How to keep the sting out of summer

From itches and scrapes to bites, bruises and burns, the lazy, hazy days of summertime fun can be fraught with unseen and unwanted challenges.

Safety experts and two local pediatricians — Dr. Erik Johnson of Amita Health's Alexian Brothers Medical Center and St. Alexius Medical Center and Dr. Linda Widmer of Cadence Physician Group, part of Northwestern Medicine — caution parents it's important to pack more than a simple ounce of prevention before sending children out the door to summer camp, sporting events and even a day at the local pool.

Preventing an itchy situation

Summer can mean rashes, bites and stings. Experts say it's important to prevent getting yourself into an itchy situation when encountering poison ivy, poison oak, nettles, tics, bugs and other insect irritants.

Leaves of three, leave it be

Prevalent in forest preserves, local hiking and nature trails and even in suburban backyards, both poison ivy and poison oak can be major skin irritants. A more exact saying would be “leaflets of three, beware of me,” because each leaf has three leaflets.

Each year 10 to 50 million Americans develop an allergic rash after contact with these poisonous plants. Taking on many forms ranging from small ivy plants to larger vines, bushes and even shrubs, the resin from every part of the plant — stems and leaves — can cause skin irritation. Particularly prevalent in overgrown areas of yards and abundant in forest preserves, both can cause a blistering rash and most won't know they've been exposed until it's too late.

“Wear shoes, socks and long pants to avoid accidental exposure while using overgrown pathways and be forewarned that while these plants may not have leaves in the off-season, the oils are still present,” he says. “In season, the telltale leaves of three with notched, and non-serrated edges should be major warning signs.”

Often mistaken for wild raspberry, Dr. Johnson suggests a number of websites and cellphone applications that enable parents to send photos of the plant for identification. (Check out the Penn State Extension at extension.psu.edu/pests/weeds/weed-id/poison-ivy or at the Apple App store, find the Bewilderness app.)

Mosquitoes and more

While dusk and early mornings are the worst when it comes to mosquitoes, campers and outdoor enthusiasts should wear long-sleeved clothing and use insect repellent with DEET to stave off bug bites.

“Be careful using products with DEET on the face or near glasses,” cautions Dr. Johnson, who says sunglasses may become permanently etched with contact.

With products available in varying concentrations, Dr. Johnson notes concentrations of six percent are perfect for general family use. “It's best to put the repellent on once, instead of reapplying more frequently like sunscreen,” he notes. “Concentrations of 10 percent DEET are available for those needing a bit more protection, 22 percent for deep woods use providing five to six hours of coverage.”

Dr. Johnson also reports:

• All-natural repellent options including citronella, oil of lemon and eucalyptus may provide up to an hour of benefit, but should not be used by children under age three.

• Picaridin repellents in products like Cutter are available in one concentration and provide up to eight hours of protection.

• Permethrin is a naturally occurring substance that protects plants from insects and kills insects, rather than acting as a repellent. Spraying permethrin on clothing, mosquito nets, sleeping bags, tents, or other fabrics, can provide up to two weeks of protection.  Caution, permethrin should not be applied directly to skin.

• Bracelets and ultrasonic repellents don't provide effective repellent coverage.

Targeting tics

Also prevalent in backyards, bushy areas and trees, tics are of concern for kids and pets alike. “Check hairlines, socks and even underwear lines for brown or black sesame-seed sized spots and remove with heated tweezers, keeping the tic's head intact,” Dr. Johnson recommends. He also cautions parents to watch a week or two after exposure for bluish-red spread and sites that may be hot to the touch, itchy and raised.

One tic, known as the deer tic, has been found sporadically in many Illinois counties and in recent years it has become common in northern Illinois. The larvae and nymphs are active in the spring and early summer; adults may be active in both the spring and fall. The deer tick has become known for its transmission of Lyme disease to humans.

“Not every tic results in a rash, but if it does, head to your pediatrician's office for evaluation for possible Lyme disease or another irritant/infection requiring antibiotic treatment,” Dr. Johnson advises.

