- First Aid: Tick Bites
- Tick Bite
- Is this your child’s symptom?
- When to Call for Tick Bite
- Seattle Children’s Urgent Care Locations
- Care Advice
- Tick bite
- What is a tick bite?
- What are the clinical features of a tick bite?
- Acute or early skin manifestations of a tick bite
- Chronic or late skin manifestations of tick bites
- How is a tick bite diagnosed?
- What is the treatment for a tick bite?
- How can tick bites be prevented?
- How to Know When It’s a Tick Bite and What to Do About It
- How Do I Know If I’ve Been Bitten by a Tick?
- If the Tick Is Still Attached …
- If the Tick Has Dropped Off …
- A tick bite is never something to brush off, forget about, and deal with later. Many ticks carry microbes that can cause a variety of diseases.
- Tick bite prevention
- What are ticks?
- The Paralysis Tick
- How does the Paralysis Tick affect humans?
- How to prevent tick bites?
- Removing ticks
- Further information
- This summer has been dubbed a ‘tick apocalypse’ — here’s how to spot a tick a bite
- What if I don’t get a rash but still feel super sick?
- If I did get a tick-borne illness, how long does it take for symptoms to appear?
- What if the tick that bit me didn’t transmit an infection?
- Signs of Lyme disease that appear on your skin
- Stage 1: Quickly expanding rash
- Stage 2: Small, oval rashes or a reddish lump
- Stage 3: Changing skin
- Seek medical care early to prevent Lyme disease from progressing
- What Does A Tick Bite Look Like?
- Signs and symptoms of tick bites on humans
- Where should you look for tick bites?
- What’s the easiest way to identify a tick bite?
- What do tick bites on humans look like if the tick isn’t present?
- What is the tick bull’s-eye bite?
- Removing the Tick
- Recognizing the Rash After a Tick Bite
- Requesting and Receiving Care For the Tick Bite
- Summit Medical Group Web Site
First Aid: Tick Bites
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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:
- Use tweezers to grasp the tick firmly at its head or mouth, next to the skin.
- 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.
- Wash your hands and the site of the bite with soap and water.
- Swab the bite site with alcohol.
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:
- The tick might have been on the skin for more than 24 hours.
- 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).
- Symptoms like fever, headache, tiredness, stiff neck or back, or muscle or joint aches develop.
How Can I Protect My Kids From Ticks?
- 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.
- Avoid tick-infested areas.
Reviewed by: Michelle M. Karten, MD Date reviewed: May 2019
Is this your child’s symptom?
- A tick (small brown bug) is attached to the skin
- A tick was removed from the skin
Symptoms of a Tick Bite
- A tick bite does not cause pain or itch. So, ticks may not be noticed for a few days.
- After feeding on blood, ticks get swollen and easier to see.
- Ticks fall off on their own after sucking blood for 3 to 6 days.
- After the tick comes off, a little red bump may be seen.
- The red bump or spot is the body’s response to the tick’s saliva (spit).
- While it’s sucking blood, some of its spit gets mixed in.
Causes of Tick Bites
- The wood tick (dog tick) is the size of an apple seed. After feeding, it can double or triple in size. Sometimes, it can pass on Rocky Mountain spotted fever or Colorado tick fever.
- The deer tick is the size of a poppy seed. After a feeding, it can triple in size. Sometimes, it can pass on Lyme disease.
- Over 95% of people who get Lyme disease live in or have traveled to 14 high-risk states. Lyme disease mainly occurs in the Northeast, Mid-Atlantic and upper Midwest. Many states do not have Lyme disease. The CDC reports over 30,000 new cases per year (2015).
- About 80% of Lyme disease starts with a bull’s eye rash called erythema migrans. The rash starts at the site of the tick bite. It starts on the average at 7 days. It grows larger quickly, to more than 2 inches (5 cm) wide. It can become as large as 12 inches (30 cm). It lasts 2 or 3 weeks. Treatment of this rash with an antibiotic is advised. This almost always prevents the later stages of Lyme Disease. If Lyme Disease isn’t treated, heart, joint and neurologic problems can occur.
- Giving antibiotics after deer tick bites to prevent Lyme Disease depends on the risk. The risk is low with brief attachment. The risk is high if the deer tick was attached for longer than 36 hours. It’s also higher if the tick is swollen, not flat. Ask your doctor for advice.
- The risk of Lyme Disease after a deer tick bite is low. Even in high risk areas, only 2% of deer tick bites cause Lyme Disease.
When to Call for Tick Bite
Call Doctor or Seek Care Now
- Can’t remove the tick after trying this care advice
- Widespread rash starts 2 to 14 days after the bite
- Fever or headache starts 2 to 14 days after the bite
- Fever and bite looks infected (spreading redness)
- Weak, droopy eyelid, droopy face or crooked smile
- Your child looks or acts very sick
- You think your child needs to be seen, and the problem is urgent
Call Doctor Within 24 Hours
- Deer tick was attached for more than 36 hours
- Deer tick is swollen, not flat
- New redness starts more than 24 hours after the bite. Note: bacterial infection is rare. It does not start until at least 24-48 hours after the bite.
- More than 48 hours since the bite and redness now getting larger
- Red-ring or bull’s eye rash occurs around a deer tick bite. Note: the rash of Lyme disease starts 3 to 30 days after the bite.
- You think your child needs to be seen, but the problem is not urgent
Call Doctor During Office Hours
- You have other questions or concerns
Self Care at Home
- Wood tick bite
- Deer tick bite
- Preventing tick bites
Seattle Children’s Urgent Care Locations
If your child’s illness or injury is life-threatening, call 911.
Treating Tick Bites
- What You Should Know About Wood Tick Bites:
- Most wood tick bites are harmless.
- The spread of disease by wood ticks is not common.
- If the tick is still attached to the skin, it needs to be taken off.
- Try one of the methods described below to take out the tick.
- Wood Tick – How to Remove with Tweezers:
- Use tweezers. Grasp the tick as close to the skin as possible (on its head).
- Hold the tweezers sideways next to the top of the skin.
- Pull the wood tick straight upward without twisting or crushing it.
- Keep a steady pressure until the tick lets go of its grip.
- If you don’t have tweezers, you can use your fingers.
- Other options. You can use a loop of thread around the jaws. You can also use a needle pushed between the jaws for traction. Jaws are the part of the head attached to the skin.
- Not helpful: Covering the tick with petroleum jelly or nail polish doesn’t work. Neither does rubbing alcohol or a soapy cotton ball. Touching the tick with a hot or cold object also doesn’t work.
- What You Should Know About Deer Tick Bites:
- Most deer tick bites are harmless.
- The spread of disease by deer ticks is not common.
- Even in high risk areas, only 2% of deer tick bites cause Lyme disease.
- Most people who get Lyme disease live in or have traveled to 14 high-risk states. Lyme disease mainly occurs in the Northeast and upper Midwest. Many states do not have Lyme disease.
- Deer Tick – How to Remove:
- If it is swollen, try to remove with a tweezers. See wood tick advice.
