Insect Bites and Stings

BITES:

Here are some ways you can prevent insect bites: 
- Avoid close physical contact with someone who has scabies. 
- Keep pets free from pests. Regularly check for ticks and fleas. 
- Remove standing water (such as water in flowerpots, ponds, puddles) from your yard to keep mosquitoes away. 
- Cover your skin when going outdoors. Wear long sleeves and long pants. 
- Use insect repellents when going outdoors. Insect repellants are effective in repelling insects including mosquitoes, ticks, and fleas. Carefully follow the instructions printed on product label. If you plan on using sunscreen, apply the sunscreen first and then the repellent. Here are examples of some insect repellents: 

DEET 
- DEET is the best insect repellent available. It works by releasing a vapor that repels insects from you. DEET is available in different strengths, ranging from 7% to 100%, and comes in the form of sprays, solutions, creams, and wipes.  In general, the higher the strength of the DEET product, the longer it will lasts. However, for most adults, products containing 10% to 40% are sufficient. For most children, products containing 30% or less are sufficient. Do NOT use DEET products on infants younger than 2 months old. 
- The most common side effect you can get from using DEET is skin irritation.  
Picaridin 
- Picaridin is a newer insect repellent that recently became available in the US and  works similarly to DEET. One of the advantages of Picaridin is that it causes less skin irritation. 
- There are no recommendations for children yet. 
IR3535 (Merck 3535)
- Merck 3535 is comparable to low concentrations of DEET. 
- There are no recommendations for children yet. 
Permethrin 
- Permethrin is both an insect repellent and insecticide. It should only be used on items such as your clothes, shoes, bed nets, and camping gear. - Do NOT apply to your skin. 
Oil of Lemon Eucalyptus  
- Oil of lemon eucalyptus is comparable to low concentrations of DEET. It is the most effective natural insect repellent available.  However, Do NOT use this product on children younger than 3 years old. 
Citronella, soybean oil, tea tree oil, fragranced moisturizers in mineral oil, thiamine, lavender oil, and garlic 
- If you want to try insect repellants made of natural ingredients, you can try Citronella, soybean oil, tea tree oil, fragranced moisturizers in mineral oil, thiamine, lavender oil, or garlic. However, they are less reliable because they do not last for very long periods of time. You may have to apply them on more frequently. 
Mosquito traps
- Mosquito traps emit carbon dioxide to attract and trap mosquitoes. 

References

1. Buff, Wayne, and Cliff Fuhrman. APhA Handbook of Nonprescription Drugs: Chapter 37 Insect Bites and Stings and Pediculosis. 16th Edition, Washington DC: American Pharmacists Association, 2009: 700-706 
2. Dugdale, David C. III, Jatin M. Vyas, and David Zieve. Mosquito, adult feeding on the skin. June  2011. Available at: http://www.nlm.nih.gov/medlineplus/ency/imagepages/1246.htm. Last accessed August 31, 2011. 
3. Dugdale, David C. III, Jatin M. Vyas, and David Zieve. Mosquito, adult feeding on the skin. June  2011. Available at: http://www.nlm.nih.gov/medlineplus/ency/imagepages/1239.htm. Last accessed August 31, 2011. 
4. Heller, Jacob L. and David Zieve. Bedbug-close- up. January 2010. Available at: http://www.nlm.nih.gov/medlineplus/ency/imagepages/1234.htm. Last accessed August 31, 2011. 
5. Dugdale, David C. III, Jatin M. Vyas, and David Zieve. Ticks. June 2011. Available at: http://www.nlm.nih.gov/medlineplus/ency/imagepages/1254.htm. Last accessed August 31, 2011. 
6. Heller, Jacob L. and David Zieve. Black widow spider. January 2010. Available at: http://www.nlm.nih.gov/medlineplus/ency/imagepages/19582.htm. Last accessed August 31, 2011. 
7. Heller, Jacob L. and David Zieve. Brown recluse spider. January 2010. Available at: http://www.nlm.nih.gov/medlineplus/ency/imagepages/19570.htm. Last accessed August 31, 2011. 
8. Vorvick, Linda, Kevin Berman, and David Zieve. Scabies. October 4,2010. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001833/figure/A000830.B2470/?report=objectonly. Last accessed September 1, 2011. 
9. Berman, Kevin and David Zieve. Chiggers. May 13,2011. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002309/figure/A001333.B2046/?report=objectonly. Last accessed September 1, 2011. 
10. Ehrlich, Steven. Insect bites and stings. December 2009. Available at: http://www.umm.edu/altmed/articles/insect-bites-000095.htm. Last accessed August 31, 2011. 
11. FDA U.S. Food and Drug Administration. Beware of Bug Bites and Stings. June 2008. Available at: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048022.htm. Last accessed August 31, 2011. 
12. Saklatvala, Jeremy. Glucocorticoids: do we know how they work? Arthritis Res. 2002; 4(3): 146–150.

STINGS:

Here are some ways you can prevent insect stings:
- Limit use of perfume or lotions with a strong fragrance.
- Cover your skin when going outdoors. Wear long sleeves and long pants.
- Avoid wearing brightly colored clothes or clothes with flowery prints when going outdoors.
- Wear shoes when going outdoors.
- Destroy the nests of stinging insects near your house.
- Control food aromas/odors when eating outdoors.
- Keep garbage lids closed.
- Do not disturb bee or wasp nests.

References
1. National Institute for Occupational Safety and Health Education and Information Division. Insects and Scorpions. August 9, 2010. Available at: http://www.cdc.gov/niosh/topics/insects/. Last accessed September 1, 2011.
2. National Agricultural Pest Information System. Africanized Honey Bee, Apis mellifera scutellata. Available at: http://pest.ceris.purdue.edu/searchpest.php?selectName=ISAEAEA. Last accessed September 1, 2011.
3. University of Kentucky College of Agriculture, Department of Entomology. Controlling Wasps, Hornets, and Yellowjackets. January 10, 2010. Available at: http://www.ca.uky.edu/entomology/entfacts/ef620.asp. Last accessed September 1, 2011.
4. Clark, Jack Kelly. UC IPM Photo Yellow Jacket. 2000. Available at: http://www.ipm.ucdavis.edu/PMG/V/I-HY-VPEN-AD.004.html. Last accessed September 2, 2011.
5. Buff, Wayne, and Cliff Fuhrman. APhA Handbook of Nonprescription Drugs: Chapter 37 Insect Bites and Stings and Pediculosis. 16th Edition, Washington DC: American Pharmacists Association, 2009: 700-706
6. University of Maryland Medical Center. 2011. Insect bites and stings. Available at: http://www.umm.edu/altmed/articles/insect-bites-000095.htm. Last accessed September 2, 2011.
7. U. S. Food and Drug Administration. Beware of Bug Bites and Stings. June 19, 2008. Available at: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048022.htm. Last accessed September 2, 2011.
8. Shelov, Steven. Insect Bites and Stings. June 9, 2011. Available at: http://www.healthychildren.org/English/health-issues/conditions/skin/pages/Insect-Bites-and-Stings.aspx. Last accessed September 2, 2011.