What to Do About Tick Bites (for Parents)

en español: Primeros auxilios: Picaduras de garrapata

Medically reviewed by: Yamini Durani, MD

Primary Care Pediatrics at Nemours Children’s Health

Most tick bites are harmless and don’t need medical treatment. But some ticks (like the deer tick, wood tick, and others) can carry harmful germs that cause diseases like Rocky Mountain spotted fever and Lyme disease. The deer tick is tiny, no larger than a pencil point. Other ticks are larger and easier to find on the skin.

How Do I Remove a Tick?

It’s important to remove a tick as soon as possible. Follow these steps:

1. Use tweezers to grasp the tick firmly at its head or mouth, next to the skin. Use a magnifying glass, if you have one, to see the tick clearly.
2. Pull firmly and steadily until the tick lets go of the skin. Do not twist the tick or rock it from side to side. Parts of the tick might stay in the skin, but eventually will come out on their own.
3. Wash your hands and the site of the bite with soap and water.
4. Swab the bite site with alcohol to disinfect the skin.

Note: Never use petroleum jelly or a hot match to kill and remove a tick. These methods don’t get the tick off the skin, and can make it burrow deeper and release more saliva (which makes it more likely to pass a disease).

What Are the Signs of Tick-Related Diseases?

Watch out for:

• a red bump ringed by an expanding red rash, which looks like a bull’s-eye (Lyme disease)
• red dots on the ankles and wrists (Rocky Mountain spotted fever)
• flu-like symptoms such as fever, headache, tiredness, vomiting, and muscle and joint aches

When Should I Call the Doctor?

Call your doctor if:

• Your child has had a tick bite, especially if the tick might have been on the skin for more than 24 hours. Sometimes, doctors prescribe a preventive dose of antibiotics for kids at high risk for Lyme disease.
• Part of the tick remains in the skin.
• A rash of any kind develops (especially a red-ringed bull’s-eye rash or red dots on wrists and ankles).
• The bite area looks infected (increasing warmth, swelling, pain, or oozing pus).
• Your child gets symptoms like a fever, headache, tiredness, stiff neck or back, joint swelling, or muscle or joint aches.
• Your child has facial paralysis (can’t move areas of the face).

How Can I Protect My Kids From Ticks?

To help prevent tick bites:

• After kids play outside, check their skin and hair — especially the scalp, behind the ears, around the neck, in the eyebrows and eyelashes, and under the arms.
• When playing in wooded areas, kids should wear long-sleeved shirts and pants and tuck pant legs into their socks.
• Use an insect repellent with at least 10% to 30% DEET for protection against bites and stings in kids older than 2 years. Always carefully follow the label directions for applying.
• Clothes also can be treated with a specific insecticide (like permethrin) to help prevent bites.
• Wash kids’ skin with soap and water when they come back inside. If you’ve been in an area with ticks, wash all clothes in hot water and tumble dry on high heat before they’re worn again.
• Avoid tick-infested areas.

Medically reviewed by: Yamini Durani, MD

Date reviewed: June 2023

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4 Reasons Poppyseed-Sized Ticks Are More Dangerous Than Adult Ones

Poppyseed muffin lovers across the United States cringed this month after seeing two photos tweeted by the Centers for Disease Control and Prevention (CDC). The first photo depicts a perfectly golden poppyseed muffin speckled with the black seeds — or so it seems.

But after squinting our eyes and pulling our phones closer to our faces — our stomachs turned. There! On the second photo — a closer image — we spotted the tiny, blacked-legged ticks, (called nymph ticks) — atop our favorite poppyseed muffins.

Comments of all sorts, from the garden-variety jokester to critics and advocacy groups, came flooding in.

Lyme disease, transmitted by tick bites, is one of the fastest growing infectious diseases in the United States. Preventing Lyme disease and other tick-borne illnesses has been on America’s radar for a while, but we often think of ticks as those easily visible, half dime-sized bugs that burrow into our skin — or our dogs’.

So, what’s the difference between the tiny ticks and larger ones? Nymph ticks can’t be that dangerous, right? Wrong.

