The Memorial Day weekend, the official start of summer is behind us, so it’s time to begin thinking about summer safety tips. Here’s the latest evidence-based advice on preventing tick and mosquito bites from the experts at ConsumerLab.com.

Tickborne illnesses such as Lyme disease have more than doubled in the United States since 2004 (CDC, Tickborne Disease Surveillance Data Summary, Accessed 4/25/22). While mosquitoes in the U.S. often cause nothing more serious than itchy, red bumps (which nevertheless can be an annoyance), they also have the potential to transmit serious diseases such as Zika and West Nile virus (EPA 2021). For these reasons, it is important to know which preventative measures – including bug sprays and other strategies — are most effective at helping avoid insect bites.

There are a series of effective strategies for avoiding tick and mosquito bites, according to the CDC. The first of these is to use an Environmental Protection Agency (EPA)-registered insect repellent. This assures you that the ingredients have been proven to be safe and effective, even for women who are pregnant or breastfeeding.

Be aware that all repellents that are effective for ticks are effective against mosquitoes, but not all mosquito repellents work against ticks. For example, catnip oil is active against mosquitoes but not against ticks.

EPA-registered tick repellents include:

• DEET,
• picaridin,
• IR3535,
• oil of lemon eucalyptus (OLE),
• para-menthane-diol (PMD), or
• 2-undecanone.

However, DEET and picaridin have stronger repellent efficacy or longer duration of action than the others and are likely your best options, according to the Wilderness Medical Society.

So, which should you choose for yourself and your family? Based on the comparable efficacy of picaridin and DEET, but the better safety profile of picaridin, ConsumerLab.com recommends bug sprays with 20% picaridin (which is the highest concentration available).

CONSUMERLAB.COM TOP PICKS

ConsumerLab.com’s Top Pick among repellants applied to the skin is Sawyer Premium Insect Repellent 20% Picaridin Spray Pump. This product is EPA-registered and has provided evidence that it can protect against both ticks and mosquitoes for up to 8 hours. (It has also been chosen as Wirecutter’s Top Pick insect repellent and is recommended by Consumer Reports). It can be purchased on Amazon for $8.47 for 4 oz ($2.12 per ounce).

If you want longer protection, ConsumerLab.com suggest Ranger Ready Repellents Tick + Insect Pump Spray (which also contains 20% picaridin). This product is slightly more expensive – $13 for 5 oz ($2.60 per ounce) on the Ranger Ready website — but can protect for up to 12 hours, based on evidence submitted to the EPA.

WHY CHOOSE A SPRAY OVER A LOTION OR WIPES?

Insect repellents containing 20% picaridin are also available in lotions and wipes, but lotions may take longer (about 20 minutes) to start working than sprays, according to Joseph Conlon, a previous technical advisor for the American Mosquito Control Association, and wipes (at least those containing picaridin) don’t seem to work as well as the sprays, according to testing by Consumer Reports.

WHEN TO APPLY

The CDC recommends applying insect repellent about 5 to 10 minutes after your sunscreen (CDC Yellow Book 2020), although the reason for this recommendation is uncertain, as research shows that DEET insect repellents have similar efficacy when applied before or after sunscreen (Murphy, J Am Acad Dermatol 2000).

Certain insect repellents are included in sunscreen products, but the use of these combined products is not recommended by the CDC, as sunscreen generally needs to be reapplied more often than insect repellents, so the combined products may lead to excessive repellent use (CDC Yellow Book 2020).

OTHER REPELLANTS

Be aware that some commercially available tick repellents are not EPA-registered — meaning that their effectiveness has not been confirmed, despite potential evidence of benefit in laboratory studies.

Such ingredients include 

• cedar oil, 
• geranium oil, 
• peppermint oil, 
• soybean oil, and
• Some citronella oil products.

These unregistered products are considered “minimum risk pesticides” because the active ingredients are found to pose a minimal health risk (EPA, Regulation of Skin-Applied Repellents).