- Tiny deer ticks need to be scraped off.
- You can remove them with the edge of a credit card.
- Tick’s Head – When to Remove:
- If the wood tick’s head (mouth parts) breaks off in the skin, remove any large pieces.
- Clean the skin with rubbing alcohol.
- Use a clean tweezers or needle to scrape it off.
- If a small piece remains, the skin will slowly heal and shed it.
- Antibiotic Ointment:
- After the tick is removed, wash the wound with soap and water. Also, wash your hands after you are done.
- This helps to prevent catching any infections carried by the tick.
- Use an antibiotic ointment (such as Polysporin). No prescription is needed.
- Put it on the bite once.
- What to Expect:
- Most often, tick bites don’t itch or hurt.
- That’s why they may not be noticed.
- The little bump goes away in 2 days.
- If the tick transferred a disease, a rash will occur. It will appear in the next 4 weeks.
- Call Your Doctor If:
- You tried and can’t remove the tick
- Fever or rash happens in the next 4 weeks
- Bite starts to look infected
- You think your child needs to be seen
- Your child becomes worse
Prevent Tick Bites
- Prevent Tick Bites:
- After being outdoors in deer tick areas, check for ticks. Remove any that are attached. Also, take a shower soon after coming inside.
- Tumble any clothing in a hot dryer for 10 minutes. That should kill any ticks left in the clothing.
- When hiking outside where there are ticks, wear long clothing. Tuck the ends of pants into socks.
- Use a bug repellent to shoes, socks and exposed skin.
- Tick Repellent for Clothing – Permethrin:
- Permethrin products (such as Duranon) work well to repel ticks.
- Unlike DEET, these products are put on clothing instead of skin. They also can last through many washes. Use it on pant cuffs, socks and shoes. You can also put it on other outdoor items (bug netting, sleeping bags).
- Do not put it on skin. Reason: Sweat changes it so it does not work.
- Tick Repellent for Skin – DEET:
- DEET also works well to repel ticks. It can be used on the skin not covered by clothing.
- Use 20-30% DEET for children and teens (AAP). Note: 30% DEET protects for 6 hours.
- DEET is approved for use in children over 2 months of age (AAP).
And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Last Reviewed: 02/01/2020
Last Revised: 03/14/2019
Copyright 2000-2019 Schmitt Pediatric Guidelines LLC.
What is a tick bite?
Ticks are blood-sucking parasites. When they take a blood meal, they can cause dermatologic disease directly by their bite, or indirectly as vectors of other diseases. Tick-borne diseases include:
- Bacterial infections including Lyme disease, relapsing fever, tularaemia, and babesiosis
- Rickettsial infections including Rocky Mountain spotted fever, other spotted fevers, ehrlichiosis and anaplasmosis, and Q fever
- Viral diseases including tick-borne encephalitis, Crimean-Congo haemorrhagic fever, Colorado tick fever, Powassan encephalitis, and others
- Tick bite induced red meat allergy.
This page will focus on skin diseases that occur as a direct result of tick bites. Risk factors for tick exposure include outdoor activities such as camping, hiking, walking in long grass, or contact with animals. In endemic areas, infections can also be acquired during routine activities. Many cases of the tick-borne disease occur in the summer months when ticks are most active.
What are the clinical features of a tick bite?
While tick bites can be painful, in many cases they can go unnoticed. Once the tick is full from its blood meal it falls off the skin.
Ticks can be categorised as either hard or soft ticks and this distinction determines some of the clinical features of the tick bite. Hard ticks feed for a few days to several weeks, while soft ticks feed quickly and leave their host rapidly.
Ticks cause acute and chronic skin diseases through physical trauma, salivary secretions, toxins, excretions, body parts, or by causing a host to scratch. Skin disease may occur away from the site of the bite, and tick bites can also cause disease in other parts of the body such as ‘flu-like symptoms, vomiting, paralysis and even anaphylaxis.
Acute or early skin manifestations of a tick bite
For both hard and soft tick bites, 0.5–2 cm red areas, papules (small bumps), or thin plaques may form at the site of attachment within 1 to 3 days. The lesion may feel hard and may be surrounded by redness. Mild swelling or blister formation can occur. The bite can be mild to severely itchy.
Necrotic (dead tissue) ulcers can form in severe cases; usually due to bites from soft ticks. Bites from soft ticks may be painful.
Specific tick species can also cause characteristic lesions such as bruising (purpura), urticaria, and ulceration.
Chronic or late skin manifestations of tick bites
Acute skin lesions can persist and become papules, nodules (larger solid lumps), or plaques. Over days to months, these lesions can form a tick bite granuloma; a 0.5 to 2 cm nodule made up of mixed inflammatory cells.
Tick bites can also rarely result in hair loss (alopecia), which may resolve within 1 to 3 months, or be permanent.
Tick bites can develop wound infection due to secondary infection by bacteria such as Staphylococcus aureus and Group A Streptococcus. Retained tick material and host scratching may increase the likelihood of this complication.
How is a tick bite diagnosed?
Diagnosis can be difficult, especially if the bite has gone unnoticed. Microscopic examination of skin biopsy specimens may assist diagnosis. Sometimes if a tick is still attached, it can be removed and identified. Additional tests may be done according to the tick identified and whether or not it is a vector for certain diseases.
What is the treatment for a tick bite?
Itch resulting from a tick bite may be relieved with topical steroids and oral antihistamines. Tick bite granulomas can be surgically removed.
Ticks still attached to the skin should be physically removed. Equipment necessary for tick removal includes gloves, isopropyl alcohol or other skin disinfectant, and fine-toothed forceps. The patient should be comfortably positioned so that the doctor can easily access the tick.
While wearing protective gloves, gently grasp the tick with tweezers as close as possible to the skin and slowly, gently pull it upwards and away. Do not twist or jerk the tick as this may cause the tick mouthparts to break off and remain in the skin. Also, do not squeeze or puncture the body of the tick as this may contain infectious organisms that cause disease.
How can tick bites be prevented?
- Avoid areas such as forests or fields where ticks are found.
- Use insect repellent containing DEET on the skin, and permethrin on the clothes.
- Wear long-sleeved clothing that fits tightly around the wrists, waist, and ankles.
- Check twice daily for attached ticks and remove immediately.
- Dry clothing at high heat in a tumble dryer.
How to Know When It’s a Tick Bite and What to Do About It
How Do I Know If I’ve Been Bitten by a Tick?
Detecting tick bites can be tricky. Unlike the bites of mosquitoes and other insects, tick bites do not tend to cause itching or immediate skin irritation.
“Every blood-feeding arthropod and insect introduces saliva into the wound,” explains Jonathan Day, PhD, a professor of medical entomology at the University of Florida. In the case of mosquitoes and some other biting insects, this saliva contains proteins that prevent the bite wound from clotting, which would slow the outflow of blood and therefore disrupt feeding, Dr. Day explains.
