness)	​​Well tolerated Does not tend to damage fabrics
IR3535	Affects olfactory receptors in mosquitos	​Mosquitos Biting flies Body Lice Fleas Deer Ticks	7.5% to 19.7% protection lasts for about 2 hours	​Well tolerated Eye irritation Can damage fabrics
Oil of lemon eucalyptus (OLE) P-menthane-3,8-diol (PMD) (extract from lemon eucalyptus, Corymbia citriodora)	Unclear mechanism of action Unstable in air and high temperature	​Mosquitos Biting midges Ticks	10% to 40% : comparable to low concentrations of DEET
Citronella (extracted from Cymbopogon nardus)	​Unclear mechanism of action	Mosquitos NOT EFFECTIVE AGAINST: Ticks (*unless combined with thyme oil), fleas, flies and biting midges	0.5% to 20% Up to 2 hours	​Eye irritation Contact dermatitis
Catnip Oil (nepetalactone) Nepeta cataria	​Not Known	Mosquitos Black Flies	7-15% 7 hours
2-undecanone (methyl nonyl ketone) extracted from wild tomato (Lycopersicon hirsutum Dunal f. glabratum C. H. Müll)	​Not Known	Mosquito	​Unclear data on efficacy and duration

Please note hyperlinks link to references for data in the literature.

Are there any foods or drinks in our diet that make us more attractive to mosquitoes?

There is not a lot of research on this topic, however, there are some studies linking some items to making us more attractive to mosquitoes. The food and drink items with hyperlinked studies are below for reference.

• Bananas

• Beer Consumption

Are insect repellents safe to use for children?

Remember that the point of wearing an insect repellent is not just to avoid the nuisance of bites- it is actually to reduce the transmission of illness, some of which can be severe, the benefits of wearing insect repellent outweigh the risks.

As a mom and a Dermatologist, I look at this through the lens of needing an effective product while understanding how these products work and best practices help reduce unnecessary exposure.

Let's review DEET use in children first. DEET gained attention for possible risks associated with absorption leading to possible encephalopathy. There is a study that sought to study if it was the concentration of the DEET in these products or if it was the fact that the product is applied to the skin directly that leads to toxicity. This study found that regardless of strength and duration of exposure the potential for toxicity still exists. It is known that absorption of DEET through the skin can occur and of course, with a smaller body surface area for children, the risk of absorption can be higher. Concentrations of DEET in different formulations vary. Higher concentrations do not protect more, they just allow for a longer duration of action. With all this being said, in the past with fewer options in certain circumstances, it may have been important to still consider use but we have other options now available for consideration. Of note, the American Academy of Pediatrics recommends that the maximum concentration of DEET should not exceed 30% and should not be used in children under the age of 2.

My recommendation for my patients and my own family tends to be the use of Picaridin based on safety and effectiveness.

Are insect repellents safe to use while pregnant?

Pregnancy presents a special challenge for vector-borne illness. Pregnant women are thought to be twice as attractive to mosquitoes compared to the nonpregnant state.

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