Tick bites are generally painless. Many people may not even notice the bite and may never find
the tick if it falls off. Small ticks, like the deer tick that transmits Lyme disease, are so tiny they
may be nearly undetectable. Some ticks are about as small as the period at the end of this
sentence. However, there are some symptoms that may occur that can be directly related to the
tick itself; they are due to the tick bite.
The results of the illnesses transmitted by ticks often begin days to weeks after the tick is gone.
That's why doctors may not suspect a tick-related illness because many people ignore or forget
about barely noticeable "bites." The most important clue about any tick-related illness is to tell
the physician about a tick bite. Also, the individual needs to tell their physician about outdoor
activity (camping, hiking, etc.) in tick-infested areas even if the person does not remember a tick
After a tick bite, individuals may develop any of these symptoms that may be due to the
pathogen(s) that the tick transmits during its bite:
pain and swelling in joints,
shortness of breath, and
nausea and vomiting.
When to Seek Medical Care
Call or see a doctor if any of these conditions exist:
The person or child bitten by a tick exhibits any weakness, paralysis, lethargy,
confusion, fever, numbness, headache, or rashes.
The tick cannot be removed from the skin, or the head and mouthparts remain in the
skin after removal.
Symptoms listed above persist or get worse.
Pregnant individuals should inform their doctors of tick bites and particularly before they
take any medications.
Immunosuppressed individuals (for example those with HIV or cancer or who are
receiving cancer chemotherapy) should inform their physicians of tick bites.
Go immediately to a hospital's emergency department if a tick bite causes any of the
weakness or paralysis,
difficulty breathing, or
How to remove a tick
1. Use a small pair of curved forceps or tweezers. Wear some sort of hand protection such
as gloves so you don't spread pathogens from the tick to your hands.
2. Using the tweezers, carefully flip the tick over onto its back. Grasp the tick firmly with
the tweezers as close to the skin as possible. Apply gentle pulling until the tick comes
free. Twisting or turning the tick does not make removal easier because the mouthparts
are barbed; in fact, such actions may break off the head and mouthparts, thereby
increasing the chances for infection. The illustration below from the U.S. CDC (Figure 4)
shows the proper technique for removal of a tick.
Figure 4: The proper
technique for tick removal.
3. Once removed, don't crush the tick because you may transmit disease. Rinse it down a
sink or flush it down a toilet. Consider keeping it in a tightly closed jar or taped to a
piece of paper. Show the tick to the doctor if you become ill from the tick bite.
4. The area of the bite should leave a small crater or indentation where the head and
mouthparts were embedded. If portions of the head or mouthparts remain, they should
be removed by a doctor.
5. Thoroughly cleanse the bite area with soap and water or a mild disinfectant. Observe
the area for several days for development of a reaction to the bite, such as a rash or
signs of infection. Apply first-aid antibiotic cream to the area. Application of an antibiotic
to the area may help prevent a local infection but usually does not affect the chance of
developing diseases transmitted by the tick.
6. Remember to wash hands thoroughly after handling any tick or instruments that
touched a tick. Clean and disinfect any instruments that were used
Tick Bite Prevention
Avoid grassy areas and shrubs where ticks may be lying in wait to tag a ride on a
Avoid tick season completely by staying away from outdoor areas where ticks thrive,
usually during the months of April through September in the U.S.
Wear light-colored clothing so ticks can be easily seen, and brush them off.
Tuck pants into boots or socks.
Apply insect repellant, specifically the brands designed to repel ticks. Follow label
instructions. Avoid use of DEET-containing repellents on children. Carefully follow
instructions and apply some repellents directly to skin and others to clothing.
DEET-containing repellents with concentrations of 15% or less may be suitable for
children. These should be carefully applied strictly following label directions.
Repellents containing permethrins may be applied to clothing but not to skin.
In high tick areas, DEET-containing repellents may need to be reapplied more
frequently than for repelling mosquitoes. Follow the package label instructions carefully.
Promptly check yourself, others, and pets if exposed to tick areas