1. Nymph ticks are most active now, and they’re most likely to transmit infections to humans

A single tick will progress through four stages of development in its lifetime: egg, larva, nymph, and adult. The nymph tick is most active in the spring through the summer months, and it’s about the size of a poppy seed.

And they don’t pack less of a punch because of their size. Nymph ticks are actually the most likely to transmit Lyme disease or another tick-borne infection to humans than ticks at other stages, according to the CDC.

Less than two millimeters in size, nymphs can bite people and remain virtually undetected. They also burrow into your or your pet’s skin.

Although adult ticks may also transmit Lyme disease, they’re much larger, so you’re more likely to see them and promptly remove them.

How to check for ticks

1. Inspect yourself, your child, and your pets for ticks whenever you’ve been outdoors. Be sure to check the hidden spots and crevices of the body like the scalp, along the hairline, under the armpits, in the belly button, in the groin, and on the genitals.

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2. A tick bite doesn’t feel like a mosquito bite

Many people think they’ll be able to feel when a tick bites them, just like they feel a mosquito bite.

But ticks are sneaky little bloodsuckers, and they’ve evolved with some sophisticated, almost science fiction-like mechanisms.

Their saliva contains natural anesthetic and immune suppressors to ensure that you don’t feel anything at all when they jab you to feed, reports the Internal Lyme and Associated Diseases Society (ILADS).

The less access the ticks have to your skin, the better. Wear light-colored clothing and tuck your long-sleeved shirt into your pants and your pants into your socks.

Protect your skin and clothing

1. When outdoors, the CDC recommends using a tick repellent that contains at least 20 percent DEET or picaridin on your skin. Treat your clothing by spraying on a product with at least 0.5 percent permethrin.

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3. It’s unclear how long ticks must be attached to you to transmit infections

Should you happen to quickly find a tick embedded in your skin, don’t assume you have no chance of contracting Lyme disease or another tick-borne infection.

The CDC states that a tick must be attached to a host for 24-48 hours to transmit Lyme disease. But a 2015 review stated that the minimum attachment time for transmission of an infection has never been established.

That study also brought to light six documented cases of Lyme disease that had been transmitted in less than 6 hours. Plus, the other diseases that ticks carry — such as babesiosis and bartonellosis — may occur within minutes after a tick has latched onto your skin.

What does this mean for you? While the transmission risks may be lower the less time a tick is attached to you, the risk isn’t completely eliminated if you find an embedded tick and remove it before 24 hours has passed.

Also, keep in mind, many people may not know how or when they acquired a tick bite, making it very difficult to calculate the length of time it was attached for.

How to remove a tick

1. Use fine-pointed tweezers to grasp the tick’s mouth as close to your skin as possible. Don’t put Vaseline on the tick, essential oils, or burn it. Instead, use your tweezers to pull the tick straight out of the skin and save it for testing. Wash your hands and the area of the bite with soap and water.

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4. If you’ve been bitten by an infected tick, you may not develop a rash

Following a tick bite, many people wait and see if they develop a bulls-eye rash. If not, they may wrongfully assume they’re in the clear.

In reality, less than 50 percent of people infected with Lyme disease have a memory of any rash. Other symptoms, like fatigue and aches, occur in many common illnesses. That can make obtaining an accurate diagnosis challenging.

Tick testing

1. If you choose to have your tick tested, organizations like the Bay Area Lyme Foundation will test your tick free of charge or for a small fee.

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Lyme disease is already an epidemic across many parts of the United States, and cases doubled between 2005 and 2015. Although it’s most prevalent in the Northeast, Midwest, and West Coast, it’s been found in all 50 states.

When Lyme disease is caught in its early stages, the chances it can be cured are greater. But if left untreated, it can lead to a myriad of chronic, debilitating symptoms. Antibiotic treatment is inadequate for 10-20 percent of people, leading to ongoing symptoms, or Post-Treatment Lyme Disease Syndrome.

Ultimately, your best defense is to remain vigilant of any unusual symptoms that pop up.

In the early stages of an infection, the symptoms may include flu-like symptoms such as:

• fever
• chills
• sweats
• muscle aches
• fatigue
• nausea
• joint pain

Neurological symptoms like facial drooping (Bell’s palsy) or serious cardiac issues like Lyme carditis can also occur.

