How Parents Can Prevent and Treat Summer Bug Bites
by: Morgan Fowler, RN, MSN, CPNP, guest blogger
If your family is like mine, you spend tons of time outside this time of year. It is our favorite time of year to eat an early dinner and send the kids out to play in the yard until bedtime. But, with an increase in outdoor play, comes an increase in bug bites! The majority of medical questions I receive from my friends and family this time of year are about skin issues secondary to bug bites. How can we prevent them? What can you watch and treat at home? When do you need to seek medical attention? Let’s break it down.
I find myself a little homeless between the worlds of holistic and Western medicine. After a family cancer diagnosis in 2019, I started looking at different chemicals in all of our household items. I looked for more holistic regimens to use on myself and for my children. That being said, I am a strong believer in medicine and the benefits of some medications. To be honest, some of the natural remedies just don’t work as well, and I always consider the risk/benefit of using anything on my children. So, as you read, know that if you fall in either camp, or in-between like me, you are in good company.
The best way to prevent bug bites is to be inside during prime times of day that bugs bite (dawn and dusk) or to cover as much of the skin as possible with airy clothes. However, I have kids who are hot natured, so pants and long sleeves in the heat of North Carolian summers is not an option. So, when looking at bug sprays, what am I looking for? I am looking for the safest option that also works.
How to Evaluate Bug Sprays
There are many bug spray options on the market. The most common chemical bug sprays contain either Deet (Off!, Cutter), Picaridin (other Off!, Ranger Ready, Sawyer), or PMD (Off! Botanicals, Babyganics, Murphys, Repel Lemon) as the active ingredient.
The American Academy of Pediatrics (AAP) states that deet bug sprays are safe in children of all ages, however other countries do not recommend deet sprays until after 6 months of age. Research shows 10-30% deet solutions are safe on infants older than 2 months of age. There isn’t much reputable research on deet sprays younger than 2 months of age.
Picaridin based sprays are often preferred by parents. They are odorless and tend to be less sticky than deet sprays. Along with the positives, you lose some of the efficacy of deet-based sprays.
PMD is the active ingredient oil of lemon eucalyptus. This cannot be used in children younger than 3 years old.
There are A LOT of essential oils based bug sprays on the market to include ones with citronella and botanical oils (cinnamon, peppermint, sandalwood, geranium, and soybean). While these smell nice and are “natural”, they also don’t work as well as the chemical-containing solutions.
Okay, so we have talked about prevention, but what if all of that fails and your kid is dealing with a bite? Let’s get into it.
Understanding Common Bug Bites in Children
The four most common types of bug bites I see in children are mosquito bites, spider bites, red ant bites and tick bites. Across the board, my number one recommendation for all bug bites is to ensure that your child’s nails are kept short and blunt. Why? Because children are master scratchers when they itch. Oftentimes, secondary infections at the site of a bug bite occur because a child has scratched their skin so severely and caused an infection. Bacteria loves to hide under long nails!
Mosquito Bites: Some kids are prone to these bites and some aren’t. The old wives tale is that it is dependent on your blood type, that mosquitoes like certain types more than others or “sweet blood.” Whether that is true or not, I don’t know, but what I do know is that if you spend lots of time outside where I live, you are bound to end up with a few bites.
These bites usually show up as a white bump on the skin with the skin around it being red. They itch terribly! There are some natural remedies for itch such as colloidal oatmeal, which is a very finely blended oatmeal. You can mix with water and lather it on the skin or put in your child’s bath water to help with itch. Application of apple cider vinegar or menthol (mint) oils can also help calm itchy skin, but can also cause rash if your child’s skin is very sensitive. If natural remedies aren’t cutting it, Hydrocortisone 1% is readily available over the counter and can be applied safely twice/day for up to a week to the affected area. There are many different anti-itch creams on the market that contain hydrocortisone 1%. My personal favorite is to mix it with vaseline for moisturization and anti-itch to the area.
2. Spider Bites: These can get a little tricky. MOST bites will heal on their own and you can use the same anti-itch remedies as above to help with discomfort. However, sometimes spider bites can turn into small skin infections. Spider bites often show up as a triangle of puncture marks. They usually become raised and the surrounding skin turns red. If the skin turns red, I recommend outlining the red area with a sharpie and closely watching if the redness spreads.
At the first sign of redness, you can use an over the counter antibiotic ointment such as neosporin. If the redness is getting larger and the skin under the redness is hard, it's time to pack it in and head in to see a professional. Sometimes, infections can occur below the top layers of the skin that topical antibiotics can reach and an oral antibiotic may be needed.
3. Red Ant Bites: Technically, they don’t bite, but they do sting! Kids usually know exactly when the bite occurs. Typical progression of a red ant bite is that it causes a pimple of the skin where the bite occurred, usually about one day after the bite. It will be red and often have a white head on the tip. You can use the same hydrocortisone 1% discussed above to calm down the inflammation. If left alone, these rarely become more serious and need medical attention.
4. Tick Bites: Tick bites can range from harmless to a very serious matter. Ticks can transmit multiple diseases. Typically ticks need to be attached to the skin for a prolonged period of time to spread disease. For Lyme disease, it is thought the tick needs to be attached for 36-48 hours to spread it. For Rocky Mountain Spotted Fever (RMSF), they can transmit in as little as 3-6 hours. In general, if you take a tick off of your child and do not know how long it fed, it may be best to call the triage nurse line at your doctor’s office and follow their guidance. Both Lyme disease and RMSF CAN come with a rash, but not always. If your child had a tick on them in the last month and starts showing signs of illness (fever, fatigue, headache, dizziness), you should have them seen by a provider.
RMSF: The rash typically comes on after other symptoms have already shown up. This rash shows up as small, flat, pink spots on the skin. They usually start on the wrists, forearms and ankles and then spread inward on the body. This rash doesn't itch. These symptoms usually show themselves 1-2 weeks after a tick bite. If this happens, take your child to the doctor immediately for treatment.
Lyme Disease: The rash associated with Lyme disease can show up as a “bullseye.” It is a red, flat rash that has what we call “central clearing” where the skin looks fairly normal in the middle of the red area. The rash can show up anywhere from 3-30 days after a tick bite. This also warrants treatment by a healthcare professional.
As always, you know your child better than anyone in this world, and if your gut is telling you that something isn’t right, it probably isn’t and you should seek medical attention. Bug bites can be scary, but definitely come with the territory of enjoying the outdoors in the summer months. Outdoor play has SO many benefits and, in most cases, outweigh the risk that most bug bites carry. So explore the great outdoors, and I hope this bit of knowledge is helpful to know what you can handle at home vs. what needs to be medically treated by your pediatrician.
Morgan is a mother of three and a pediatric nurse with extensive experience in physician office and emergency room settings. She believes many pediatric visits can be avoided with proper education and she’s on a mission to share her experience to benefit families.
Disclaimer: The information provided on this blog is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Restored is not a medical provider and does not offer medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.