Burns and Bites
By: Nicole Dorotik, MD
Summer is upon us, and along with the usual park time, swimming, barbeques and other fun in the sun, you may also experience two other well-known features of summer — sun- burns and insect bites.
Beyond the physical discomfort, burns and bites can also pose more serious health risks. Each sunburn increases your skin cancer risk, and our higher altitude increases the intensity of the sun’s rays. Insect bites carry the risks of disease exposure and immune reactions. A little prevention and planning can reduce your risk.
Other than staying out of the sun, use of sunscreen is your best option. The choice of sun- screen can be very confusing, however, with the myriad of products available.
The American Academy of Dermatology has the following recommendations:
- Everyone, regardless of skin type, should use sunscreen because all skin types can be damaged by the sun’s rays.
- Use a sunscreen that is labeled “broad-spectrum,” which means that the sun- screen protects against both UVA and UVB rays.
- Use a sunscreen that has an SPF of 30 or higher, and is water- or sweat-resistant, so that the sunscreen maintains its SPF after 40 minutes of water activity or sweating.
- Apply and re-apply often and liberally. To achieve full protective effect, an average sized adult needs to apply approximately one ounce of sunscreen for skin exposed when swimming. Additionally, sunscreen should be applied approximately 15-30 minutes before sun exposure or getting into water and reapplied at least every 2 hours, more frequently if swimming.
- Children under 6 months should avoid sun exposure because adverse reactions to sunscreen may occur.
Insects fall into two main categories: stinging insects, such as bees, wasps, ants and spiders; and blood-sucking insects such as mosquitoes, biting flies, fleas, midges and ticks.
Unfortunately, there are no effective chemical repellents against stinging insects; however, most stings, while painful, are not dangerous to most people. Vulnerable populations should take necessary precaution. See your doctor if you are allergic as you may need to carry an epi pen with you for emergencies.
Biting insects are carriers of numerous communicable diseases. When used properly, chemical repellents can greatly reduce the number and frequency of bites. The Environmental Protection Agency (EPA) research indicates that the most effective chemical repellent contains at least 10 percent DEET, which is considered the gold standard of insect repellents. The effectiveness of DEET plateaus at approximately 30 percent. Chemical repellents containing Picaridin, an ingredient usually found in Cutter brand products, are also effective, but for a shorter duration.
Guidelines when applying a chemical repellent:
- Lightly cover but do not saturate the skin. Unlike sunscreen, there is no additional benefit to a “thicker coat” of chemical repellent.
- Repellents should be applied onto, but not under, clothing.
- Repellents should not be sprayed onto the face. A thin layer can be applied to the face by first applying to the palms and then rubbing.
- Hand washing is recommended after ap- plication to prevent contact with the eyes or mouth.
- Avoid contact with wounds or irritated skin.
- Do not inhale aerosols or spray in an en- closed area or near food.
- Any area treated with repellent should be washed once the repellent is no longer needed
- If applying with sunscreen, apply the sun- screen first.
- The American Academy of Pediatrics recommends that children younger than two months not use products containing DEET.
- Do not apply insect repellent to the hands of small children because it will inevitably end up in the eyes or mouth. Toxicity occurs when the repellent is ingested.
- Do not use combination sunscreen/DEET products on children.
- Pregnant women should use chemical repellents with the same guidelines as nonpregnant adults.
Additionally, the following products have not proven to be effective: Citronella, botanical oils, oral agents, vitamin/herbal remedies, repellent wristbands, and electronic devices.