If you experience any of these symptoms following a possible exposure to an infected tick, visit a healthcare practitioner who has expertise in the diagnosis and treatment of Lyme disease.

Though a poppyseed-sized tick may seem like a little issue, it has the potential to ruin much more than your cravings for muffins.

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Jenny Lelwica Buttaccio, OTR/L, is a Chicago-based freelance writer, occupational therapist, health coach in training, and certified Pilates instructor whose life was transformed by Lyme disease and chronic fatigue syndrome. She writes on topics including health, wellness, chronic illness, fitness, and beauty. Jenny openly shares her personal healing journey at The Lyme Road.

Small Tick – Big Trouble

Tick bites are to be expected in warm, non-rainy weather. Favorite places are ravines, edges and paths overgrown with grass. The tick does not fall on a person or animal from above. During the bite, the tick injects a special anesthetic substance, so the attack occurs completely unnoticed. For bites choose hidden clothes and tender places. Favorite places of suction are elbows, scalp, legs and arms, groin.

Bloodsucking mites appear in the middle of spring, their number increases rapidly and by May becomes the maximum, remaining until the very beginning of July. After which they die out, but a small number can be observed until the beginning of autumn.

One of the most serious consequences is contracting a disease:

1. Viral encephalitis is a disease that affects the nervous system. In severe cases, the patient develops paralysis and death occurs.

You can become infected both by a tick bite and by drinking unboiled milk of cows or goats infected with encephalitis.

Symptoms appear a week or two after being bitten by a tick: weakness of the arms and legs, impaired sensitivity of the skin of the upper body, temperature up to 39- 40 degrees, severe headache, vomiting, redness of the skin of the upper body and mucous membranes.

2. Tick-borne borreliosis or Lyme disease – the disease occurs in a chronic form, borreliosis can stay in the body for decades.

Symptoms appear 2 to 30 days after the bite. A large bright scarlet spot appears at the site of the introduction of the virus. After 20-30 days, the spot disappears completely, and after 4-6 weeks, symptoms of damage to the nervous and other systems appear. It is necessary to treat this disease in a hospital, because if the pathogen is not destroyed, a chronic form develops, resulting in disability.

3. Relapsing tick-borne typhus – a blister appears at the site of the bite, the victim suddenly starts to shiver, his head hurts, he is very hot, he is lethargic, his limbs aches, the temperature is up to 39 – 40 degrees, he feels sick. The body becomes covered with a rash, the liver and spleen increase in size, yellowing of the sclera and skin can be observed. Sometimes there are symptoms of involvement in the process of the heart, respiratory organs. The acute period lasts 2-6 days, then the temperature returns to normal.

The patient’s condition is improving. But after a few days, the second attack begins. Attacks can be from four to twelve. Subsequent attacks are usually milder than the first. The disease is diagnosed with a blood test.

Inpatient treatment. If a person was healthy and not exhausted before infection, then he has every chance of fully recovering.

4. Q fever

Ticks are one of the carriers of pathogens. Possible infection from the patient through sputum or breast milk.

Symptoms may appear a few days or a month after the tick bite. Usually the onset of the disease is rapid: aches all over the body, headache, cough, aversion to food, redness of the face, an increase in body temperature up to 38 – 40 degrees.

In many cases, inflammation of the lungs is detected.

Q fever is treated only in the hospital. The disease responds well to medical treatment. A cured person is not re-infected.

The probability of getting infected when bitten by a tick is the higher, the longer the insect was in the sucking state. Therefore, the tick should be removed as soon as possible.

It is best to use tweezers for removal, the most convenient is a surgical clip. The grip should be carried out as close to the head as possible. Firmly grabbing the insect, you need to start twisting it and gently pulling it towards you. No need to sharply pull the insect towards you – the proboscis can come off.

You can remove the insect with a normal thread. To do this, tie a knot between the head of the tick and the body. It turns out that the knot is tightened at the base of the proboscis. You need to pull the thread very carefully and slowly. Otherwise, the insect will tear.

