From the Guidelines
To treat a tick bite, prophylactic antibiotic therapy should only be given to adults and children within 72 hours of removal of an identified high-risk tick bite, with a single dose of oral doxycycline being the preferred regimen 1. The treatment of a tick bite involves several steps to minimize the risk of infection and disease transmission.
Initial Steps
- Remove the tick completely using fine-tipped tweezers, grasping the tick as close to the skin as possible and pulling upward with steady, even pressure.
- Clean the bite area with rubbing alcohol, an iodine scrub, or soap and water.
- Monitor the bite site for signs of infection like increasing redness, swelling, or pain.
Antibiotic Prophylaxis
- A single dose of oral doxycycline within 72 hours of tick removal is recommended for high-risk Ixodes spp. bites in all age groups 1.
- The dose of doxycycline is 200 mg for adults and 4.4 mg/kg (up to a maximum dose of 200 mg) for children.
- Prophylactic antibiotic therapy should only be given to adults and children within 72 hours of removal of an identified high-risk tick bite, but not for bites that are equivocal risk or low risk 1.
Symptom Management
- Apply an over-the-counter antibiotic ointment like Neosporin to prevent infection, and use hydrocortisone cream or calamine lotion to reduce itching and inflammation.
- Take acetaminophen (Tylenol) or ibuprofen (Advil) for pain if needed.
- Watch for symptoms of tick-borne illnesses such as fever, rash (especially a bull's-eye pattern around the bite), fatigue, muscle aches, or joint pain in the weeks following the bite.
- If these symptoms develop, or if you cannot remove the entire tick, seek medical attention promptly. Some key points to consider when treating a tick bite include:
- Quick removal is crucial because many disease-causing organisms aren't transmitted until the tick has been attached for 24-48 hours, so proper tick removal significantly reduces your risk of infection.
- A tick bite is considered to be high-risk only if it meets the following 3 criteria: the tick bite was from an identified Ixodes spp. vector species, it occurred in a highly endemic area, and the tick was attached for ≥36 hours 1.
From the FDA Drug Label
Doxycycline is indicated for the treatment of the following infections: Rocky Mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers caused by Rickettsiae.
- Treatment for tick bite: The FDA drug label for doxycycline indicates that it can be used to treat tick fevers caused by Rickettsiae, which may be a consequence of a tick bite.
- Key consideration: The use of doxycycline for tick bite treatment should be guided by the presence of symptoms or exposure to specific tick-borne diseases, such as Rocky Mountain spotted fever or rickettsialpox, as indicated in the drug label 2.
From the Research
Treatment Options for Tick Bites
- The use of antibiotics for the prevention of Lyme disease after a tick bite has been explored in several studies 3, 4, 5.
- A single dose of 200-mg doxycycline has been shown to be effective in preventing Lyme disease, with a pooled risk ratio of 0.29 (95%CI: 0.14-0.60) 3.
- Combination antibiotic therapy has also been found to be effective in eradicating persistent Borrelia burgdorferi infections in mice, with four dual combinations and three triple combinations showing promise 4.
- A single dose of 100 mg doxycycline has been shown to be 100% effective in preventing tick-borne relapsing fever when taken up to 72 hours after exposure to ticks 5.
Antibiotic Treatment for Lyme Disease
- Doxycycline, amoxicillin, and cefovecin have been found to be effective in treating experimentally induced early Lyme borreliosis in dogs 6.
- Cefovecin, a novel extended-spectrum cephalosporin, has been shown to be as efficacious as doxycycline or amoxicillin in treating Lyme disease in dogs, with the added benefit of requiring only two injections two weeks apart 6.
Non-Antibiotic Treatment Options
- There is limited evidence to support the use of non-antibiotic treatments for tick bites, with one study from 1978 investigating the use of calcitonin for the treatment of algodystrophic syndromes, which is not directly related to tick bites 7.