Apart from preventing your blood from clotting, these proteins also trigger a reaction from your immune system. This reaction produces redness, swelling, itching, and all the other unpleasant skin irritations that come with bug bites, Day explains.
RELATED: How to Identify 11 Common Bug Bites
But tick bites are different. “Ticks suppress that reaction with immunosuppressants in their saliva,” Ostfeld explains.
Since you can’t feel a tick’s bite, you can detect it in one of two ways:
- By spotting or feeling a tick on your skin
- By identifying a bite once the tick has dropped off
If the Tick Is Still Attached …
Finding a tick on your skin can be quite difficult, Ostfeld says — especially during the spring and early-summer months when ticks are in their nymph stage, and so are roughly the size of a poppy seed. You have to closely examine your skin — and have a loved one scan the places you can’t see — in order to spot them. While adult ticks are a little larger, they’re still difficult to identify.
Running your hands over those parts of your body ticks tend to bite is another way to find them before they’ve dropped off. (They’ll feel like small, unfamiliar, hard nodules on your skin.)
If the Tick Has Dropped Off …
While tick bites don’t immediately itch like other bug bites, they can still cause a red welt or itchy lesion to rise on the skin after the tick has dropped away, Ostfeld says.
The size and quality of this lesion can vary a lot from person to person, he says, and so it may be impossible to differentiate a tick bite from a mosquito bite. Especially if the tick that bit you was not carrying Lyme disease or some other infection, the bite is likely to resemble a mosquito bite and quickly fade away.
RELATED: How to Identify These 11 Common Skin Rashes
But if you find a tick on your skin or notice an itchy lesion that doesn’t go away within a few days, that could indicate Lyme disease or some other kind of tick-borne infection. (3) The same is true of a large, bull’s-eye-shaped skin lesion — something that looks like a red welt surrounded by one or more outer rings of inflamed red skin. (3) This bull’s-eye rash is a hallmark of Lyme disease.
Bulls-eye rashes, like this one, can be a warning sign you may have been bitten by a tick that transmitted Lyme disease to you. iStock
A tick bite is never something to brush off, forget about, and deal with later. Many ticks carry microbes that can cause a variety of diseases.
If diseases caused by tick bites are left untreated, they can lead to serious health problems that could potentially affect your muscles, joints, brain, heart, vision, and nervous system. Many tick-borne illnesses can have serious consequences that alter your lifestyle and activities by limiting your mobility, cognition, and overall quality of life. Knowing how to identify a tick bite and recognizing the general symptoms of tick-borne diseases can alert you to possible health risks sooner, so you can consult with your healthcare provider about appropriate next steps as soon as possible.
What a tick looks like
The first step in identifying tick bites is to know what ticks look like. Ticks will look different at each stage of their life cycle. Belonging to the arachnid class (scorpions, spiders, mites), ticks begin their life as an egg then hatch as a larva, which grows into a nymph and finally an adult tick. Dozens of tick species exist, but all are similar in appearance.
Photo taken by Christopher Paddock. Image Source: https://phil.cdc.gov/Details.aspx?pid=10879 Ticks generally have four stages of life: egg, larvae, nymph and adult. Ticks advance through each of these stages by molting, a process during which they shed their outer skin.
What a tick bite looks like
Tick bites are painless, so it’s likely you won’t immediately know that you’ve been bitten. The tick injects an anesthetic into the skin at its point of entry, which helps it avoid detection so it can continue feeding. Many patients with the tick-borne Lyme disease don’t recall having a bug bite of any kind.
So how do you know if you have a tick bite? The following pictures of tick bites may help. Take a moment to review each one closely and read through the accompanying descriptions to better spot and identify potential tick bites on you or your loved ones.
In this photo, the tick is still attached, having burrowed its head into the skin to feed. The redness around the tick indicates inflammation in the skin. In this photo, the tick is still attached to the skin and appears larger because it has been feeding longer. This is an example of an engorged tick, so called because it has been gorging on blood.
Other bug bites can sometimes resemble tick bites, and therefore, it isn’t always easy to know whether you or a loved one have been bitten by a tick. The following guidelines can help, but it is always best to consult with your healthcare provider if you suspect a tick bite.
- Tick bites are not fluid-filled, whereas bites from ants and other insects are typically pus-filled.
- Location can sometimes help distinguish tick bites from other insect bites because ticks most commonly bite the back of the neck, scalp, groin, and legs.
- Other insect bites may be multiple in number. Ticks typically bite once then burrow their head under the skin.
Rashes May (or May Not) Indicate a Tick-Borne Infection
A bulls-eye rash is often a telltale sign—not only of tick bite but of a potential Lyme disease infection. Other insect bites typically do not produce a rash with this distinctive pattern.
The skin is reddened in the area immediately surrounding the tick bite in this picture. Look closely and you’ll also see another “ring” of redness farther out from the site. This is called a bulls-eye rash – also known technically as Erythema Migrans (EM) rash – and appears only about 33 percent of the time when a person has been infected with Lyme disease. In this photo, you see the bull’s-eye rash (EM) but no tick.1Chaaya, G., Jaller-Char, J.J., and Ali, S.K. “Beyond the Bull’s Eye: Recognizing Lyme Disease.” Journal of Family Practice 65, no. 6 (June 2016): 373–9. https://www.ncbi.nlm.nih.gov/pubmed/27474818. In this photo, you see the rash caused by bartonella.
Rashes may also indicate other types of tick-borne diseases, including tick-borne relapsing fever, Rocky Mountain spotted fever, Ehrlichiosis or Bartonella.
If you see this or any other rash pattern near a site, notify your healthcare provider immediately.
How to Safely Remove a Tick
If you see a tick still attached to the skin, remove it immediately. There are many ways to remove ticks, but some are more effective than others.
First, preserving the tick can help your doctor determine whether it carries a potential disease in the event that you develop any symptoms following the bite. Smashing a tick that is attached to your skin can also release more toxins into your body, which can further expose you to potential infectious diseases. So even though your initial inclination may be to squash a tick that has attached to your skin, try instead to keep it intact.
The following steps can help you remove the tick quickly and carefully:
- Grab the tick with pointed tweezers close to the skin where it has burrowed in.
- Do not squeeze the tick—that may cause more pathogen-laced saliva to enter the body.
- Pull upward with steady, even pressure. Do not twist or jerk the tick; this can cause mouth parts to break off and remain in the skin. Tick removal can get tricky if the tick’s body breaks apart during removal. If this happens, try to tweeze out the remainder of the tick body or leave it in place and have a healthcare provider remove it as soon as possible.
- You may hear a pop when the tick is removed.
- Place the tick in a ziplock bag and close it tightly. Keep it in the freezer.
- Clean the skin with alcohol and wash your hands.
- Do NOT use cigarette butts or matches.
Grab the tick with pointed tweezers close to the skin where it has burrowed in.
