Summer is here, so its officially bug-bite season! Nothing puts a damper on a barbeque or relaxing evening with friends and family like the redness and itching that comes along with mosquito bites, so heres your guide to protecting yourself and dealing with the aftermath.

Bug bite prevention

One of the most common ingredients in insect repellent is DEET, and it works for about four hours at 20 percent concentration. If youre going to be outdoors for longer than that, be sure to reapply. Follow the instructions on the can or bottle.

If youre using insect repellent and sunscreen at the same time, apply the sunscreen first and let it absorb before slathering on the Off! The DEET in insect repellents can inactivate some sunscreen formulations, so it is very important to keep this in mind. Remember to reply sunscreen every 30 to 60 minutes when in direct sun, but you should not reply the insect repellent every time you apply the sunscreen. This would expose you to too much DEET.

Though it may seem like a good idea, dont use a combination repellent/sunscreen product. Theres evidence that this can increase insect repellent toxicity because it may increase absorption of DEET. In addition, reapplying sunscreen as recommended can lead to overexposure to the insect repellent.

For those with sensitive skin (or anyone who wants to avoid DEET), citronella is a great, natural alternative. In addition to candles and lanterns, you can find it in lotions and sprays. One product I like is Burts Bees Herbal Insect Repellent. To avoid smelling like a delicious appetizer to a mosquito, avoid wearing perfume or scented lotion. In Miami, where mosquitos are a huge problem, I have had great results using a device called a Mosquito Magnet. It is a DEET-free way to get rid of pesky mosquitos.

How to relieve itching

Before you reach for the diphenhydramine or Benadryl cream, you should know that topical antihistamines can cause allergic reactionsand wearing antihistamine ointment in the sun increases the likelihood of allergy. My favorite topical antihistamine for itching is a prescription cream called Zonalon. Oral forms of these medications such as Xyzal, Benadryl, Claritin and Zyrtec are preferred in those with a history of skin allergies, but these may cause drowsiness.

Topical steroids such as hydrocortisone work will for rashes but do not seem to help redness and itching associated with bug bites. Pramoxine is an over-the-counter anesthetic treatment for itching found in brands such as Itch-X and Gold Bond Anti-Itch. Believe it or not, hemorrhoid creams such as Analpram and Rectocort-HC contain hydrocortisone and pramoxine, and therefore can be used for itching due to bug bites as well. EMLA cream is another over-the-counter anesthetic that will temporarily numb the skin. (EMLA is often used in a dermatologists office to numb the skin prior to Botox or Restylane injections.)

Over-the-counter preparations that contain menthol, capsaicin and camphor cool the skin by stimulating nerve fibers that transmit the sensation of cold, thereby masking the itch sensation. Capsaicin is a potent component of cayenne pepper often used to treat the pain and itching seen with shingles, and it works by desensitizing the nerve endings. It burns when you first put it on (I cannot tolerate it with my sensitive skinow!!!) and then it numbs the skin.

There are many less painful and natural ways to treat the itching of bug bites. Witch hazel (Hamamelis virginiana) is rich in tannins that relieve inflammation and soothe the skin. Strangely enough, most commercially available witch hazels lose these tannins in the distillation process and do not work well, but people still swear that witch hazel helps their bug bites. I am trying to find a brand of witch hazel that still contains these tannins to recommend to you, but the search continues

Many herbs and natural ingredientssuch as licorice, turmeric, willowbark, chamomile, yarrow, oak bark, and aloe veramay have anti-inflammatory properties as well. While these have not been extensively studied for itching, there are many anecdotal (i.e. not scientific) reports on their effectiveness.

Some people turn to anti-itch products with ammonium, which has been proven to relieve itching after mosquito bites. It is unknown by ammonium relieves itching but I have heard it hypothesized that it causes skin swelling that essentially shocks the nerves in the skin and prevents you from feeling the itch. Ammonium does not make bug bites go away any faster.

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