‘Tis the Season for Mosquitoes

It’s been a rainy summer in central North Carolina, and more rain attracts more mosquitoes because of the standing water left behind.  Standing water is a necessary part of the mosquito life cycle.  So, with an influx of mosquitoes in the area, now is a great time to discuss mosquito bites, prevention and treatment.

What happens when a mosquito bites the skin?
When a mosquito bites, the redness and swelling that develop are an inflammatory response to the proteins in the mosquito’s saliva.  You’ll probably get a puffy white bump that turns into a hard red bump, then a blister.  People can have different degrees of reaction, but unless the bump is oozing with puss and you have a fever, it’s not infected.  Typically, mosquito bites do not cause infection.

Who is at risk for a more adverse reaction?
People with immune disorders are more likely to have a severe reaction to mosquito bites.  They can develop hives, fever and even swollen lymph nodes. 

Why should we be concerned about mosquito bites? 
A mosquito can transmit viruses through its bite.  In the United States, this includes West Nile Virus and encephalitis.  Outside of the United States, they can carry dengue fever, yellow fever and malaria.

What’s the 4-1-1 on mosquito repellents?
When using a mosquito repellent, spray exposed skin only – not skin that is covered by clothing – and be sure to wash with soap and water soon after use.  Three repellents are most effective:

  • DEET – A synthetic compound that is considered safe.  Mosquitoes do not like the smell.  Concentration is equal to efficacy.  For a good, lasting result, choose a repellent containing 10 to 30 percent DEET.  According to the American Academy of Pediatrics, this is also safe for kids age 2 to 12 with a maximum application of three times per day (less than 2 years old, one time per day).  You can apply repellent with DEET to children as young as 2 to 3 months.
  • Picaridin – An insect repellent that appears to prevent the mosquito from finding its host.  The same DEET application rules apply, except do not use Picaridin on children under the age of 3.
  • Oil of Lemon Eucalyptus – This oil contains a chemical that repels mosquitoes.  It is less potent than DEET and picaridin, and does not last as long after applied.  Do not use on children under 3.

Additionally, permethrin is a repellent and insecticide used on clothing and equipment, such as a camping tent.  Some clothing brands, especially those that sell outdoor gear, already contain permethrin – just read the label.

What are some other methods of prevention?
Wear long sleeves, long pants, socks, and a hat with neck and ear protection.  Light colors also tend to keep mosquitoes away.  Around your home, get rid of standing water – unclog gutters regularly, empty kiddie pools, and change bird bath water at least two times per week.

How can we treat mosquito bites?
Most bites can be treated topically, with calamine lotion, over-the-counter hydrocortisone cream and/or cold packs.  Only use oral medications if your bite is more severe, for example, diphenhydramine (Benadryl®), chlorpheniramine, loratadine (Claritin®) or cetirizine (Zyrtec®).  However, beware of potential side effects, such as drowsiness, by reading the labels carefully.  Call your doctor immediately if your bite is oozing puss and/or results in a fever.

Dr. Michele Casey is the director of Primary Care for WakeMed Physician Practices, a primary care physician at Wake Specialty Physicians – Falls Pointe Medical Group and a Fellow of the Academy of Wilderness Medicine.

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