General symptoms of tick-borne diseases
If infected with a tick-borne illness, symptoms generally start to present themselves a few days after the bite. Although the symptoms vary based on the type of tick and the disease it may be carrying, general signs to watch for include the following:
- Mild itching
- Reddened area on the skin
- Very specific type of bulls-eye rash (EM) for Lyme
- Non-EM rash for other tick-related infections
Some of the diseases carried by ticks include borreliosis (Lyme disease and tick-borne relapsing fever—TBRF), babesiosis, ehrlichiosis, bartonellosis, anaplasmosis, tularemia, and rickettsiosis (including Rocky Mountain spotted fever). With certain diseases, symptoms may worsen over time. These may include memory loss, muscle weakness, fatigue, fevers that come and go, and declining cognitive functions.
Careful observation is an important first step after identifying any tick bite. Write down dates and circumstances of any bites you or a loved one encounter, along with any symptoms that present immediately or over time. If you see signs of a potential tick-borne illness, be sure to share this information with your healthcare provider. In many cases, patients and their doctors simply don’t realize that a tick bite from several weeks or months ago is responsible for their illness. Alerting healthcare providers as quickly as possible to any exposure to ticks may contribute to an earlier diagnosis of tick-borne illnesses.
Testing for tick borne diseases early and alerting healthcare providers as quickly as possible to any exposure to ticks may contribute to an earlier diagnosis of tick-borne illnesses.
Tick bite prevention
This page provides information about tick bites
Page last updated: 25 November 2015
What are ticks?
Ticks are parasites that feed on animal and human blood. There are more than 800 species of ticks around the world, with 70 found in Australia and 16 species have been reported as feeding on humans.
There are two major groups of ticks: hard ticks and soft ticks.
Hard ticks (family: Ixodidae) have a hard flat body and elongated mouthparts with rows of backward pointing teeth. This group includes the most important species that bite humans.
Soft ticks (family: Argasidae) have a wrinkled leathery appearance. Only a few species of this type are found in Australia and they rarely come into contact with people.
The most important tick in Australia is the Paralysis Tick, Ixodes holocyclus, and over 95% of tick bites in Eastern Australia are due to this species. Most tick-borne illnesses are due to this species.
The Paralysis Tick
The Paralysis Tick, Ixodes holocyclus, is found along the eastern seaboard of Australia east of the Great Dividing Range, and possibly into Tasmania. It is commonly referred to as the grass tick, seed tick and bush tick depending upon its stage of development. It is not known to occur in South Australia, Western Australia or the Northern Territory.
While I. holocyclus is the most common, there are two other Ixodes species in Australia which cause paralysis: I. hirsti, which occurs in South Australia and also has been documented in NSW and Tasmania, and I. cornuatus, which occurs in Tasmania and Victoria.
There are four stages in the life cycle of a tick; the egg, larvae (around 1mm and light brown in colour when not full of blood), nymph (around 2mm and pale brown) and the adults (4–5mm in length, without blood). The Paralysis Tick needs to feed on blood to develop through its lifecycle from the larvae stage to a nymph and to an adult. The adult female takes blood to obtain protein for the laying of eggs.
When fully engorged it is grey-blue in colour up to around 1cm in length.
Tick life cycle (S.L. Doggett, Department of Medical Entomology, Westmead Hospital) as described above.
The Paralysis Tick is most common in moist, humid coastal areas with abundant native animals that serve as hosts for the tick. Long grasses and bushland provide ideal environments for ticks, and if you live close to these areas, it is not uncommon to have Paralysis Ticks in your garden. This tick has a distinct seasonality; the larval stage is most active during the autumn months, the nymph during winter and the adult during the spring. This tick is most active during periods of high humidity, especially after rain, and this is when you should take particular care to avoid tick bites.
Paralysis Ticks are not particularly mobile, and rely on passing animals for a blood meal. The Paralysis Tick will crawl up the stems of grasses or along branches and ‘perch’ ready to latch on to a passing animal, including humans. They rarely climb higher than 50cm in their habitat, so do not drop out of trees, despite this common belief. However, after landing on a person or animal they can walk up the body and attach to the head area.
Female Ixodes holocyclus (S.L. Doggett, Department of Medical Entomology, Westmead Hospital) photograph above
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How does the Paralysis Tick affect humans?
A tick attaches itself by piercing its sharp mouthparts into skin. It then injects an anticoagulant (a substance that prevents blood from forming clots) saliva which allows it to feed without the blood clotting. In the case of the Paralysis Tick, the saliva may be highly toxic to some animals and, potentially, humans.
Most tick bites pose no medical problems apart from some localised swelling and redness at the bite site if the tick is removed promptly. However, in some cases people can experience more severe conditions such as tick paralysis or allergic reactions including anaphylactic shock. Early symptoms of tick paralysis may include rashes, headache, fever, influenza like symptoms, tenderness of lymph nodes, unsteady gait, intolerance to bright light, increased weakness of the limbs and partial facial paralysis. Tick paralysis, while rare, is usually seen in children rather than adults. Allergic reactions can result in swelling of the throat, and may lead to breathing difficulties or collapse. It is important to seek medical attention quickly if such symptoms occur. If you have had similar symptoms in the past after being bitten by a tick, then it is a good idea to always be prepared.
Some serious tick-borne diseases also occur in Australia including, Queensland tick typhus and Flinders Island spotted fever. There are concerns that other serious illnesses, such as a Lyme disease-like syndrome, may be caused by exposure to Australian ticks, however there is no evidence yet this is the case (Lyme Disease).
Recently a new syndrome known as “tick-induced mammalian meat allergy” has been described, whereby people bitten by the Paralysis Tick, which is found in coastal Eastern Australia, can subsequently develop an anaphylactic reaction to consuming meats and animal by-products such as gelatine. This syndrome has also been described overseas.
How to prevent tick bites?
The best way to prevent tick bites is to avoid tick-infested areas.
If this is not possible, wear appropriate clothing such as:
- a long sleeved shirt
- long pants tucked into socks
- light coloured clothing to make it easier to see ticks on clothes before they attach to the skin
Before entering possible tick infected environments apply an insect repellent containing diethyl-meta-toluamide (DEET) or picaridin to the skin. The repellent should be applied and re-applied according to the manufacturer’s instructions. Clothing treated with permethrin is also recommended.
Permethrin wash kits for treating clothes can be obtained from outdoor recreational stores and it is important to follow the label directions. Permethrin-treated clothing is considered the most effective means of preventing tick bite in tick infested areas.
All clothing should be removed after visiting tick infested areas and placed into a hot dryer for 20 minutes to kill any tick that could be still on the clothing. The entire body should be then checked for ticks of all sizes and stages, paying particular attention to areas behind the ears and the back of the head or neck, especially on children.
If you suffer from allergic reactions to ticks, only attempt to remove a tick whilst at a medical facility such as an Emergency Department.
In non-allergic individuals or for larval or nymphal stage ticks:
- When removing a tick with fine tipped forceps (not household tweezers unless fine tipped forceps are not available), grasp the tick as close to the skin’s surface as possible. Pull upwards with steady pressure and avoid jerking or twisting the tick.