Creepy crawlies on the loose

When it comes to creepy crawlies, the brown recluse spider is a local resident found commonly in crawl spaces, attics and storage lockers. Its painful sting is an irritant and untreated, can create skin ulcers. Watch for spiders and stinging insects under overhangs, downspouts and eaves, pool toy storage bins, backyard sheds and other protected areas.

Here comes the sun

Although the sun provides a shot of vitamin D, sunburns and increased cancer risk are no laughing matter. Beware increased risk, says Dr. Widmer, who points to guidelines set by the American Academy of Pediatrics:

• Limit or avoid exposure to the sun during the midday hours from 10 a.m. to 4 p.m.

• When outdoors, cover with as much loosefitting clothing as possible, especially arms, legs and torso. Dr. Widmer suggests looking online for swim shirts and other “sun-resistant” active wear with an ultraviolet protection factor (UPF) measuring both UVA and UVB protection.

• Wear hats with wide brims to shade the face, ears, scalp, and neck.

• Wear sunglasses to protect the eyes from UV light.

• Use sunscreen with a sun protection factor of 50 or higher for kids and apply 15-20 minutes before going outside. “Don't forget to reapply liberally and frequently, especially after a swim,” she states. “Ears and the top of feet are two common places for sunburn in children.”

Two types of sunscreen

Chemical sunscreens contain ingredients to reduce UV penetration into the skin. Physical sunblocks contain titanium dioxide and/or zinc oxide, to physically block UV radiation.

The beginning of each season, she says, is a great time to double-check expiration dates, and replace sunscreen supplies.

“It's a good rule of thumb to remember to apply sunscreen liberally and bug spray sparingly for the littlest ones,” says Dr. Widmer, who notes that inhalation is a concern with any spray.

Experts say common medications also can be a source of photodermatitis. Beware the sun, especially if your child is on antibiotics, uses one of several popular acne medications, takes a nonsteroidal anti-inflammatory medication, antihistamines, antifungal medications, blood pressure or diuretic drugs or a host of other photosensitizing medications.

Protective gear

Whether it's a helmet for skateboarding, bike or horseback riding, swim shoes to protect vulnerable feet from rocks and unseen debris, sports goggles, or a U.S. Coast Guard-approved life vest for boating and swimming, Dr. Widmer says parents need to take heed to remind children of the need for safety first.

Because there's a lot of growth that happens over the course of the year, safety experts say the first step is to make sure the equipment still fits properly, whether it is shin guards, helmets, wrist guards or knee pads.

Summer is the high season for trauma, especially among seasonal athletes. According to the Department of Health and Human Services, nearly two million people every year suffer sports-related injuries and are seen in the emergency department for treatment — especially as the weather turns warm and families head outside.

Doctors caution that children don't need a contact sport or even a sports camp misadventure to end up at the doctor's office this summer. Plantar fasciitis, tendinitis, stress fractures, and pulled muscles also occur in higher frequency as runners, swimmers and would-be athletes of all ages take to the trails, lakes, pools and parks during the warmer months.

Heading for camp

Before signing up for overnight camp, Dr. Widmer recommends a careful assessment of child readiness. “Camp can be a wonderful experience for your child, but there is nothing worse than homesickness, which can be at the root of anxiety, depression, and can have physical symptoms such as tummy troubles,” she says.

Day camp programs are a great way to ease into the sleep-away experience, according to Dr. Widmer, who says children vary in readiness — and so do parents!

“Children under age 7 may not adjust easily to being away from home,” suggests Dr. Widmer, who says parents should consider the day camp experience to prepare youngsters for future overnight camp. “Talk about the camp experience, daily schedules, activities, and gauge your child's interest. Many camps limit overnight camping experience to children ages 10 and up, others even older. Your child's readiness is a very individual consideration.”

For first-time and even experienced campers, Dr. Widmer says it is important to let your child help with preparations and packing, and encourage them to bring special items like pictures, a blanket or favorite toy.

The mother of two also recommends advance planning to make sure vaccines are up-to-date, food allergies reported to appropriate camp personnel, and that medical supplies like EpiPens, diabetes care items, and other essential medications are on hand, labeled and at the ready. Check for individual camp policies and procedures for the administration of medications, the handling of emergency situations and care of homesick campers.