Fort Worth, Texas,
16:40 PM

The deets on DEET from a pediatrician

Let's learn something about ... protecting your children from mosquitoes

Let's learn something about ... DEET!

DEET gets a pretty bad rap. In a day and age where people are pushing for the more "natural" approaches to prevention and medical care, DEET seems to be the least natural thing out there, right?

You know what is natural? West Nile virus. Zika virus. Chikungunya virus. Powassan virus. Ugh. All nasty viruses which are passed from human to human thanks to mosquitoes.

Citronella hasn't been proven to last very long and has to be at high concentrations to have any effect. So it has to be used really frequently to make up for its lack in efficacy.

Wristbands have been proven time and again in studies not to work, regardless of ingredients.

Lemon eucalyptus oil actually can help - but studies have shown that it's about half as effective as DEET and hasn't been tested for safety in kids under 3.

"Various botanical oils other than those discussed previously, including sandalwood, geranium, soybean, and others, have been used alone or in combination for repelling mosquitoes and ticks. The majority of studies of these alternative plant-based repellents show that the protection they offer is far inferior to DEET" - straight from a peer-reviewed medical article (UpToDate). I had high hopes for my marigold and lavender plants but I don't think they will work (Insert your own frown emoticon here).

So what do I put on my kids? DEET. Because no other compound (natural or synthetic or otherwise) has been proven to be as effective at keeping away mosquitoes, ticks, fleas, and chiggers.

DEET comes in different percentages - 10 percent to 70 percent. Stick with the 10-30 percent range. Ten percent will get you about two hours. Twenty-four percent gets you about five hours of protection. If your children are older, you can use higher concentrations if you'll be outside longer than five hours. The higher the concentration, the longer the effect will last.

DEET can be used on kids as young as 2 months. I know, I know - the thought of putting a synthetic compound on a sweet baby makes me cringe too. But honestly - it's OK for a few hours at a time. Scary things like neurotoxicity have actually only occurred in giant, massive doses after prolonged exposure, and even then it's super rare. Fewer than 20 cases of this happening have been recorded WORLDWIDE since the beginning of time.

If you have aerosolized spray, do what I do - spray it on your hands, then rub it on their arms, legs, neck, ankles, torso. Don't spray it on them directly , and try to avoid inhalation. Don't put it on their hands (because if they're anything like my kids, their hands are in their mouths nonstop). Avoid the eyes. Give them a bath when you're done with outside time.

DEET really is the best way to keep the bites away. And with such a wet "winter" that we had this year - it sounds like we will all need some.


Dr. Diane

Get to know Diane Arnaout, M.D.

"Dr. Diane Arnaout is a pediatrician at the Cook Children's Forest Park practice. If you would like to see her at Forest Park, call 817-336-3800 or click here for an appointment. Dr. Diane has been a Cook Children’s physician since 2011.

She got her undergraduate degree at Texas A&M University, went to medical school at the UT Health Science Center in San Antonio, and completed her pediatric residency in the Texas Medical Center at UT Health Science Center in Houston.

She is board-certified by the American Board of Pediatrics. She has two small kids, whom she credits as being her toughest (and best) teachers. She loves being a pediatrician and loves to teach parents all about their childrens’ health daily, both in-person and online.”

Click to learn more.

Comments 1 - 4 (4)
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Joan Sigoski
My 6-year-old granddaughter is EXTREMELY allergic to mosquito bites! Landed in hospital on several occasions! Other than putting her in a bubble....her pediatrician has her her parents saturate high dose Deet on a hat for her to wear while outside! Nothing stops them!!!! So frustrating
Dr. Diane
Thank you for this excellent comment! Absolutely – Picaridin is a good option for families to use as well. While there aren’t many studies out there to prove its safety long-term, it’s absolutely fine to use on the short-term and is a good alternative to DEET.
Perhaps you should also mention Picaridin as an option for families.

According to the U.S. Centers for Disease Control and Prevention (CDC), of the registered active ingredients, Picaridin (KBR 3023) also provides long lasting protection in peer-reviewed, scientific studies. According to EWG: "Picaridin does not carry the same neurotoxicity concerns as DEET but has not been tested as much over the long term. Overall, EWG’s assessment is that Picaridin is a good DEET alternative with many of the same advantages and without the same disadvantages."

I also find it interesting the levels of DEET you/AAP recommend vs Health Canada. For 0 to 6 months: No DEET. 6 to 24 months: Only when bug risks are high, 5-10% DEET products, Limit to 1 application per day. 2 to 12 years: 5-10% DEET, Limit to 3 applications per day. Avoid prolonged use. General population: No more than 30% DEET allowed in products.
Barbara Leal
We have a pool. What is the best protection for kids getting in and out of the water?