- Prior to removal, the tick may be sprayed with an aerosol insect repellent containing pyrethrin or a pyrethroid chemical, although there is currently no evidence to suggest that this is of benefit. Permethrin based creams, which are available from chemists may also be used. Apply at least twice with a one minute interval between applications.
- If you have difficulty removing the tick or suffer any symptoms after removal, seek medical attention urgently.
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- Use only fine tipped forceps and avoid squeezing the body of the tick.
- Don’t use folklore remedies such as matches or pins because they will irritate the tick and make it harder to completely remove.
- Avoid scratching and do not use irritant chemicals such as methylated spirits or kerosene.
The Australasian Society of Clinical Immunology and Allergy has recently recommended killing an adult tick in place by using an ether-containing spray to kill the tick by freezing it. These products are normally used for the treatment of warts and skin tags and are readily available from chemists.
This document does not recommend this method until evidence-based research becomes available. When new evidence is published this document will be reviewed.
If you are concerned about ticks, contact:
- your Medical Practitioner
- the Poisons Information Centre: 13 11 26
- your state or territory health department
- your local council Environmental Health Officer
- Australasian Society of Clinical Immunology and Allergy (www.allergy.org.au).
In this section
- Dengue Fact Sheet
- Listeria Fact Sheet
- Tick bite prevention
This summer has been dubbed a ‘tick apocalypse’ — here’s how to spot a tick a bite
The INSIDER Summary:
- Experts say that 2017 could be one of the worst tick seasons ever.
- Prevention is the best defense against tick-borne disease, but everyone should know how to spot a bite, too.
- Always conduct a thorough search of your skin when you come inside, look for distinctive tick-related rashes, and pay attention to symptoms like fever, chills, and aches.
For being such tiny little animals, ticks cause some enormous problems.
The Centers for Disease Control and Prevention (CDC) says that cases of Lyme and other tick-borne diseases have been steadily rising in the US — and this particular tick season might be the worst yet.
In the northeast, a milder winter set the stage for a surge in ticks that can carry dangerous bacteria and viruses, according to experts at Cornell University. One news station in Massachusetts even dubbed this season a potential “tick apocalypse.”
Even scarier is that some tick-borne disease can have serious complications or even be fatal. Experts say the best defense is prevention — think insect repellent, avoiding tick-heavy areas, and showering right when you get inside — but you should also know how to spot a tick bite if you happen to get one.
Here’s what you need to do:
1. Thoroughly check your skin.
Ticks can be tiny, so look carefully.
The best way to spot a tick bite is to actually see a tick on your skin. If you’ve been outside in a grassy, brushy, or wooded area — especially if you live in one of the country’s tick hotspots — always check your skin once you’re inside.
The CDC says you should check your entire body, but pay special attention to more hidden areas, like your underarms, your ears, inside your belly button, the backs of your knees, between your legs, your waist, and especially your scalp and hair. Break out a mirror to check the parts of yourself that are difficult to see, and use a fine-tooth comb to carefully look through hair.
Keep in mind that some ticks are extremely small, so it pays to be extra careful. An adult deer tick — the kind that causes Lyme and five other diseases — grows only as big as a sesame seed, for example.
If you do see a tick embedded in your skin, don’t panic. Here’s a step-by-step guide for what to do.
2. Look for a rash.
The “bulls eye” rash sometimes seen in people with Lyme disease. CDC/Wikimedia Commons
Not all tick bites lead to tick-borne disease. But if you do develop one of these illnesses, there’s a chance you’ll get a rash. There are 5 different tick-borne diseases that all produce slightly different rashes, according to the CDC. Here’s the full breakdown:
- Lyme disease: 70–80% of people who get Lyme get a rash at the site of the bite. It usually appears 3 to 30 days after a bite, and though it may feel warm to the touch and slowly expand in size, it’s usually not painful or itchy. A Lyme rash may take on the classic “bullseye” shape, but it might not — here’s a photo gallery showing all the different ways a Lyme rash can look. It can also appear anywhere on the body, not just at the site of the bite.
- Southern tick-associated rash illness (STARI): The STARI rash is almost identical to the Lyme rash, and appears at the site of the bite.
- Rocky Mountain spotted fever (RMSF): The RMSF rash can vary a lot from person to person, though it occurs in about 90% of infected people. Usually, it starts 2 to 5 days after the onset of the illness, showing up as small, flat, pink, non-itchy spots on wrists, forearms, and ankles. Then it can spread to other parts of the body, In 35–60% of cases, the rash can become purple and spotty starting at day 6 or later.
- Tularemia: With this illness, it’s common for a skin ulcer to appear at the site of the bite. The nearby lymph nodes will swell up, too.
- Ehrlichiosis: Rashes only appear in about 30% of adult ehrlichiosis cases, but they are possible. The rash can range from flat, red and splotchy to purple and spotty, and it’s more generalized, It’s also not itchy.
3. But remember that not everyone gets a rash.
Headache can be a symptom of tick-borne illness. Patrick Denker / Flickr
Rashes don’t occur in every case of tick-borne disease, so it’s good to know the other common symptoms: fever, chills, fatigue, headache, muscle pains, and sore joints.
If you know you’ve been bitten by a tick and you experience any of the symptoms listed above, see a doctor, stat. The CDC notes that catching and treating tick-borne diseases early is key to reducing potential complications.
The hallmark sign of Lyme infection is a rash that resembles a bullseye. “, the rash is a localized infection,” Dr. Mudassar says. “The center may be clear with a red, circular margin outside.” This rash may also become itchy or swollen for some people.
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Here’s where it gets a little more complicated: Not everyone who develops Lyme disease gets a rash, and even the people that do often don’t notice it, Dr. Mudassar says. Plus, the rash can show up on other areas of the body away from the bite site, so it might not raise any red flags.
A Rocky Mountain Spotted Fever rash, on the other hand, is more obvious. This bacterial infection causes a rash on the extremities of the body (think: your palms, ankles, and soles of your feet), which migrates toward the center of your body, per Dr. Schrading.
What if I don’t get a rash but still feel super sick?
Since you can’t always rely on a rash to clue you in, pay attention to other signs of illness you experience after possible exposure.
Dr. Mudassar says that tick-borne illnesses can cause fever, fatigue, loss of appetite, headache, muscle pain, and regional lymph node swelling in the early stages of the disease.
Dr. Schrading adds that you might simply have nonspecific viral illness symptoms, like malaise and myalgia—so it helps to consider the time of year you’re feeling sick. “More people are outside and around ticks in the summer, which isn’t flu season,” he says. “So if you’re feeling like you have the flu in the middle of summer, think about whether you could have been exposed to a tick.”
Does it matter what kind of tick bit me?
There are many different species of ticks, but the detail that matters is whether you were bitten by a deer tick (a.k.a. a blacklegged tick) or dog tick, which are known to transmit these two major diseases to humans.
“The only two major diseases we see reside in deer and dog ticks—if you’re bitten by a random tick that doesn’t transmit disease, you’ll be fine,” says Dr. Schrading, who clarifies that deer ticks transmit Lyme disease and dog ticks transmit Rocky Mountain Spotted Fever.
