Treatment for Larvae Tick Bite
The immediate treatment for larvae tick bites is to remove all ticks as soon as possible using fine-tipped tweezers or forceps by grasping the tick close to the skin and pulling upward with steady, even pressure, followed by thorough cleaning of the bite area with soap and water, alcohol, or an iodine scrub. 1
Immediate Management
Tick Removal
- Use fine-tipped tweezers or forceps to grasp the tick as close to the skin as possible and pull back and upward with constant pressure 1
- Never use gasoline, kerosene, petroleum jelly, fingernail polish, or lit matches to remove ticks as these methods are ineffective and potentially harmful 1
- Avoid removing ticks with bare fingers when possible to prevent exposure to infectious organisms that might be present in the tick's body 1
- Do not crush removed ticks between fingers to prevent contamination 1
Post-Removal Care
- Clean the bite area thoroughly with soap and water, alcohol, or an iodine scrub immediately after tick removal 1
- Wash hands thoroughly after handling ticks, especially before touching face or eyes 1
- Consider submitting the removed ticks for species identification if possible 2
Antibiotic Prophylaxis Considerations
When to Consider Prophylaxis
- Antibiotic prophylaxis may be considered when the tick can be identified as Ixodes scapularis (blacklegged tick) and was attached for ≥36 hours in areas where local rate of tick infection with Borrelia burgdorferi is ≥20% 2
- Prophylaxis should be started within 72 hours of tick removal to be effective 2, 3
- For most larvae tick bites, prophylactic antibiotics are not routinely recommended 4, 5
Prophylactic Regimen When Indicated
- For adults and children ≥8 years, a single 200 mg dose of oral doxycycline is the recommended prophylactic treatment when indicated 2, 6, 3
- Doxycycline is indicated for treatment of Rocky Mountain spotted fever, typhus fever, Q fever, rickettsialpox, and tick fevers caused by Rickettsiae 6
- For children <8 years and pregnant women, doxycycline is relatively contraindicated and single-dose prophylactic regimens with alternative antibiotics have not been established 2
Follow-Up Monitoring
Signs and Symptoms to Monitor
- Monitor for signs and symptoms of tick-borne diseases for 30 days after tick removal 2, 5
- Be particularly vigilant for development of erythema migrans (expanding rash) at the bite site, which may indicate Lyme disease 2, 5
- Watch for fever, headache, fatigue, muscle/joint pain, or other systemic symptoms that could indicate tick-borne illness 1, 7
When to Seek Medical Care
- Seek medical attention if a persistent reaction or granuloma develops at the bite site 8
- Consult healthcare provider if symptoms of tick-borne illness develop, including fever, rash, headache, or joint pain 1, 7
- Complete surgical resection may be necessary for tick bite granulomas that persist 8
Prevention of Future Tick Bites
- Use tick repellents containing DEET, IR3535, or picaridin on exposed skin when outdoors 1, 7
- Wear protective clothing including long-sleeved shirts, pants, socks, and closed-toe shoes 1, 7
- Consider treating clothing with permethrin for additional protection 1, 7
- Perform regular tick checks on persons and pets after being in tick-infested areas 1
- Limit exposure to tick-infested habitats and tick-infested animals when possible 1, 7