Tick bites: First aid

    Overview

    Most tick bites are painless and cause only minor signs and symptoms, such as a change in skin color, swelling or a sore on the skin.

    But some ticks spread bacteria that cause illnesses, including Lyme disease and Rocky Mountain spotted fever. In general, to spread Lyme disease a tick needs to be attached to a person's skin for at least 36 hours. Other infections can be transferred in a few hours or even a few minutes.

    When to seek emergency help

    Call 911 or your local emergency number if you develop:

    • A severe headache
    • Difficulty breathing
    • Paralysis
    • Heart palpitations

    Treatment

    To take care of a tick bite:

    • Remove the tick promptly and carefully. Use fine-tipped forceps or tweezers to grasp the tick as close to the skin as possible. Gently pull out the tick using a slow and steady upward motion. Avoid twisting or squeezing the tick. Do not handle the tick with bare hands. Do not use petroleum jelly, fingernail polish or a hot match to remove a tick.
    • Secure the tick and take a picture. A picture of the tick can help you and your health care provider identify what type it is and whether you are at risk of a transmitted disease. You can trap the tick in a piece of tape for disposal in the garbage. Your provider may want to see the tick or a photo if you develop new symptoms.
    • Wash your hands and the bite site. Use warm water and soap, rubbing alcohol, or an iodine scrub.

    When to call your doctor

    Contact your healthcare professional if:

    • You aren't able to completely remove the tick. The longer the tick remains attached to the skin, the greater the risk of getting a disease from it. Your skin may also get irritated.
    • The rash gets bigger. A small bump may appear at the site of the tick bite. This is typical. If it develops into a larger rash or you develop a rash anywhere, possibly with a bull's-eye pattern, it may be a sign of Lyme disease. The rash usually appears within 3 to 14 days.

      Consult your provider even if the rash disappears because you may still be at risk of having the disease. Your risk of contracting a disease from a tick bite depends on where you live or travel to, how much time you spend outside in woody and grassy areas, and how well you protect yourself.

    • You develop flu-like signs and symptoms. Fever, chills, fatigue, muscle and joint pain, and a headache may accompany the rash.
    • You think the bite site is infected. Signs and symptoms include pain, change in skin color or oozing from the site.
    • You think you were bitten by a deer tick. You may need antibiotics.

    If possible, bring the tick, or a photo of the tick, with you to your doctor's appointment.

    1. Tick bites. Merck Manual Professional Edition. https://www.merckmanuals.com/professional/injuries-poisoning/bites-and-stings/tick-bites. Accessed Oct. 14, 2021.
    2. Tick prevention and property management. Maine Center for Disease Control & Prevention, Division of Disease Surveillance. https://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/lyme/tick-prevention-and-property-management.shtml. Accessed Oct. 14, 2021.
    3. Tick removal. Centers for Disease Control and Prevention. https://www.cdc.gov/ticks/removing_a_tick.html. Accessed Oct. 14, 2021.
    4. Symptoms of tickborne illness. Centers for Disease Control and Prevention. https://www.cdc.gov/ticks/symptoms.html. Accessed Oct. 14, 2021.
    5. Lyme disease: What you need to know. Centers for Disease Control and Prevention. https://www.cdc.gov/lyme/toolkit/index.html. Accessed Oct. 14, 2021.
    6. Tintinalli JE, et al. Zoonotic infections. In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 9th ed. McGraw Hill Education; 2020. https://accessmedicine.mhmedical.com/. Accessed Oct. 14, 2021.
    7. Hu, L. Evaluation of a tick bite for possible Lyme disease. https://www.uptodate.com/contents/search. Accessed Oct. 14, 2021.
    8. Tick attachment and tickborne diseases. Maine Center for Disease Control & Prevention, Division of Disease Surveillance. https://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/lyme/tick-attachment-and-tickborne-diseases.shtml. Accessed Oct. 14, 2021.
    9. Medical review (expert opinion). Mayo Clinic. Oct. 29, 2021.

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