Other ticks, like the Lone Star tick, for example, also transmit diseases. But infections from Lone Star ticks make up a small percentage of all tick-borne illnesses, per the CDC.
The tricky thing is that there’s no way to tell from the actual bite itself which tick nabbed you. That said, if you develop the classic bullseye rash or a spotted rash spreading across your body, it’s pretty clear which tick was the culprit. At that point, you should definitely hightail it to your doctor’s office for evaluation, which Dr. Mudassar says is worth doing for *any* tick bite, even one that isn’t causing symptoms yet.
“It’s better if you go to the doctor right away when you know you’ve had a tick bite,” says Dr. Mudassar. “If you go within 36 hours of the bite, you can be treated with a lesser dose of antibiotics .”
Your doctor may be able to test you for illness with blood work to identify the pathogen. But Dr. Schrading warns it can take a while for results to come back, and false negatives can occur.
If I did get a tick-borne illness, how long does it take for symptoms to appear?
A tick will spend the first 12 to 24 hours on your body looking for a place to settle in, Dr. Mudassar says. Once it finds a desirable spot—like your armpit, groin, or the back of your neck—it will latch on.
From there, it takes a few days for the tick to actually transmit any illness it might be carrying; Dr. Schrading notes that it could be about four to seven days before a rash or symptoms appear.
What if the tick that bit me didn’t transmit an infection?
If you know for sure a tick bit you because you found it attached to your skin, it’s still totally possible you won’t contract an illness. Why? Well, not all ticks carry diseases, for starters. But there’s also a correlation between the length of time the tick was attached to you and how likely you are to get sick.
“Removing the tick as soon as possible reduces risk of infection if it’s carrying a disease,” says Dr. Schrading. “The less time it’s attached to you, the less likely it is to infect you, especially if it’s been less than 12 hours.”
Remember: Your best bet for avoiding tick-borne illnesses is prevention, and then early detection. Do careful tick checks after you’ve spent time outside and don’t wait around for symptoms to start if you think a tick bit you. You can also keep tabs on local tick activity in your area by contacting your state’s health department (or visiting their web site).
Sarah Bradley Sarah Bradley is a freelancer writer from Connecticut, where she lives with her husband and three sons.
Signs of Lyme disease that appear on your skin
Signs of Lyme disease
If you find a sign of Lyme disease on your skin, see your primary doctor right away. When caught early and treated, Lyme disease can be cured with antibiotics and most people recover fully.
Lyme disease is caused by a bite from a black-legged tick. This bite can deliver the microbe that causes the disease. If you are bitten by this tick and develop Lyme disease, you may see a bull’s-eye rash. It’s a common sign of Lyme disease, but it’s not the only sign.
Lyme disease occurs in stages. Here’s what you may see on your skin during each stage.
Stage 1: Quickly expanding rash
After being bitten by a black-legged tick, a quickly growing rash can appear. This is the earliest stage of Lyme disease, known as stage 1.
Most people who develop a rash, get it within days or weeks of being bitten by a tick.
Where you see the rash: If you develop a rash, it appears near (or where) the tick bit you. For most people, that means the back, groin, armpit, or a lower leg. However, a tick can bite you anywhere.
What the rash can look like: You may see a spot or bump on the skin, which is the bite mark. Around or near the bite mark, a rash develops. Some people see the bull’s-eye rash (shown below). You can also have one of the other rashes shown here.
Early rash caused by Lyme disease
Notice the bite mark in the center of this early rash, which will expand quickly.
Bull’s-eye rash on woman’s upper arm
This is another early sign of Lyme disease.
Lyme disease rash with lighter color on the outside
This rash has expanded, but you can still see the bite mark in the center.
Rash from Lyme disease has begun to clear
As the rash begins to clear, the redness fades.
If you develop a rash during this stage, you may notice that it:
Feels smooth and warm to the touch
Causes a burning sensation
Itches or feels painful
Has an outer edge that feels scaly or crusty
When the rash and symptoms begin: According to the Centers for Disease Control and Prevention (CDC), the rash begins 3 to 30 days after the tick bites you.
About 50% of people who have Lyme disease develop flu-like symptoms , which include:
Swollen lymph nodes near the bite
Symptoms tend to begin before the rash appears.
Stage 2: Small, oval rashes or a reddish lump
When a tick that causes Lyme disease bites you, it infects you with bacteria. Without treatment, the bacteria can spread to other areas of your body. If it spreads, you have stage 2 Lyme disease.
During this stage, you may see small, oval rashes on your skin. Some people develop a bluish-red lump.
Where you see these signs: Because the infection has spread, small rashes can appear anywhere on your skin, except for your palms and soles. Most rashes appear on the arms, legs, and face.
Some people develop a lump, which your doctor may refer to as borrelial lymphocytoma. In children, this lump tends to appear on an earlobe. Adults often see a raised growth form around a nipple.
Borrelial lymphocytoma on a child’s ear
This can appear in stage 2 of Lyme disease.
What you may see on your skin: The rashes that appear during stage 2 differ from the rash that can appear in stage 1. In stage 2, the rashes stay the same size rather than grow larger.
When the rashes, lump, and symptoms begin: About 30 to 45 days after the tick bites you, you may notice rashes or a lump. These can also take longer to appear, sometimes six months or more.
Some people develop symptoms, which make them feel ill, including:
Arthritis that comes and goes
Muscles aches, especially neck stiffness
Numbness or pain
Shortness of breath and dizzy spells
Bell’s palsy, which causes one half of the face to droop
Heart problems, such as chest pains or an irregular heartbeat
How long do the rashes, lump, and symptoms last: If treated with antibiotics, signs and symptoms tend to clear within three weeks. Without treatment, the symptoms tend to come and go indefinitely, and some people develop stage 3 Lyme disease.
Stage 3: Changing skin
In stage 3, few signs of Lyme disease appear on the skin. Most problems occur in the heart and nervous system, and these can be serious.
Where you see signs on your skin: If you were in Europe when bit by a tick, you may see changes to your skin in this late stage. These changes usually appear on a hand or foot. Some people develop this change on both of their hands or feet. It can also occur on a knee, elbow, or elsewhere.
What the skin looks like: The skin begins to swell, and you may notice some redness. These signs are caused by having a bacterial infection for a long time. The affected skin may also feel sore.
In time, the skin starts to harden and shrink, causing deep lines to form. If you have hair in the area, it tends to fall out. The sweat glands can die, and the skin often becomes so thin that it tears easily. The medical name for this condition is acrodermatitis chronical atrophicans.
In stage 3, you may also see tumors on your skin. It is believed that the long-term infection and swelling in the lymph nodes can lead to a cancer known as cutaneous B-cell lymphoma.
Skin starts to harden and shrink, causing deep lines to form
The medical name for this condition is acrodermatitis chronical atrophicans. Swelling, hardened skin, and deep lines on the foot of someone who has had Lyme disease for years.
When you see signs of changing skin and symptoms: These tend to occur months or years after you are bitten by a tick.
