Did I tell you about that time I got 64 mosquito bites from head to toe...

Summertime is here, which means pool days, backyard dinners, evening walks, playground time…and mosquitoes ready to ruin the vibe.

Me and mosquitoes? We go way back–and not in a good way. I grew up in Southern California, and back in the 80s/90s, we had ZERO mosquitoes where I grew up. My only exposure was when we went camping a few hours away and boy, did they love me. My parents would joke, “It’s because you are so sweet! They love you!” Nice try, Mom and Dad, give me some prevention, please?!

Fast forward years later, and I’ve ended up in the mosquito hotbed of the U.S.-Florida. It’s just not working out–if I go outside with insect repellent as my summer scent, I come back inside with welts from bites. 

But before that, my husband and I did a trek to Machu Picchu, 6 days. Backpacking. Living in tents. Eating out of pots warmed on a campfire. So very non-glamping. But, I NEGLECTED proper mosquito prevention. One beautiful evening at dusk, I wore capri leggings and no bug spray—well in a matter of a few hours, I had over 40 bites on my legs. By the end of the trip, 60+ bites from head to toe. It was like a connect the dots on my body. NOT cute and super itchy. I ended up having raised bumps over a month later due to all the scratching that required high-dose steroid ointment and frequent visits to a dermatologist. 

So, I’ve made it my life’s mission to make sure you, your kids, and my kid’s don’t end up in that fate especially since we didn’t take precautions. 

Depending on where you live, it may feel like there are only one or two peaceful weeks outside before the mosquitoes arrive in full force. And if you have a child who seems to attract every mosquito within a five-mile radius (like yours truly), you know how quickly a fun evening can turn into itchy legs, swollen bumps, and a lot of “please stop scratching.”

We recently covered ticks, so this newsletter is focused more on mosquitoes, everyday bug bite prevention, and how to choose an insect repellent for kids without feeling overwhelmed in the store aisle.

Because I get it. Parents want something that works, but they also want to feel comfortable putting it on their child’s skin. And when you see words like DEET, picaridin, essential oils, natural repellent, stickers, patches, and sunscreen combinations, it can feel like a lot.

So let’s make it practical.

Why do mosquito bites get so itchy?

When a mosquito bites, a tiny amount of its saliva enters the skin. Your child's immune system recognizes that saliva as something foreign and triggers a histamine response. Histamine is what causes the redness, swelling, itching, and raised bump we all associate with mosquito bites.

Children can be especially reactive, which is why bites often look more dramatic in kids than in adults. You may see a larger area of redness or swelling, especially on the face, temples, cheeks, arms, or legs. Sometimes the first thing you notice is a hive-like bump that later turns into the classic mosquito bite. This does not automatically mean your child is allergic or that the bite is infected. For many kids, it is simply a bigger local reaction.

And then comes the itch-scratch cycle. The bite itches, your child scratches, the skin gets more irritated, and then it itches even more. Treating the itch early makes a real difference.

But some kids go a step further. Instead of a bigger-than-average bump, they swell up like they lost a boxing match. That is called skeeter syndrome, and despite how it looks, it is not an infection. It is an allergic reaction to proteins in mosquito saliva, where the immune system goes a little overboard and produces significant swelling, redness, warmth, and sometimes a low fever.

It is most common in young children although I do know some adults who still get it–which is honestly just dumb immune system luck. 

What bug spray is safe for kids?

I cannot stress enough how important insect repellent is for mosquito bites. I call it my summer perfume–my summer scent. Prevention is key to minimize the chance of getting the bite in the first place leading the itch-scratch cycle misery. 

There are a few main insect repellent options parents usually hear about:

• DEET

• Picaridin

• Oil of lemon eucalyptus and other plant-based options

• Stickers, patches, bracelets, and other “natural” products

The best choice depends on your child’s age, how long you’ll be outside, how intense the mosquito exposure is, and what actually works for your child.

A helpful way to think about it is this:

The best repellent is one that is age-appropriate, used correctly, and actually prevents bites.

Hear that last part? If you like the stickers and swear by it–awesome! But if you’re putting stickers on and your kid is coming back inside with connect four on their arm, it’s time to escalate prevention. 

If your child is outside for 20 minutes in an area with very few mosquitoes, you may not need the same option you’d choose for a long hike, camping trip, or evening event in a mosquito-heavy area.

To find the right insect repellent for you or your family, visit the EPA website’s insect repellent search tool.

DEET: Effective and safe when used correctly

DEET is one of the most common active ingredients in insect repellents, and it is also one of the most studied.

It has gotten a bad reputation over the years, largely because of old concerns from reports in the 1980s. But based on what we know now, DEET is considered safe for children when used as directed.

DEET should not be used on babies younger than 2 months old. For children older than 2 months, products with 10% to 30% DEET are commonly recommended. The percentage mainly affects how long protection lasts, not how "strong" it is. You want to choose a product based on how long your child actually needs protection and avoid overapplying.

If you feel hesitant about DEET, I understand. A lot of parents do. But if your child is getting covered in bites, or you are in an area where mosquitoes are intense, DEET can be a very reasonable and effective option.

Picaridin: Another great option

Picaridin is another insect repellent option that can be used for children older than 2 months.

Many families like picaridin because it tends to feel less oily and has less of the classic bug spray smell compared to some DEET products. It is also considered effective against mosquitoes when used as directed.

If you want something that works well but feels a little more pleasant to apply, picaridin may be a good option to consider.

Picaridin is my go-to in Florida. It works wonders for me. However, if I travel to a new area for a nature adventure, I often travel with DEET because I don’t want to take chances. New location can mean different mosquitoes, and I want the best protection possible.

