Tick Bites

How to Manage a Tick Bite

We encourage our parents to do a daily inspection for ticks, especially in the spring and early summer, or if you have pets that go outside.  Daily tick checks are invaluable given the prevailing medical knowledge that a tick must be on the body for 24-36 hours to pass the illness to humans.  Thus, a tick check with prompt tick removal is an essential component of Lyme Disease prevention. 

Once a tick is found you can remove the tick and record the date and site of where the tick was removed on your calendar.  The use of alcohol, nail polish, or a hot match is not recommended for tick removal.  The best method for removing a tick is to grab the base of the tick, against the skin, with a fine tweezers and steadily pull the tick out.  Once the tick is removed it can be discarded.  Testing of the tick is not recommended unless it has been in place more than 36 hours or is engorged.

A frequently asked question is what to do if the entire tick is not removed.  If tick’s  head is embedded in the skin and cannot be easily removed, just leave it alone.  The main disease carrying portion of a tick is the abdomen and this is the most easily removed portion.   There is no increased risk if the head is left alone to come out on its own.  You can keep the bite area clean with soap and water and apply a topical antibiotic for a few days. 

A small area of redness or inflammation may be seen for a few days after a tick bite.  This is normal and not a Lyme rash.  Lyme Disease rashes are typically seen 2 to 30 days after the tick bite.  The rash is flat, red, usually non-itchy and at least the size of a silver dollar.  The rash does not disappear overnight, therefore if you see a rash at night your child can safely be seen the next day without worrying that a Lyme rash could be “missed”.  The appearance of a rash is seen in approximately 75% of children with Lyme Disease.  

Pediatric Infectious Disease experts do not recommend treating children with antibiotics just because a tick bit them.  It is also not helpful to do diagnostic blood tests right after a tick bite because it takes 4-6 weeks from the time of the bite for a blood test to become positive, if an infection occurred.  The best course of action after removing a tick is careful observation.

Therefore:

  1. Please remove tick as soon as possible by yourself
  2. Mark your calendar
  3. Observe area of bite for the next 30 days
  4. Call if your child develops a lyme-like rash, high fever/headache, muscle aches or red, warm, swollen joint within the 30 days following a tick bite.

The most current recommendations on diagnosis and treatment of tick borne diseases:
http://cid.oxfordjournals.org/content/43/9/1089.full

For more information on Lyme Disease, as well as pictures of ticks and the bulls-eye rash, please visit:
http://www.uptodate.com/contents/what-to-do-after-a-tick-bite-to-prevent-lyme-disease-beyond-the-basics