In stage 3, a person tends to have many symptoms of illness, which may include:
Problems remembering and concentrating
How long the changes last: Even with treatment for Lyme disease, the changes to the skin, tumors, and symptoms tends to be permanent.
Seek medical care early to prevent Lyme disease from progressing
It’s easy to get bit by a tick and not know it. Most people don’t feel a tick on their skin or the bite. Checking your skin for ticks after spending time outdoors can help you find a tick and remove it.
Removing a tick can prevent Lyme disease. A tick must be attached to your skin for at least 36 hours to infect you with the bacteria that cause Lyme disease.
It’s not always possible to find a tick, so it’s important to pay close attention to your skin. If you notice any signs of Lyme disease or develop a rash, get medical care right away. Ticks can cause other serious diseases, such as Rocky Mountain spotted fever.
Related AAD resources
How to remove a tick
Image 1: Centers for Disease Control and Prevention, Public Health Image Library, Last accessed May 11, 2017.
Images 2, 3, and 7: Used with permission of the Journal of the American Academy of Dermatology. J Am Acad Dermatol. 2011; 64:619-36.
Images 4 and 5: Getty Images
Image 6: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Bhate C and Schwartz RA.
Centers for Disease Control and Prevention:
“Signs and symptoms of untreated Lyme disease.” Page last updated October 26, 2016. Last accessed May 2, 2018.
“Lyme disease: transmission.” Page lasted updated March 4, 2015. Last accessed May 2, 2018.
McGinley-Smith DE and Tsao SS. “Dermatoses from ticks.” J Am Acad Dermatol. 2003;49:363-92.
Meyerhoff JO. “Lyme disease: Clinical presentation.” Medscape. Last updated January 29, 2017. Last accessed May 2, 2018.
Vasudevan B and Chatterjee M. “Lyme borreliosis and skin.” Indian J Dermatol. 2013; 58(3): 167–74.
What Does A Tick Bite Look Like?
Signs and symptoms of tick bites on humans
If you have a tick bite, you need to identify it fast, remove the culprit from your skin and preserve it for species identification by a professional. Taking these steps helps with tick-borne disease prevention and if necessary, treatment. Unfortunately, things don’t always go according to plan and bites aren’t always easy to identify. Here’s what you need to know about tick bites to keep you, your family and your pets safe this tick season.
Where should you look for tick bites?
Ticks can bite you anywhere on your body, but they really love moist, warm places. These pests will often latch onto your socks or shoes, then make their way up to your groin area. If your sleeve or arm brushes up against some tick-infested grass, they’ll make their way up to your armpit instead. Always check these areas first, then check the rest of your body. Pay particular attention to any areas that have hair, especially on your head and face. It’s easy for ticks to hide in hair. On both humans and pets, ticks love to attack behind and around the ears. At the nymph and larval stages, ticks will attach to the backs of pets, while at the adult stage, they tend to feed around the paws and between the toes of dogs and cats. Tick bites on humans can occur all over your body, no matter the life cycle stage, so enlist the help of a loved one to perform a thorough search of your body. Look or feel for new bumps on your skin.
What’s the easiest way to identify a tick bite?
Being bitten by a tick is never a good thing, but in the best case scenario, youll know that you have a tick bite by the tick literally being attached to your body. Ticks take a long time to fully engorge themselves (how long depends on the size and life stage of the tick). If you’re practicing the recommended frequent tick checks after coming in from outdoors, chances are you’ll find the tick bite while the bloodsucker is still attached. This is highly beneficial since ticks take at least 12 hours of feeding to transmit most tick-borne diseases. Plus, if you find the tick attached, you can remove and save it so your doctor can identify the type of tick that bit you. This is vital for monitoring and treating any diseases it might carry.
What do tick bites on humans look like if the tick isn’t present?
If the tick was removed without you knowing it (e.g., in the shower, through physical impact, random scratching or the tick is simply done feeding), you might be left with just a bite mark as evidence. Within three days of a tick bite, the most common identifying mark is a dime-sized red spot. This is caused by an allergic reaction to the tick’s saliva. This reaction can be worse if you’ve previously been bitten by the same species of tick. A tick bite mark can start off looking like any number of insect bites (even a mosquito bite, despite the fact that ticks are arachnids), so it’s important to monitor any suspicious marks you may have. Draw a circle around the site of the bite with a pen and if in 36 hours the bite expands its reddened, raised appearance, seek a medical opinion as this could be a sign of Lyme disease. Tick bites may have a black dot in the middle of them, or if the body was removed and the head and mouthparts remained in your skin, you might see a larger black mark (or even pincers). Some bites from ticks will have a hardened bump underneath the site of the puncture.
What is the tick bull’s-eye bite?
Ticks carry many diseases, perhaps none so deadly and frightening as Lyme disease. One of the telltale signs that you might be infected is if the bite expands, with another red circle appearing around the original site of the bite. This gives the bite the appearance of a red bull’s-eye, though this doesn’t have to be present in order for Lyme disease to occur. Seek immediate medical attention if you develop a bull’s-eye around your tick bite.
Ticks transmit a number of diseases that can be deadly. In addition to taking precautions when you go outdoors, call Terminix® today and find out how to shield your family and your pets from tick bites.
Removing the Tick
Tick attachment time is important. Removing ticks as soon as possible reduces the risk of infection. If you or a loved one is bitten, remove the tick promptly. Here’s how:
- Grasp the tick’s mouthparts against the skin, using pointed tweezers.
- Be patient; the long mouthpart is covered with barbs, so removing it can be difficult and time consuming.
- Pull steadily without twisting until you can ease the tick head straight out of the skin.
- DO NOT pull back sharply; this may tear the mouthparts from the body of the tick and leave them embedded in the skin.
- If this happens, don’t panic! Embedded mouthparts do not transmit Lyme disease.
- DO NOT squeeze or crush the body of the tick; this may force infected body fluids from the tick into the skin.
- DO NOT apply substances such as petroleum jelly, nail polish, or a lighted match to the tick while it is attached. They may agitate the tick and force more infected fluid into the skin.
- Once you have removed the tick, wash the wound site and your hands with soap and water, and apply rubbing alcohol or antiseptic to the site.
- Observe the bite site over the next two weeks for any signs of an expanding red rash or flu-like symptoms.
- Consult with your PCP about sending your tick to a lab to be tested for pathogens.
Recognizing the Rash After a Tick Bite
It is important to understand that a rash is not always present or easily recognizable in early Lyme disease, and this can lead to delayed diagnosis and treatment.
Please refer to our poster of varied Lyme disease rash manifestations as a helpful identification tool.
It is wise to take a picture of the rash with the date for your medical record, since a rash compatible with erythema migrans rash should prompt urgent evaluation and treatment. Lyme disease is most successfully treated in this first stage.
If you have a suspicious rash or your symptoms persist, please seek medical care immediately.
