Experts explain what to do if you find a tick attached to your skin, including how to remove it.
During tick season, which runs from April through September in the United States, people spend more time outdoors, and tiny, hard-to-spot tick nymphs are active, so your chances of an encounter are higher. Finding a tick on your skin is always worrying because all it takes is one bite and a small amount of saliva for it to transmit disease-causing pathogens (like Lyme disease) to you, its host.
If you notice a tick on yourself or a loved one, remove it right away. “The longer a tick is attached, the more opportunity it has to transmit an infectious dose of germs, and so getting it off as quickly as possible is important,” said Thomas Mather, professor of public health entomology and director of the University of Rhode Island TickEncounter Resource Center.
Here’s everything else experts suggest to quickly and safely deal with a tick bite, what to do with a tick once you’ve removed it and when to get in touch with your doctor.
Look closely: Is it definitely a tick? And is it attached? “If it’s walking, it’s trying to find a spot where it’s going to bite for a blood meal,” said Michel Shamoon-Pour, co-director of the Binghamton University Tick-Borne Disease Center. But an on-the-move tick hasn’t bitten you yet, so there isn’t any chance that it’s infected you, he reassured.
An attached tick is another story. If it’s attached, look at how engorged, or plump, it is. A tick that has not recently fed can be around the size of a poppy seed (in the younger nymph stage) or sesame seed (as an adult), “and then it gets bigger and bigger, and it might look like a small raisin when it’s filled with blood,” said Brian Fallon, director of the Lyme and Tick-Borne Diseases Research Center at Columbia University.
While some tick-borne illnesses can be transmitted in shorter time frames, many, including Lyme, require a tick to feed for at least 12 to 24 hours. “Black-legged ticks in particular, they’re the ones carrying the Lyme disease germ, can’t transmit an infectious dose until they’ve been attached and feeding for over a day,” said Mather.
Then, “try to remember when and where you were, where you think you got it,” said James Occi, a microbiologist at the Center for Vector Biology at Rutgers University. If you’re fairly certain the tick couldn’t have been attached for more than a few hours—say, because you spotted it right after a hike and it didn’t look engorged—you don’t appear quite as concerned as someone who finds a large heavily engorged tick, said Fallon.
If you do have a tick attached to you, remove it immediately. It’s most efficient to do so yourself—waiting for an appointment with your provider allows the tick to continue feeding, increasing your chances of developing a tick-borne disease. The sooner you get it out, the safer you are, said Occi.
Pointy, fine-tipped tweezers are best for tick removal (you can find some designed specifically for ticks), followed by regular tweezers. You can use your fingernails in a pinch, but they don’t have as precise a grip, so you’re more likely to break the tick’s head off as you remove it, said Shamoon-Pour. “That is not going to help, because if pathogens are present, they’re going to be in the salivary glands of the tick,” he said. Scratching at your skin can also introduce bacteria, upping the risk of infection.
With tweezers, grasp the tick close to your skin, focusing on “putting it under the belly of the tick and just lifting up,” said Fallon. Try not to squeeze the tick’s belly: “That might, in some cases, act like a syringe, pushing what’s inside the belly into the bloodstream,” he added. If any of the tick’s mouth parts remain, gently remove them with tweezers.
After you’ve detached the tick, clean the area (you can use rubbing alcohol or hydrogen peroxide, said Fallon) and wash your hands with soap and water or hand sanitizer. Now is a good time to do a thorough tick check on the rest of your body.
As for tick removal methods to skip? Some people attempt to apply heat to an attached tick, but “this is not very successful,” said Peter Krause, a senior research scientist in the Department of Epidemiology and Public Health at Yale School of Public Health. Neither is covering it in Vaseline to “smother” it, he added.
It’s a good idea to get in touch with your provider after removing a tick. Guidelines from leading expert groups recommend prophylactic antibiotic treatment, usually a single dose of oral doxycycline taken within 72 hours, for adults and children who identify a tick bite considered high risk for Lyme disease.
If you live in an area where Lyme is prevalent and suspect you were bitten by a black-legged tick, “you could ask your physician whether they think taking prophylaxis makes sense,” said Krause.
If they think you may have or be at risk of developing a different tick-borne illness, they can suggest the best treatment protocol for you.
Always seek medical care if you notice symptoms. For some tick-borne diseases, including Lyme, you might develop a rash “that expands and gets larger and larger,” said Jacob Lemieux, an infectious-disease physician in the Multidisciplinary Lyme Disease Program at Massachusetts General Hospital. Sometimes the rash will have that typical bull’s eye pattern, but not always, and other times it can appear dark red or purplish blue. Even if you don’t develop a rash (and 30 percent of people do not), you can experience flu-like symptoms like fever, headache, muscle aches and joint pain—many of which are common with most tick-borne illnesses.
Most people will develop symptoms of a tick-borne disease (like fever) within a month of being bitten. But symptoms of Lyme disease can develop weeks or even months later, such as uncomfortable swelling in one or more joints (usually a knee), which is known as Lyme arthritis and emerges on average more than six months after initial infection, said Fallon.
“And if a rash or viral-like symptoms develop in the next few weeks,” he added, “definitely consult your provider, as there may have been another attached tick that you missed.”
Kathleen Felton, Washington Post