Tuesday 26 July 2022

Avoiding and Treating Mosquito Bites - The Evidence

This blog post is a supplement to my other blog on the issue of avoiding and treating mosquito bites.  The other has a more conversational tone, but this one is just the evidence.  So this is just for the 'heavy reading' which supports what you'll find in the other blog.

DEET works.  It just does.  It's the best (or at worst the equal best) mosquito repellent, and in its higher concentrations, lasts longer than most others.  The other two proven repellents are Picaridin and Oil of Lemon Eucalyptus (or OLE).  Note - NOT 'Lemon Eucalyptus Oil' - that's something quite different.  Also, the rare IR3535 is good, though that's found more often in vaporisers (more on that later) than creams or lotions.

Links for DEET working, as well as Picaridin and OLE:

https://campushealth.unc.edu/wp-content/uploads/2016/07/InsectProtectionJuly-2016.pdf

And comparisons with IR3535:

https://www.medicaldaily.com/four-best-bug-repellents-deet-ir3535-picaridin-oil-lemon-eucalyptus-most-effective-says-ewg-247785

Link for 'Lemon Eucalyptus Oil' (sometimes called 'Lemon Eucalyptus Essential Oil') vs 'Oil of Lemon Eucalyptus' (OLE).  Please note the essential oil isn't very good.

https://www.hebebotanicals.co.nz/mosquito-repellents/

Note that DEET is often referred to as the 'Gold Standard', but different tests variously show one or other of these four as being marginally better than the others.

Regarding Avon Skin So Soft.  Avon used to sell this product under the sub-banner 'insect repellent'.  However, they've stopped doing so at the same time as they stopped using Picaridin as an ingredient.  You can check this yourself; just go to Avon's website and search 'Skin So Soft'.  These are the results.  None now say 'insect repellent' on the bottle, which in itself should flag up a warning.

https://avon.uk.com/search?type=product&q=skin+so+soft

Several of the products no longer state their ingredients, but those that do show that Picaridin has been replaced with 'citronellol'.

https://avon.uk.com/products/skin-so-soft-original-dry-oil-spray

Citronellol works, but only for a very short time, and is simply not reliable.  Given that there are several alternatives available, it would appear to be deliberately contrary to opt for a less effective repellent.  Details here:

https://www.fitfortravel.nhs.uk/advice/malaria/mosquito-bite-avoidance

You cannot repel mosquitos by eating garlic tablets...

https://pubmed.ncbi.nlm.nih.gov/15752181/

...or Vitamin B, or bananas (garlic here, too)...

https://abcnews.go.com/Technology/mosquito-mythbusting-real-repellents-stand/story?id=10543307#:~:text=%22Garlic%20is%20a%20classic%2C%22,in%20them%2C%22%20he%20said.

...Vitamin B again...

https://pubmed.ncbi.nlm.nih.gov/16033124/

...or marmite...

https://mobile.twitter.com/LSHTM/status/1539630785078099969

...or devices which emit ultrasonic sound...

https://learn.eartheasy.com/articles/what-keeps-mosquitoes-away-mosquito-controls-that-actually-work/#:~:text=They%20don't%20work.,that%20ultrasonic%20technology%20repels%20mosquitoes.

...or bracelets/wrist bands...

https://learn.eartheasy.com/articles/what-keeps-mosquitoes-away-mosquito-controls-that-actually-work/#:~:text=They%20don't%20work.,that%20ultrasonic%20technology%20repels%20mosquitoes.

...or citronella candles...

https://www.science.org/content/article/want-repel-mosquitoes-don-t-use-citronella-candles#:~:text=Citronella%20candles%20are%20great%20for,%2C%20dengue%2C%20and%20other%20diseases.

Here's a video covering many of the above:



By the way, whilst ultrasonic plug-ins don't work, you can buy vaporisers containing IR3535, and other repellents.  Scroll down here to "What else is bugging you" Q5.

https://www.bug-off.org/

More here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3549831/

Note, 'coils' that are left to burn slowly are effective, but there are concerns about their safety.  As there are alternatives, I see no point taking the risk.

More:

https://www.nea.gov.sg/dengue-zika/stop-dengue-now/types-of-spatial-repellents

Scented toiletries attract mosquitoes:

https://www.mrmr.biz/mosquito-control-tips-mosquitoes-human-scents/

Interestingly, if you've ever wondered why you get bitten but your partner doesn't, your attractiveness to mosquito bites may be up to 85% genetic.

https://www.webmd.com/allergies/features/are-you-mosquito-magnet

But there's nothing you can do about your genes.

Mosquitos appear to be attracted to CO2 and alcohol.  I strongly advise not exercising too heavily whilst on holiday, but avoiding alcohol is not an idea for which I'm prepared to offer the oxygen of publicity.  

Taking one-a-day antihistamines may reduce swelling and itching if you are bitten, with cetirizine being best:

https://pubmed.ncbi.nlm.nih.gov/8094995/#:~:text=These%20results%20indicate%20that%2C%20in,and%20delayed%20mosquito%2Dbite%20symptoms.

Applying various treatments after being bitten can help reduce swelling and itching, including ammonium solution (as found in After Bite):

https://pubmed.ncbi.nlm.nih.gov/9689301/

Or try calamine lotion or hydrocortisone cream:

https://www.geelongmedicalgroup.com.au/2018/11/how-to-get-rid-of-mosquito-bites-asap

I prefer the After Bite 'pen' as it's easiest to carry and least messy to apply.  You just take the top off and press the exposed 'pen' on the bite.  No need to run cream in, getting it all over your hands, etc.

I hope I've covered everything.  In each case I've chosen just one or two links, but you'll find many more in most cases.

I've tried to limit links to reputable studies and reliable sources.  If you want, you'll e able to find sites proposing quack remedies, and some look both professional and plausible.  But if something claims to work, look to see if there's been repeatable, peer-reviewed, double-blind test to support it.