However, the Wilderness Medical Society, the CDC, and the Lyme Disease Association all recommend sticking with EPA-registered products for tick bite prevention (Ho, Wilderness Environ Med 2021; Lyme Disease Association, Lyme & TBD Prevention; CDC, Preventing Tick Bites on People).

ADDITIONAL STRATEGIES RECOMMENDED BY CONSUMERLAB.COM AND THE CDC:

In addition to the use of a repellent on your skin and clothing, the following steps are also recommended by the CDC and summarized by ConsumerLab.com:

• Wear permethrin-treated clothing: Permethrin is an insecticide (not just a repellent) that can be applied on the outer sides of outdoor clothing and gear such as sleeping bags to kill ticks and mosquitoes. The combined use of permethrin-treated clothing and skin-based insect repellent seems to help prevent insect bites better than using either product alone. ConsumerLab.com’s Top Pick among permethrin insecticide products for use on clothing and gear is Sawyer Premium Permethrin Insect Repellent for Clothing, Gear & Tents. Each 24-ounce bottle of this spray, which costs $19 on Amazon (79 cents per ounce), can protect five complete outfits each consisting of a shirt, pants, and socks. An evaluation by Wirecutter found that the bottle’s trigger spray is easy to use and allows for more controlled and even application of the spray than other products such as Ben’s Clothing and Gear Insect Repellent or Coleman’s Gear and Clothing Permethrin Insect and Tick Repellent.
• Wear long sleeves: Although wearing long-sleeved clothing has not been proven to prevent illnesses transmitted by insects including ticks or mosquitoes, it can limit an insect’s ability to attach to the body, which may reduce the chance of a tick or mosquito bite.
• Wear light clothing: Although wearing light-colored clothing has not been associated with reduced risk of Lyme disease or other insect-borne illnesses, wearing light clothing may help the wearer to visualize any insects — especially ticks during tick checks, which may help aid in tick removal.
• Perform tick checks: There is mixed evidence regarding the prevention of tick-borne illness with tick checks. However, at least one study found that performing tick checks and bathing within 2 hours of being outdoors helped prevent tick-borne illnesses.
• Know how to remove a tick: If a tick is spotted during a tick check, the CDC recommends removing it as soon as possible using fine-tipped tweezers — grasping the tick close to the skin and pulling straight out — and then cleaning the affected area with rubbing alcohol or soap and water. The CDC, as well as the Lyme Disease Association, advise against using removal methods that involve covering the tick in any substance (such as petroleum jelly or oils) or heating it to make it detach, as these methods require waiting for the tick to “back out”; the goal is to remove the tick as quickly as possible. Both organizations also advise against twisting the tick to remove it, as this may cause the tick to regurgitate or may cause the mouthparts to break off in the skin, which may increase the chance of disease transmission (CDC, Tick Removal and Testing; Lyme Disease Association, Tick Removal Fact Sheet).
• Wash and dry clothes at hot temperature: Washing clothes at 130° F (typically the “hot” setting of a washing machine) and drying clothes in high heat for at least 10 minutes, or simply drying unwashed clothes on high heat for at least 6 minutes, can kill ticks (Nelson, Ticks Tick Borne Dis 2016). In theory, this might reduce the risk of tick-borne illness, although this has not been confirmed in any clinical studies. Be aware that high heat may reduce the duration of effectiveness of permethrin-treated clothing.

Full details and even more recommendations are available to ConsumerLab.com subscribers at their article: What are the best bug sprays to prevent tick and mosquito bites? Is the insecticide permethrin safe to use? 

It’s a subscription I have and I highly recommend it as it’s worth its weight in gold!

© Copyright WLL, INC. 2022. This blog provides healthcare tips and advice that you can trust about a wide variety of general health information only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment from your regular physician. If you are concerned about your health, take what you learn from this blog and meet with your personal doctor to discuss your concerns.