Bug Off: Repellent and Relief with Dr. Kathryn McCusker, MD

When a kid runs inside scratching like crazy, how do you know if a bug bite is normal, infected, or something more serious? In this episode, we talk with pediatrician Dr. Kathryn McCusker about bug bites in children and teens — what’s normal, why some reactions look worse than they are, and warning signs like trouble breathing, throat swelling, or vomiting that require urgent care.

We also discuss bug bite prevention, including the best insect repellents for kids, how to use them safely, and the truth about DEET percentages. Plus, Dr. McCusker shares simple treatment tips to stop itching, prevent infection, and keep kids comfortable all summer long.

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Transcript

Meet Your Pediatric Bug Bite Guide

SPEAKER_00 0:10

Welcome to the Medlink Health Connections Podcast. I'm your host, Tangela, and today we'll be joined by Dr. Catherine McCusker. Dr. McCusker is a pediatrician at our Medlink Winder office. She attended and completed residency at the Medical College of Georgia and has been with Medlink since 2011. She specializes in the care of pediatric and adolescent patients, welfare, primary care of infants and children with special needs, behavioral health, outpatient sick visits, and in-office same-day testing for illnesses. Dr. McCusker, thank you so much for joining us today.

Normal Bite Symptoms Vs Red Flags

SPEAKER_00 0:53

So to kind of start us off, bug bites are something almost every parent deals with. What are some of the most common symptoms of a typical bug bite?

SPEAKER_01 1:02

Well, thank you for having me. And yes, bug bites are one of the things that I see a lot of, and parents have a lot of concerns about. Oftentimes they come in with uh areas of redness, swelling, a lot of itching, and sometimes even painful areas.

SPEAKER_00 1:21

And um, so at what point should parents kind of become concerned? And how do you tell if a bug bite may be poisonous or require medical attention?

SPEAKER_01 1:30

Thankfully, in our area, there aren't a lot of poisonous bites.

Infection Signs From Scratching

SPEAKER_01 1:34

The main ones are the black widows, the brown recluse, and occasionally scorpions, but those are very, very rare, um, thankfully. When um you have a poisonous bite, those usually cause more systemic symptoms. Um, things like intense pain, uh, fevers, muscle cramps, um, things like that. So those usually require more urgent care. When you have a bite uh that causes or a sting that causes more anaphylactic reactions, those are things with difficulty breathing and vomiting, throat swelling, those also require more emergent or urgent care. That's significant. When you have a bug bite that is becoming infected, usually from a child scratching at it and itching when they get bacteria into it, that will result in increased swelling, redness, significant pain in the site, and sometimes even drainage. That usually requires a visit to your pediatrician or family doctor to have it evaluated.

Repellent Types That Actually Work

SPEAKER_00 2:37

So prevention is obviously important. So, especially during the summer months, what are some different types of bug repellents that are out there?

SPEAKER_01 2:47

So there are tons of bug repellents on the market. Of course, bug sprays only prevent biting bugs, not stinging insects. Uh, one of the best ways to actually prevent is not wearing flowery prints and not wearing heavy flowery scents when you're outside. That's one of the best ways to actually prevent attracting bugs to you. Uh but repellents come in multiple forms: lotions, sticks, different kinds of sprays. Some are the aerosolized, like pressurized sprays, and then you have the non-pressurized sprays. And there is a difference in using those. These are the ones that have been found to be effective, the ones with the chemicals in them, the DEET, the Picarotin, and the oil of eucalyptus, those are the most effective. Uh, there are other things on the market, things like bracelets and ultrasound, ultrasonic sound waves, those are not as effective. Really, I don't recommend using those. So, how should the buck spray be applied?

How To Apply Repellent Safely

SPEAKER_01 3:52

When you are using the sprays, you want to use them in well-ventilated areas. Um, I do recommend when you have young kids use the lotions or sticks. Those are usually better because you're not getting that inhalation. You don't have to worry about your child breathing in those sprays. The non-pressurized sprays are a little safer as well because you don't get that aerosol aerosolized spray. When you are applying to this to the face of a child, you want to spray on your hands and then put it on the face so they're not getting it into their eyes and mouth. You can have to be very careful with that. When you are applying it, um, you also want to put it on the clothing and expose skin only. You don't put it under clothing. That's very important. And then, of course, at the end of the day, you always want to wash the skin and the clothes. You don't want to leave it on overnight.

Reapplication Rules And DEET Timing

SPEAKER_00 4:41

Often should it be reapplied and how long does it usually remain like effective?

SPEAKER_01 4:46

So, bug sprays actually only need to be applied once a day. And when it comes down to it, it's actually the percent of chemical in the bug spray that determines how long it lasts. So, for example, I recommend using the DEET product. Um, this is in a lot of the um like the off-brand um bug sprays or the cutter brand. And for example, with the 10% DEET, that will last about two hours. Uh, the 30% will last about five hours. So it really depends on how long you're going to be outside and exposed to the insects for which product you want to be using.

