Originally posted here by Dr. Martha Rac, maternal-fetal medicine physician at Texas Children’s Hospital


With Zika becoming more prevalent and the summer sun beating down, it can be hard to know what to apply first. Do you protect your family from the sun? From Zika? How can you protect your family from both?

The Zika virus is transmitted primarily by the Aedes mosquito, a species found in Houston, as well as other areas with similar climates. In 2015, a dramatic increase in the number of Zika infections was reported in South America, with Brazil being the most heavily affected area.

The best way to prevent Zika is for you and your partner to not travel to areas with active Zika virus transmission while attempting pregnancy or during pregnancy.  These areas are listed on the CDC website and can be found at here. Most recently, Miami has confirmed to have local transmission of Zika virus and has been added to list of places to avoid if pregnant or contemplating pregnancy.

If travel is unavoidable, then precautions should be taken to protect you and your partner from mosquito bites. This includes wearing long-sleeve shirts and pants, wearing and reapplying insect repellent frequently, sleeping with the windows closed and the AC turned on, as well as sleeping under mosquito nets if you are in an area without AC or window screens.

So, which comes first, sunscreen or bug spray? If you want to protect your family from the sun and mosquitoes, apply sunscreen first and insect repellent second. This is recommended because sunscreen gets absorbed into the skin, while repellant sits on top of the skin.

Remember to always follow product instructions when applying insect repellent to children. You shouldn’t use insect repellants on children younger than 2 months and do not use products containing oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD) on children younger than 3 years old. Remember, do not apply insect repellent onto a child’s hands, eyes, mouth, cuts or irritated. To apply insect repellent onto a child’s face, always spray the repellent on your hands and then apply to their face.

When choosing an insect repellant, remember the CDC recommends products that have been registered with the U.S. Environmental Protection Agency (EPA) for use as repellents. Products containing DEET, picaridin, IR3535 and some oil of lemon eucalyptus and para-menthane-diol products provide longer-lasting protection. When used according to the label instructions, insect repellants do not cause adverse effects to human health or the environment. Any repellent that is EPA approved is also safe to use during pregnancy when used according to the label instructions.

Further, since Zika can be sexually transmitted, it is advised that women use adequate contraception to delay pregnancy for at least eight weeks after return from a ZIka-active area. Asymptomatic men who travel to Zika-active areas should use condoms for at least eight weeks and up to six months if they experienced symptoms compatible with Zika virus, which includes fever, rash, red eyes and/or joint pain.

Lastly, remember if you do travel to areas with local transmission of Zika virus, we recommend you take precautions to prevent mosquito bites and sexual transmission for at least four weeks after you return.