In general, travelers should avoid perfumes, soaps, lotions and hair products containing floral fragrances; these products can attract mosquitoes.
Insect repellent products containing one of the following active ingredients in sufficient concentration are thought by CDC to typically provide reasonably long-lasting protection: DEET, picaridin, ole of lemon eucalyptus (or PMD), IR3535 or 2-undecacone. The active ingredients DEET and picaridin are considered by EPA to be conventional repellents.
When used at concentrations of >20%, the most effective topical insect repellent known is considered by most to be N, N-diethyl-m-toluamide, commonly called "DEET." At 20% concentration, however, picaridin-containing products are thought to be as effective as 20% DEET-containing products, but in contrast to DEET-containing products, products containing >20% picaridin are likely not available in the U.S.
DEET repels a variety of mosquitoes, ticks, fleas and biting flies. Although concentrations of DEET range from less than 10% to 98% in different products, those with 20-40% or up to 50% provide protection for at least 4-6 hours or longer and are considered safe and effective for adults and children older than 2 months. Higher concentrations of DEET (> 50%) do not necessarily improve effectiveness or duration of protection. DEET may decrease the effectiveness of sunscreens; when they are used together, sunscreen should in general be applied first and a higher SPF factor should be used. DEET-containing repellents can damage plastics such as eyeglass frames and watch crystals, as well as rayon fabrics, spandex and leather. They are safe on cotton, nylon or wool. Examples of DEET-containing products include: Cutter Outdoorsman (30% DEET); Ultrathon (25% (aerosol) or 33% (lotion) DEET which provides 8-12 hours of protection); Off! Deep Woods (23.8% DEET) and Sawyer Controlled Release (20% DEET).
IR3535 (20% solution)-containing products and picaridin (20% formulation)-containing products (such as Sawyer 20% Picaridin Repellent and Natrapel 8-Hour) can protect for up to 8 hours or longer and are likely as effective as 20% DEET; however, some picaridin-containing products available in the U.S., such as Cutter Advanced and Skin So Soft, contain less picaridin (7-15% formula tions) and should be re-applied every 3-4 hours or more frequently. Other synthetic or botanical repellents, including those based on citronella and oil of eucalyptus, probably provide less protection than DEET-containing repellents.
Permethrin, an insecticide and a repellent, is not for use on skin but is marketed as a liquid solution or spray for clothing, mosquito nets, tents and sleeping bags for protection against both mosquitoes and ticks. Permethrin-treated clothing should provide protection for up to two weeks and permethrin should be reapplied after 5 washings. Permethrin-containing products include: Repel Permanone (0.5% permethrin) and Duranon (0.5% permethrin).
Wearing protective clothing treated with permethrin in addition to using DEET on exposed skin provides the greatest degree of protection for both adults and children against mosquito and tick bites.
Topical corticosteroids can decrease the redness, itching and swelling of mosquito bites. Oral antihistamines also reduce symptoms caused by mosquito bites. Travelers who are highly sensitive to mosquito bites may benefit from taking an oral non-sedating antihistamine prophylactically.
The US EPA provides a Search Tool to help the traveler select amongst various types of insect repellents which are skin-applied and registered with the EPA. https://www.epa.gov/insect-repellents/find-insect-repellent-right-you The products are listed for informational purposes only and are not actually endorsed by the FDA.
Additional Information and References:
CDC Health Information for International Travel 2020, Protection against Mosquitoes, Ticks, and Other Insects and Arthropods, p. 133-138.
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