Health & Wellness Committee: Keep Your Kids Healthy, Happy & Outside This Summer

Connie Winkler, for the Shuttle

Sending them outside to play? Good. Sunlight elevates the mood and is essential for synthesis of vitamin D.

But it also can cause sunburn, photo-aging and skin cancer. 

Then there are the bugs. While insects might ruin an outing, most bug bites have little long-term health effect — except those than can, like tick bites.

Your first line of defense is putting them in long pants, long sleeves and a hat. Not happening? Here’s some information you can use about sunscreens and insect repellents. 


Sunscreens are classified as organic (formerly known as chemical sunscreens) and inorganic. 

“Organic” sunscreens — so-called because they are made up of carbon-containing molecules, not because they are akin to organic food — absorb damaging ultraviolet light, keeping it from the skin. Broad-spectrum versions are generally combinations of products that absorb both ultraviolet B and ultraviolet A radiation.

“Inorganic” sunscreens include zinc oxide and titanium dioxide, which work mainly by scattering the sun’s rays, rather than absorbing them. They are considered less irritating and thus are the preferred sunscreen for infants and children, although the UV filters known to be contact sensitizers, such as PABA, are now rarely used in sunscreen manufacturing.

Apply sunscreens 15 to 30 minutes before sun exposure to allow the formation of a protective film on the skin and it is important to use the recommended amount (approximately 1 to 1.5 ounces per total body application). Alternatively, you can follow the so-called “teaspoon rule.” It involves the application of approximately 1 teaspoon (visually measured) of sunscreen to the face and neck area, a total of 2 teaspoons to the front and back torso, 1 teaspoon to each upper extremity, and 2 teaspoons to each lower extremity.

The American Academy of Pediatrics recommends avoiding the use of any sunscreen on infants younger than six months. However, when adequate clothing and shade are not available, a minimal amount of sunscreen with at least 15 SPF can be applied to small areas, such as the infant’s face and the back of the hands.

Insect Repellents

Repellents are variably useful in deterring mosquitoes, biting flies, fleas, midges, chiggers and ticks, with DEET concentrations around 10 percent effective for periods of approximately two hours. Used as directed, DEET appears to be safe for children older than 2 months. 

Picaridin, a plant-derived piperidine compound, is effective against mosquitoes, ticks and sand flies 

PMD is the active ingredient in oil of lemon eucalyptus and is effective against mosquitoes, biting flies, and gnats. The compound has not been adequately tested in children under 3 years. 

Permethrin is effective against mosquitoes, flies, ticks, and chiggers, but should only be applied to clothing or bedding, not to the skin. These materials maintain their repellency through approximately 70 laundry cycles, according to the manufacturer. 

Wristbands impregnated with insect repellents are not effective, regardless of the repellent used.

To maximize effectiveness and minimize side effects, especially important with DEET-based repellents, follow these EPA guidelines: 

  • Use just enough repellent to lightly cover but not saturate the skin.
  • Repellents should be applied to exposed skin, clothing or both, but not under clothing.
  • A thin layer can be applied to the face by dispensing repellent into the palms, rubbing hands together and then applying to the face. Repellent should be washed from the palms after application to prevent contact with the eyes, mouth and genitals.
  • Do not use repellents over cuts, wounds, inflamed, irritated or eczematous skin.
  • Do not inhale aerosols, spray them in enclosed spaces or near food, or get them into the eyes.
  • Do not apply insect repellent to the hands of small children, as it will inevitably be rubbed into the eyes.
  • Frequent reapplication of repellent is unnecessary.
  • The areas treated with repellent should be washed with soap and water once the repellent is no longer needed.
  • If both sunscreen and repellent are being applied, apply sunscreen first and then repellent. 

Connie Winkler, MD, FAAP, is a hospital-based pediatrician who works at Abington-Jefferson Health. Email her at