How to remove a retained tick (Ixodida) appendage from the body?

From the Guidelines

To remove a retained tick leg from your body, use fine-tipped tweezers to grasp the leg as close to your skin as possible and pull it out with steady, even pressure, as recommended by the most recent guidelines 1. This method is supported by multiple studies, including those published in 2021 by the Infectious Diseases Society of America, American Academy of Neurology, and American College of Rheumatology 1, which emphasize the importance of prompt removal using mechanical means. When removing the tick leg, it's essential to:

• Avoid twisting or jerking the tweezers, as this may cause the leg to break further
• Clean the area thoroughly with soap and water after removal
• Apply an antiseptic, such as rubbing alcohol or hydrogen peroxide, to the affected area If the leg cannot be removed, it's crucial not to dig into the skin, as the body will typically expel the foreign material naturally over time. It's also important to monitor the site for signs of infection, such as increasing redness, warmth, swelling, pain, or red streaks extending from the bite, and seek medical attention if any of these symptoms develop, or if a rash, fever, headache, fatigue, or muscle aches occur within several weeks after the tick bite, as these could indicate a tick-borne illness requiring antibiotics 1.

From the Research

Removing a Retained Tick Leg

To remove a retained tick leg from the body, it is essential to follow proper procedures to minimize the risk of infection.

• The area should be cleaned with antiseptic solution after tick removal 2.
• The bite area should be inspected carefully for any retained mouthparts, which should be excised 2.
• If a part of the tick's leg remains in the skin, it can be removed using a sterile needle or a pair of fine-tipped tweezers 2.

Preventing Infection

After removing a tick, it is crucial to monitor for signs of local or systemic illness.

• Routine antibiotic prophylaxis following tick removal generally is not indicated but may be considered in pregnant patients or in areas endemic to tick-borne disease 2.
• A single dose of doxycycline after a tick bite can prevent the development of Lyme borreliosis in North America and Europe 3, 4.
• The use of antibiotics for the prevention of Lyme disease reveals advantages of using single-dose, however, further confirmation is needed 5.

Important Considerations

• Ticks are best removed as soon as possible, because the risk of disease transmission increases significantly after 24 hours of attachment 2.
• The dynamics of antibiotic treatment in mice may differ from humans, and translation of animal studies to patient management must be approached with caution 3.