Skin Reactions And Asthma Concerns

SPEAKER_00 5:23

So some parents may like worry about reactions to the actual uh propellant itself. Are there any side effects or reactions that kids can potentially have to bug spray?

SPEAKER_01 5:36

Absolutely. Kids have sensitive skin, as we all know. Um, the main reaction I see oftentimes is rash. Uh, fortunately, this is easily treated. Uh, you wash off the bug sprays. You usually can just use like a plain lotion for a few days and the rash will resolve. Sometimes there's a lot of itching. Hydrocortisone over the counter is great for itching of any kind, and that you can mix into a lotion and put it on topically, and it will take care of the itch and the rash, um, usually within a day or two. Um, usually, even if a kid has sensitive skin and has a rash to one product, they can oftentimes tolerate a different product. Um, you don't want to totally avoid bug sprays because the risk of infection or um disease from a bug bite is higher than the reactions from a bug spray. So you do still want to use your bug sprays. The other risk of bug sprays is with that inhalation. Of course, with kids with asthma or other breathing problems, you do have to be careful with those aerosolized uh sprays and avoid that inhalation risk.

Treating Bites To Stop The Itch

SPEAKER_00 6:46

And are there any like natural insect repellents?

SPEAKER_01 6:51

So those are on the market. Uh, things like the citronella, the peppermint, and soybean oil are the main natural repellents that are on the market. Um unfortunately, while these are safe, they have not been proven effective. And so I do recommend using the chemically based bug repellents instead of those natural insect repellents.

SPEAKER_00 7:15

Okay, and if you were to get a bug bite, what do you do?

SPEAKER_01 7:20

So when you notice the bug bites, you want to wash with soap and water to avoid any possible infection immediately. Cold packs can be helpful, a cold rag, take down any swelling or irritation from the area. And I love over-the-counter hydrocortisin. It helps with the swelling, it helps with the itch. Your main goal here is to stop your kid from scratching at it because that's the main source of infection in any bug bite. Um, over-the-counter antihistamines, things like Benadryl and Zertec, can be very helpful as well to help with itching. Uh, nighttime is a big time when kids scratch and they don't even realize they're scratching. And so sometimes nighttime is a good time to use those oral antihistamines. Oftentimes they have the side effect of sleepiness, and so it'll help uh with sleep and prevent the itch.

SPEAKER_00 8:11

Anything that can help reduce itchiness, swelling, rediness, or the spread of a bug bite.

SPEAKER_01 8:17

Yeah, and you can't reiterate this enough with the topical hydrocortisone and oral antihistamines. And with kids, I usually do tend to leave bites uncovered, but if they are scratching at a bite, definitely cover it because you do not want them scratching it.

SPEAKER_00 8:32

And are there any home solutions or like temporary remedies?

SPEAKER_01 8:38

And again, it is all prevention, prevention, prevention. Use the bug sprays, and then when you see those bites, treat them immediately as soon as you see them to keep them from getting too out of control.

SPEAKER_00 8:50

And are there any tricks for kids who are um like help remember to put on their bug spray?

Make Bug Spray A Daily Habit

SPEAKER_01 8:56

And this is always a hard one. I keep bug sprays everywhere. I keep it in my car, I keep it at every outer door. The more routine it becomes for you to remember your bug sprays, the more you remember it. And so just keep it in your bag that you take to the park. Keep it in your purse, a little container of it. Um, parents should have it in their diaper bag wherever they're going. They should always have a little can of it or a little bottle of lotion or um spray, whatever, you know, wherever you're going. Also, put it with your sunscreen.

Sunscreen Order And Closing Advice

SPEAKER_01 9:32

Um, I don't recommend using the combination products because remember, bug sprays are only applied once a day. Sunscreens need to be reapplied every one and a half to two hours. And so you don't want to use those combination products.

SPEAKER_00 9:48

So, with that, just would you apply the bug spray first and then the sunscreen on top, correct? Absolutely, yes. And is there any closing remarks that you may have before we wrap everything up?

SPEAKER_01 10:00

What I would say is bug sprays and sunscreens in the summertime and year-round, honestly, are so so important to keep your skin, your skin safe and kids from getting these bad bites and keep everyone safe.

SPEAKER_00 10:24

Thank you for tuning in to the Medlink Health Connections podcast. We hope you found today's episode informative and helpful. If you enjoyed this episode, please subscribe and be on the lookout for our next episode. Remember, the information shared in this podcast is for educational purposes only and should not replace professional medical advice. Always consult with your healthcare provider for any medical concerns. Stay connected with us on social media at medlinkga or visit our website at medlinkga.org for more resources and updates. Until next time, stay healthy and take care.