Corresponding Author Adelaide A. Hebert, M.D. Professor of Dermatology and Pediatrics UTHealth McGovern Medical School at Houston 6655 Travis St., Suite 980 Houston, TX 77030 Phone: 713-500-8339 Fax: 713-500-8321.
Malaria, Zika virus, West Nile virus, Dengue fever, and Lyme disease are common causes
of morbidity and mortality around the world. While arthropod bites may cause local
inflammation and discomfort, a greater concern is the potential to develop deadly
systemic infection. The use of insect repellents (IR) to prevent systemic infections
constitutes a fundamental public health effort. Cost-effectiveness, availability,
and high-efficacy against arthropod vectors are key characteristics of an ideal IR.
Currently, numerous IRs are available on the market, with DEET (N,N-diethyl-3-methylbenzamide)
being the most widely used. DEET has an excellent safety profile and remarkable protection
against mosquitoes and various other arthropods. Other EPA-registered IR ingredients
(permethrin, picaridin, IR3535, oil of lemon eucalyptus, oil of citronella, catnip
oil, and 2-undecanone) are alternative IRs of great interest due to some having efficacies
comparable to that of DEET. These alternative IRs possess low toxicity and favorable
customer experiences in utilization (e.g., cosmetically pleasant, naturally occurring).
This review summarizes currently available EPA-registered IRs: the origins, mechanisms
of action, side effect profiles, and available formulations will be discussed. This
review will enable the clinician to select the best IR option to meet patients’ needs
and provide the greatest protection from arthropod bites and sequelae.