The Lyme disease rash, called erythema migrans, is:
- Round or oval, enlarges in size over days/weeks, & will not fade in a few days
- Usually greater than 2” inches in diameter, often 6-8”
- Usually uniformly red
- Sometimes but not often, a “bull’s eye” rash with a red ring surrounding a clear area and red center
- Minimally tender, minimally itchy (much less itchy than poison ivy), and sometimes warm
- Often confused with spider bites
The incubation period from tick bite to rash is usually 3-10 days but can be 30 days.
The Lyme rash can spread through the bloodstream to other areas of the skin.
Sometimes blisters develop in the center of the rash.
Tick bite reactions are often confused with the rash of Lyme disease.
Tick bite reactions:
- Are small red bumps, less than 1-2” in size
- Appear at the site of the bite, often in the groin, belt area, arm pits, or behind the knee
- Do not expand in size when observed over 24-48 hrs
- May feel warm and tender to the touch
- Can last days, even weeks
Requesting and Receiving Care For the Tick Bite
If you have a tick bite, watch for an expanding red rash or lesion at the site of the tick bite or an unexplained feverish, achy, fatiguing illness within 1 to 4 weeks after the tick bite. If you are concerned about symptoms or a rash, take a picture of the rash and contact your physician.
Diagnosing Lyme Disease:
- Lyme disease is a clinical diagnosis made by a doctor or nurse by examining the patient.
- Acute Lyme disease is not a laboratory diagnosis; a negative Lyme blood test does not exclude Lyme disease in the first few weeks of the illness.
- Many with Lyme disease have a flu-like illness and NO rash.
- Fever, aches, and abrupt and severe fatigue can be the main symptoms of acute Lyme.
- Lyme disease is different from a respiratory “cold”.
- A runny nose and prominent cough are NOT symptoms of Lyme disease.
- Blood tests do not accurately diagnose Lyme disease in the first few weeks of infection, so being vigilant about looking for symptoms is a more reliable way to identify an early case of Lyme disease.
Summit Medical Group Web Site
What are ticks?
Ticks are small wingless bugs that feed on the blood of animals, birds, and people. They have 8 legs and are related to spiders and mites. There are many different kinds of ticks. Black-legged ticks, or deer ticks, are usually tiny, no bigger than the head of a pin. Wood and dog ticks are usually much larger—about a quarter inch before feeding and half an inch when they are full of blood.
How do tick bites occur?
Ticks are found among plants and trees as well as on animals in low-lying brush in woodlands, grasslands, and marshlands and at the seashore. Wild birds and animals, as well as domestic animals and pets such as dogs, horses, and cows, can carry ticks. Ticks may climb on humans from animals, leaf litter, or low-lying brush. Ticks cannot jump or fly.
How do I know if I have been bitten by a tick?
You usually will not feel anything when a tick bites you. If you find a tick attached to your skin, you have been bitten. You may have a little redness around the area of a bite.
Can I get sick from a tick bite?
There is little risk from the bite of a tick most of the time. However, some ticks carry infections that can be passed to people. For example, deer tick bites may cause Lyme disease. The early symptoms of Lyme disease occur within the first week to months after being bitten by an infected tick. These include flulike symptoms and a rash that resembles a bulls-eye or target located on one area of the skin. A bite from other ticks such as the wood tick or dog tick may cause Rocky Mountain spotted fever (RMSF). RMSF may first cause flulike symptoms and then a pink or red spotted rash. Tick bites may cause other diseases as well.
How are tick bites treated?
If you find a tick attached to your body, you need to remove it. You can remove it yourself or get help from your healthcare provider. To remove an attached tick:
- Grasp the tick with tweezers as close to the skin as possible.
- Gently pull the tick straight away from you until it releases its hold. Use a slow gentle pulling motion. Pulling the tick out too quickly may tear the body from the mouth, leaving the mouth still in the skin. If you are unable to remove the tick completely, you may need to see your healthcare provider.
- Do not twist the tick as you pull, and try not to squeeze its body. Squeezing or crushing the tick could force infected fluids from the tick into the site of the bite.
After you have removed the tick, thoroughly wash your hands and the bite area with soap and water. Put an antiseptic such as rubbing alcohol on the area where you were bitten.
Save the tick in case you later start having symptoms of disease and need to know what kind of tick bit you. Put the tick in a clean dry jar, small plastic bag, or other sealed container and keep it in the freezer. Identification of the tick may help your provider diagnose and treat your symptoms. If you do not have any symptoms of disease after 1 month, you can discard the tick.
How can I take care of myself?
If you find a tick on your body, remove it right away. Infected ticks usually do not spread an infection until after the tick has been attached and feeding on your blood for several hours.
Check for a rash and other symptoms for about 4 weeks after the bite.
Call your healthcare provider if:
- You have flulike symptoms after a bite such as fever, headache, muscle aches, joint pain or swelling, and a general feeling of illness.
- You have signs of infection, such as new or worse redness, swelling, pain, warmth, or drainage.
- A tick has bitten you and you think the tick may be a deer tick.
- You develop a bulls-eye rash or a rash with tiny purple or red spots.
How can I help prevent tick bites?
- Be aware of the areas where ticks live. Do not walk, camp, or hunt in the woods of tick-infested areas without precautions.
- In areas of thick underbrush, try to stay near the center of trails.
- When you are outdoors, wear long-sleeved shirts tucked into your pants. Wear your pants tucked into your socks or boot tops if possible. A hat may help, too. Wearing light-colored clothing may make it easier to spot the small tick before it reaches your skin and bites. While you are outside, check for ticks every 4 hours and remove any ticks on clothing or exposed skin.
- Use approved tick repellents on exposed skin and clothing. Don’t use more repellent than recommended in the package directions. Don’t put repellent on open wounds or rashes. Don’t put it on your eyes or mouth. When using sprays for the skin, don’t spray the repellent directly on your face. Spray the repellent on your hands first and then put it on your face. Then wash the spray off your hands.
- Adults should use products with no more than 35% DEET. Children older than 2 months can use repellents with no more than 30% DEET. DEET should be applied just once a day. Wash it off your body when you go back indoors.
- Picaridin may irritate the skin less than DEET and appears to be just as effective.
- Spray clothes with repellents because insects may crawl from clothing to the skin or bite through thin clothing. Products containing permethrin are recommended for use on clothing, shoes, bed nets, and camping gear. Permethrin-treated clothing repels and kills ticks, mosquitoes, and other insects and can keep working after laundering. Permethrin should be reapplied to clothing according to the instructions on the product label. Some commercial products are available pretreated with permethrin. Permethrin does not work as a repellent when it is put on the skin.
- Treat household pets for ticks and fleas. Check pets after they have been outdoors.
- Brush off clothing and pets before entering the house.
- After you have been outdoors, undress and check your body for ticks. They usually crawl around for several hours before biting. Check your clothes, too. Wash them right away to remove any ticks.
- Shower and shampoo after your outing.
- Inspect any gear you have carried outdoors.
- If you spend much time hiking, you may want to include a pair of tick tweezers in your first-aid kit. The tweezers are available at many sporting goods stores.