For children, summer brings the delight of endless hours outdoors, enjoying nature in full flourish. But that natural world includes insect life, some of which bite humans — including our children. While most are harmless, there are several issues that can cause concern. Let’s explore briefly the world of insect bites — when to worry, and when not to.
• Prevention.
Prevention is the best strategy. This does not mean that you should keep your child indoors (outdoor play and nature are good for children), but taking some straightforward measures to prevent bites will go a long way. Long (but light) clothing will minimize the amount of skin exposed to potential biting insects, especially if you tuck the pants legs into socks to prevent insects from making their way up legs. Hats — and for babies, mosquito netting over a stroller or carrier — can also help.
Insect repellents are safe and effective for children over 2 months old. Although there is limited evidence that “natural” repellents (such as citronella and other essential oils) have some effectiveness, the best results have been found from those containing DEET or picaridin. DEET lasts about two to five hours (depending on the concentration used — you don’t need more than 30 percent), and picaridin about three to eight hours. Follow the instructions on the packaging carefully to apply it safely and with the best results.
You may hear advice about using garlic, vitamins, ultrasonic devices, repellent wristbands, and other such solutions, but none of these has been shown to be effective. Stick with what works.
• Reactions to bites.
Most issues involving insect bites have to do with reactions to the bites. They can vary from a little bit of redness all the way to severe allergic reactions. It may come as a surprise to learn that health-care providers often can’t tell what kind of insect bit your child based on the appearance of the bite. Even bites by two mosquitoes of the same species can result in two very different reactions. You’ll be relieved to know that much of the time, knowing what insect caused the bite is not important.
Usually, reactions consist of small amounts of redness, swelling and itching. These are harmless and primarily annoying. Sometimes, in a phenomenon known as a large local reaction, the redness and swelling can be a few inches in size. These often occur in the first few hours after a bite, and the concern is often that the bite has become infected. This is unlikely, especially if it itches. It’s unusual for an infection to develop so quickly, particularly spreading evenly in all directions from the bite.
These can be handled via a brief application of ice, topical steroids like 1 percent hydrocortisone (available without a prescription), and oral antihistamines, which can help reduce the itching. The swelling and redness will usually go away without any intervention within three to four days.
• Infections.
Still, infections do happen — either a local bacterial infection or an insect-carried infection. Local infections also present with redness and swelling, but usually develop a day or two after the bite. There is less itching, and there might be a pocket of pus present, which is a sign that an infection is present. There might also be a streak of red heading away from the bite site, rather than an even red circle around that location.
