While Halloween is not the holiday that sends the most children to the ER — that dishonor goes to Labor Day — it comes in fourth, trailing Memorial Day and the Fourth of July.
The biggest risk to children is not the candy they bring home, but dangers presented by their costumes or traffic, said Dr. Benjamin D. Hoffman, a spokesman for the American Academy of Pediatrics.
To protect your family from traffic hazards, buy reflective tape to affix to costumes and candy bags, and give everyone a flashlight.
You might want to avoid the glow sticks, because the liquid inside them can make children sick if they break and children ingest it or get the substance in their eyes. Hundreds of children go to Nationwide Children's Hospital in Ohio every year for glow stick injuries, U.S. News & World has reported.
As for the costumes themselves, here are four potential hazards to avoid.
Lice in wigs and masks
Head-to-head contact or sharing a comb or brush is the most common way in which children pick up head lice. But anything you put on your head could result in the pests taking up residence in your scalp.
"We have a lot of people going into stores right now, trying on masks, trying on costumes and trying on wigs. And a lot of people don't give much thought into the fact that several people could've tried it on before them,” pediatric nurse practitioner Cherie Sexton told WTOL, a CBS affiliate in Toledo, Ohio.
The risk is small because lice can only live for about 48 hours when not attached to a host, and lice can only crawl, they can’t jump or fly, according to the Centers for Disease Control and Prevention. But they can cling to a single strand of hair, so if one is caught in a wig or mask, they’ll be delighted to move if a new host comes along.
Sexton recommends that people wear a swim or wig cap when trying on wigs and to place a new costume that may have been tried on before in a sealed bag for 48 hours (especially important if it came from a thrift shop or yard sale). If the garment or headgear can go in a clothes dryer, dry it on high heat for 45 minutes. (Not only will this kill lice, but bed bugs and fleas.)
On websites like Spookyeyes.com, people can buy non-prescription contact lenses that turn their eye color pink, red, yellow or silver. The Food and Drug Administration, however, urges people to resist the temptation.
“If you have never worn contact lenses before, Halloween should not be the first time you wear them,” the FDA said in statement.
“Experts warn that buying any kind of contact lenses — which are medical devices and regulated as such — without an examination and a prescription from an eye care professional can cause serious eye disorders and infections, which may lead to permanent vision loss.”
If your teen needs more convincing of the danger, look up the story of Rita Coffee of Nashville, Tennessee. In 2010, Coffee went to Vanderbilt University Medical Center suffering from an infectious corneal ulcer that caused her left eye to look like something out of horror movie. Doctors told her it was caused by contacts she had purchased at a beauty supply store and her vision may be affected for the rest of her life.
Before you buy a costume at a store, make sure that it's flame resistant, so your child won't be at risk for severe burns if the fabric brushes against a jack-o’-lantern candle or the edge of a bonfire.
Because costumes are designed to be worn only for a short time, they are often cheaply made and flammable, the American National Standards Institute says.
“And the threat of fire is frightening, not only because it is always a possibility, but more so due to the presence of fire on Halloween. Like the bonfires that served as part of the celebrations of the early holiday, fire has remained an active part of the festivities, being a common component of the Halloween foreground through jack-o’-lanterns and candles. There are many opportunities for fire-related incidents to occur, and flammable clothing only makes matters worse,” the institute says on its website.
The institute says that making your family’s costumes at home cuts down on the risk. When purchasing costumes at a store, avoid synthetic fibers like nylon or polyester, and stay away from glitter. Also, keep costumes ankle-length; a child wearing a trailing gown or cape might not notice that it’s come into contact with a flame.
Makeup and face paint
Face paint and makeup seem like a great alternative to a mask. But if you or your child break out in hives a few minutes after applying it, Halloween may be ruined.
To minimize the risk of any problems, test any makeup or face paint a few days in advance, using just a small amount. If there’s any significant swelling or other reaction, seek medical attention. A severe reaction could cause issues with breathing and eye problems.
Even when there’s no allergy involved, some parents are leery of face paint because of the chemicals they may contain.
“Every Halloween we worry about the candy we’re putting in our kids’ mouths but nowadays, we need to worry about the face paint we’re putting on our kids’ faces,” U.S. Sen. Chuck Schumer, D-N.Y., said in 2015 when calling for stricter regulation of the products.
The FDA does not routinely test face paint, but it has rules regarding color additives, and if you're concerned about an ingredient, you can check the FDA website to see if it's allowed. (Some are approved for general use, but not on or near the eyes, for example.)
If that's too much to absorb, you can always make your own. Southern Living magazine suggests a do-it-yourself recipe that uses one-half cup of facial moisturizer, one-half cup of cornstarch, a dab of vegetable oil and all-natural food coloring.
"Be sure to keep this recipe on hand, because the face-painting opportunities are always there — even when the kids are in high school and college," the magazine's website says.