It is very important not to squeeze the body of the insect, as this may force the contents of the tick, along with pathogens, into the wound.

If, after removing the tick, a small black dot remains at the suction site, this means that the head has come off and must be removed. To do this, the affected area is treated with alcohol and the wound is cleaned with a disinfected needle. After removing the head, you need to lubricate the wound with alcohol or iodine.

Do not drip oil or alcohol on the tick, as the tick will either suffocate and remain in the wound, or it will get scared and begin to secrete more saliva and, along with it, pathogens.

To remove an insect from the ear, lay the victim, turn his head on his side and pour a small amount of slightly warm water into the ear where the insect is located. Lie down for about a minute, then turn your head to the other side and wait until the water flows out and the insect comes out with it. Sometimes this is not enough, but in such cases, medical assistance is no longer enough.

After removing the insect, place it in a glass bottle and throw in a small piece of cotton wool slightly soaked in water. Close the bottle tightly and keep it in a cold place until poisoning in the hospital. In order for the analysis to succeed, the insect must be delivered to the laboratory alive.

If the insect itself is infected, it is not necessary that the bite necessarily led to the infection of a person. The answer will be given only by a laboratory study of the insect itself or the blood of the victim. It takes at least a week for the infection to develop in the body. Therefore, usually the analysis is prescribed 10 days after the bite.

Bite prophylaxis is mandatory if a person is not vaccinated against tick-borne encephalitis, as well as in cases where there is a high probability of infection (the tick is a carrier of the virus, several ticks were found at once).

It is best if the necessary drugs are administered within 24 hours of the bite. If more than four days have passed, prevention is useless.

Immunoglobulin or antiviral drugs are used to prevent tick-borne encephalitis.

Immunoglobulin is used only on prescription.

The antiviral agents jodantipyrin are used for patients over 14 years of age and anaferon for babies. In the event that none of these drugs is available, you can use any antiviral agent sold in a pharmacy (arbidol, cycloferon, rimantadine).

Vaccination is an effective way to prevent infection. The effectiveness of the vaccine is 95%.

Primary vaccination course is carried out at intervals of 1-3 months and consists of two vaccinations. Another one is needed next year. Then, to maintain immunity, the vaccine is administered once every three years.

To avoid being bitten by a tick, you should dress appropriately when going to tick habitats. Clothing should be with long sleeves, trousers, you also need to put something on your head, preferably a hood. Thermal underwear can be very convenient, as it fits perfectly to the body and does not allow the insect to crawl into secluded places.

Long socks or stockings are required and the legs must be tucked into boots or chosen with cuffs. It is desirable that the collar be buttoned tightly enough.

Another effective remedy for ticks is repellents. They are sold in many stores and pharmacies.

Repellent should be applied to the places where the tick gets in the first place – trousers, shoes and legs to the thigh. Tick ​​repellents are quite toxic, so it is advisable to avoid getting them on open areas of the body.

To protect children, preparations with a reduced content of repellent have been developed – these are Ftalar and Efkalat creams, Pihtal and Evital colognes, Kamarant. For children from 3 years old, the use of Off-Children’s and Biban-Gel creams is recommended.

Tsifox is used to treat the territory from ticks.

And the third remedy is vigilance. Periodically, you should examine each other for preventive purposes.

If a tick is found, it should not be crushed, because through microcracks on the hands one can become infected with encephalitis.

Tick bite insurance provides a range of medical services:

The victim will be admitted to a special medical facility for seroprophylaxis.

The tick will be removed.

Within two to three days after the bite, the victim will receive a prophylactic course of immunoglobulin.

Insurance can be individual or family insurance (one insurance policy is issued for all households at once).

The insurance contract must have an appendix: a list of all medical institutions where you can get insurance assistance.

What to do if a child is bitten by a tick

We vaccinate children and adults against tick-borne encephalitis! Now the Fantasy Clinic has the Tick-E-VAK vaccine available. It is suitable for children from 1 year old and adults. Vaccination course – 2 doses.

What to do if bitten by a tick? This and other important questions are answered by Svetlana Mukhortova, pediatrician, specialist in infectious diseases in children.

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