//fpnotebook.com/
Insect Repellent
Aka: Insect Repellent, Mosquito Repellent, Diethyltoluamide, DEET, Citronella Oil, Picaridin
- See Also
- Prevention of Vector-borne Infection
- Vector-Borne Infection
- Pesticide
- Permethrin
- Epidemiology
- DEET used by 200 Million persons worldwide
- Used by 38% of U.S. population
- Only 30 adverse events reported between 1966-1997
- Indications
- Prevention of Vector-borne Infection in endemic areas
- Prevention of Insect Bite
- Mechanism
- DEET concentration above 10% lasts longer, not better
- Insect Repellents work as a chemical barrier
- Block Mosquito's detection of prey
- Adverse Effects (DEET)
- General
- Concentration >15% associated with adverse effects
- Most DEET preparations safe
- Local Effects
- Mild skin irritation
- Corneal irritation
- Mucosal irritation
- Serious effects with excessive use under Occlusion
- Neurologic
- CNS Depression
- Seizures
- Cardiovascular
- Hypotension
- Tachycardia
- Other effects: Gastrointestinal
- Nausea and Vomiting with ingestion
- Efficacy
- DEET is effective against Mosquitoes, ticks, lice, fleas
- Technique
- Apply every 1-2 hours during exposure
- Apply Sunscreen before (under) Insect Repellent
- Do not apply repellent around eyes and mouth
- Concentration up to 30% may be used in pregnancy and over age 2 months
- Preparations
- DEET concentration affects duration of activity, not the effectiveness
- Duration 2 hours: 6% DEET
- Duration 2-3 hours: 10% DEET
- Duration 3-5 hours: 20% DEET
- Duration 5-6 hours: 30% DEET
- DEET concentration above 50% offers no benefit over lower concentration, but raise toxicity risk
- Longest acting and most effective agents
- Ultrathon (34% DEET): 12 hour protection claimed
- Deep Woods Off (23% DEET): 200-360 minutes protection
- Sawyer Controlled Release (20% DEET): 180-325 minutes
- Slowly releases DEET in response to sweating
- Lower toxicity due to slow release
- Off Skintastic (6.6% DEET): 90-170 minutes protection
- Moderate duration of activity and effectiveness
- Avoid combined Insect Repellent with Sunscreen (Sunscreen needs more frequent application)
- Bite Blocker Kids (2% Soybean oil): 16-195 minutes
- Off Kids Skintastic (4.75% DEET): 45-120 minutes
- Skin-So-Soft Bug Guard Plus (7.5% IR3535): 10-60 min
- Shortest duration and minimal activity (<5 to 20 minutes)
- Citronella (avoid; 10% lasts 20 minutes)
- Natrapel
- Herbal Armor
- Green Ban for People
- Buzz Away
- Skin-So-Soft Bug Guard
- Skin-So-Soft Moisturizing Suncare
- Wrist Bands (ineffective, avoid)
- Gone Original Wristband (9.5% DEET)
- Repello Wristband (9.5% DEET)
- Gone Plus Repelling Wristband (Citronella)
- Alternatives to DEET with similar efficacy to DEET 10 to 15%
- Nootkatone
- Pending release in 2022
- Picaridin 7 to 10% (e.g. Cutter Advanced, Natrapel)
- Less irritation and better smell and feel than DEET
- Duration of effect is 2 hours
- Safe in pregnancy and children down to 2 months of age (at concentration 10% or less)
- Lemon Eucalyptus Oil 30% (e.g. Repel Plant Based)
- Do not use in children under age 3 years (not studied)
- Appears as effective as 15% DEET for Mosquito protection, but unclear if it protects against ticks
- Precautions
- Limit DEET concentration to less than 30 to 35%
- CDC recommends DEET 35% for Malaria prevention
- Avoid supplements (e.g. B Vitamins, Garlic) for Insect Bite protection (ineffective)
- Management of toxicity
- Skin Decontamination
- Seizure management with Benzodiazepines
- Supportive management
- References
- (2022) Presc Lett 29(6): 31-2
- (2005) Presc Lett, p. 36
- Fradin (1998) Ann Intern Med 128(11):931-40 [PubMed]
- Fradin (2002) N Engl J Med 347:13-8 [PubMed]