What about “natural” bug sprays?

Many families prefer to start with the least “chemical” option and that makes sense. If a plant-based repellent works well for your child and your situation, great.

Oil of lemon eucalyptus is one plant-based repellent option that can be effective, but it is not recommended for children under 3 years old. It is also important to know that not all essential oils are the same as EPA-registered repellents. Some privately sold essential oil blends are not tested for safety and effectiveness in the same way. If you use an essential oil-based product on an older child, make sure it is appropriately diluted and watch for skin irritation.

If your child is still getting bitten, that is useful information. It may mean the product is not enough for your yard or your activity, and that is when it is reasonable to consider picaridin or DEET.

Do mosquito stickers, patches, or bracelets work?

Stickers, patches, and bracelets are popular because they feel easy. I completely understand the appeal. No spraying, or rubbing. No wrestling a toddler who suddenly acts like bug spray is lava. Some families feel like these products help, and if your child is not getting bitten, that may be enough for your situation.

In general, though, these products do not provide the same full-body protection as a topical repellent applied to exposed skin or clothing. Their protection, if any, is usually limited to the area right around the bracelet, sticker, or patch. If they work for your child, great. If they do not, you may simply need a repellent with stronger evidence behind it.

Now, you get that prevention is key–here’s some safety things to consider 

• Always read the label and reapply only as directed.

• Adults should apply repellent for younger children.

• Apply repellent to exposed skin and the outside of clothing.

• Do not apply repellent to a child’s hands, especially if they put their hands in their mouth.

• Do not spray repellent directly onto the face. Spray it into your hands first, then apply carefully, avoiding the eyes and mouth.

• Avoid applying repellent to cuts, wounds, or irritated skin.

• Do not use insect repellent on babies younger than 2 months old.

• Keep repellent out of reach to prevent accidental ingestion or misuse.

One sunscreen note: avoid combination sunscreen and bug spray products. Sunscreen needs to be reapplied more often than repellent, so if the two are combined, you may end up overapplying repellent or underapplying sunscreen. When using both, apply sunscreen first, let it settle, then apply repellent over it.

Other ways to prevent mosquito bites

Repellent is one layer of prevention, but not the only one. Mosquitoes tend to be more active around dusk, dawn, and nighttime, so take extra precautions during those windows, especially if your child tends to react strongly. When realistic, lightweight long sleeves, long pants, socks, and closed-toe shoes add another layer during hikes, camping, or evenings in mosquito-heavy areas.

For babies younger than 2 months, since repellent is not recommended, physical barriers matter more: stroller netting, carrier covers designed for airflow, and lightweight clothing when appropriate.

You can also reduce mosquito exposure around your home by emptying standing water. Mosquitoes breed in stagnant water, so check buckets, water tables, plant saucers, toys, kiddie pools, and anything else that collects rainwater.

How to treat mosquito bites when they happen

Even with the best prevention, bites still happen. Clean the area with soap and water, then try a cold compress or ice pack wrapped in a cloth to reduce swelling and soothe the itch. Calamine lotion can help for mild itching. For more intense itching, over-the-counter hydrocortisone 1% ointment can be used for a short period as directed on the label.

The hardest part, of course, is preventing scratching. Keep nails trimmed, use distraction when you can, and cover bites with clothing if that helps your child leave them alone.

One tool I personally like is the Bug Bite Thing. I'm on their medical advisory board, and while this isn't sponsored, I genuinely recommend it. It uses suction and may help when used soon after a bite. For kids, start gently and briefly to make sure their skin tolerates it, and avoid the face, neck, or anywhere your child seems uncomfortable.

When mosquitoes carry more risk

Most mosquito bites are just itchy, not dangerous. But in some parts of the country and during travel to certain regions, mosquitoes can carry illnesses like West Nile virus or other infections. Risk is not the same everywhere, so it helps to know what is common where you live or where you are traveling, rather than treating every bite as equal. If you are spending time in a high-risk area, repellent becomes even more important as a layer of protection.

Most mosquito bites do not need medical treatment. The worst itching is often in the first 24 to 48 hours. But it is worth checking in with your child’s clinician if the redness or swelling continues to spread after 24 to 48 hours, the area becomes warm, very tender, or painful, you see pus, your child develops a fever, you notice red streaking from the bite, swelling interferes with movement, or your child seems ill.

When in doubt, it is always okay to ask. Sometimes mosquito bites look dramatic because kids react strongly. Other times, scratching can lead to skin irritation or infection that needs treatment.

Want a visual walk-through of prevention, repellent options, bite treatment, and when to seek care? Watch the PedsDocTalk YouTube video on bug bite prevention and treatment.

Final thoughts

Look, I have been bitten enough times to know that mosquito prevention is not something to wing. I still think about my Machu Picchu legs and arms. My dermatologist definitely does too.

The good news is that you do not need to be an expert to make a smart choice. If a plant-based option is doing the job, keep using it. If stickers make your toddler feel like a superhero and they are actually working, okay. But if your kid is walking inside looking like a connect-the-dots puzzle, that is your sign to step it up.

Picaridin and DEET are not the scary options some people make them out to be. They are just the ones with real evidence behind them. Choose what fits your child's age, your environment, and how long you are actually outside. Use it correctly. Reapply when needed.

A little prevention goes a long way. And if a bite or two still slips through? That is summer. Treat the itch early, break the scratch cycle, and get back outside.

Ask Dr. Mona

An opportunity for YOU to ask Dr. Mona your parenting questions!

Dr. Mona will answer these questions in a future Sunday Morning Q&A email. Chances are if you have a parenting concern or question, another parent can relate. So let's figure this out together!