TICK BITE

 

Symptoms | When to call | Homecare Advice

 

Deer Ticks

  • Deer ticks in various stages of engorgement (swelling) from feeding. They are filled with blood.

Deer Tick on Finger

  • This Deer tick is about the size of an apple seed.
  • The tick is flat and has not yet begun feeding.

Erythema Migrans Rash

  • It is thought that Lyme Disease can be prevented if the tick is removed within 24 hours of attachement.
  • The majority of cases of Lyme disease start with a bull's eye rash ("erythema chronicum migrans") at the site of the tick bite. The rash can occur days to weeks (typically 7-10 days) after a tick bite.
  • Treatment with antibiotics is indicated if this rash appears.

Dog Ticks & Deer Ticks with Pencil for Comparison

  • Dog Ticks: engorged female (A), female (B), male (C)
  • Deer Ticks: larvae (D), nymphs (E), males (F), females (G), engorged female (H)

The Dog Tick (Wood Tick)

  • Picture of female Dermacentor variabilis, American brown Dog Tick.
  • The Dog Tick (wood tick) is the size of a watermelon seed and can sometimes transmit Rocky Mountain spotted fever and Colorado tick fever.

The Deer Tick (Black-Legged Tick)

  • The Deer Tick (black-legged tick) is between the size of a poppy seed (pin head) and an apple seed.
  • The deer tick, Ixodes scapularis, is found on a wide rage of hosts including mammals, birds and reptiles.
  • This tick can transmit Lyme disease to humans and animals during feeding, when they insert their mouth parts into the skin of a host and slowly take in the nutrient-rich host blood.

Definition

  • A tick (small brown bug) is attached to the skin.
  • A tick was recently removed from the skin

General Information

  • The bite is painless and doesn't itch; so ticks may go unnoticed for a few days. Ticks eventually fall off on their own after sucking blood for 3 to 6 days.
  • Ticks can transmit many diseases, including Lyme disease, Rocky Mountain spotted fever (RMSF), and Colorado tick fever.
  • The Wood Tick (dog tick) is the size of a watermelon seed and can sometimes transmit Rocky Mountain spotted fever and Colorado tick fever.
  • The Deer Tick (black-legged tick) is between the size of a poppy seed (pin head) and an apple seed, and can sometimes transmit Lyme disease.

Lyme Disease

  • Lyme disease has become the most common tick-borne illness in the United States. The risk of Lyme disease following a recognized deer tick bite is estimated to be 1%.
  • The majority of cases of Lyme disease start with a bull's eye rash ("erythema migrans") at the site of the tick bite. The rash can occur days to weeks (typically 7-10 days) after a tick bite. Treatment with antibiotics is indicated if this rash appears. Flu-like symptoms may accompany the rash, including: fever, chills, headaches, muscle aches, and fatigue.
  • Removing ticks promptly may prevent Lyme disease.

See More Appropriate Topic (instead of this one) If

WHEN TO CALL YOUR DOCTOR FOR TICK BITE

Call Your Doctor Now (night or day) If

  • You feel weak or very sick

  • You can't remove the tick
  • You can't remove the tick's head that has broken off in the skin (Reason: to prevent localized infection. Note: if the removed tick is moving, it was completely removed)
  • Widespread rash occurs 2 to 14 days following the bite
  • Fever or severe headache occurs 2 to 14 days following the bite
  • Bite looks infected (e.g. spreading redness, pus; Note: infection doesn't start until at least 24-48 hours after the bite).

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

  • You think you need to be seen
  • Red-ring or bull's eye rash occurs around a tick bite
  • Probable deer tick and it was attached for more than 24 hours (or tick appears swollen, not flat) and Lyme disease is common in your area
  • No tetanus booster in more than 10 years

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

Self Care at Home If

  • Tick bite with no complications and you don't think you need to be seen

HOME CARE ADVICE FOR TICK BITE

  1. Wood Tick Removal:
    • Use a pair of tweezers and grasp the wood tick close to the skin (on its head). Pull the wood tick straight upward without twisting or crushing it. Maintain a steady pressure until it releases its grip.  
    • If tweezers aren't available, use fingers, a loop of thread around the jaws, or a needle between the jaws for traction.
    • Note: covering the tick with petroleum jelly, nail polish or rubbing alcohol doesn't work. Neither does touching the tick with a hot or cold object.
  2. Tiny Deer Tick Removal:  
    • Needs to be scraped off with a knife blade or credit card edge.
    • Place tick in a sealed container (e.g. glass jar, zip lock plastic bag), in case your doctor wants to see it.
  3. Tick's Head Removal:
    • If the wood tick's head breaks off in the skin, it must be removed. Clean the skin. Then use a sterile needle to uncover the head and lift it out or scrape it off.
    • If a very small piece of the head remains, the skin will eventually slough it off.
  4. Antibiotic Ointment: Wash the wound and your hands with soap and water after removal to prevent catching any tick disease.  Apply an over the counter antibiotic ointment (e.g. bacitracin) to the bite once.
  5. Expected Course: Tick bites normally don't itch or hurt. That's why they often go unnoticed.
  6. Prevention of Tick Bites:
    • Prevention is important if you are hiking in tick-infested areas.
    • Wear long pants and a long shirt. Tuck your shirt into your pants. Tuck the cuffs of your pants into your socks or boots. Light-colored clothing is better because the ticks can be seen more easily.
    • Inspect your entire body and your clothing every couple hours. Favorite places are in the hair, so be certain to check your scalp, neck, armpits, and groin.
    • A shower at the end of a hike will help rinse off any tick that is not firmly attached.
  7. Call Your Doctor If:
    • You can't remove the tick or the tick's head
    • Fever or rash occur in the next 2 weeks
    • Bite begins to look infected
    • You become worse or develop any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Adult SelfCareNavigator. Copyright © 2000-2004 David Thompson, M.D. FACEP

Reviewed 8/2004

Revised 7/2002

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