From the Guidelines
Tick bites should be removed promptly to reduce the risk of disease transmission, and the most effective method is to grasp the head of the tick as close to the skin as possible with tweezers or a commercial tick removal device and pull upward with steady, even pressure, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. Signs of a tick bite include a small red bump at the bite site, which may develop into a rash, particularly the distinctive bull's-eye pattern (erythema migrans) associated with Lyme disease. Other symptoms to watch for include:
- Fever
- Headache
- Fatigue
- Muscle aches
- Joint pain After removal, clean the bite area with soap and water, rubbing alcohol, or an iodine scrub, and apply an antiseptic to the site. It is essential to monitor for signs of infection or illness, and if you develop a rash larger than 2 inches, fever, severe headache, joint pain, or flu-like symptoms within several weeks of a tick bite, seek medical attention immediately. According to the 2021 clinical practice guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR), prophylactic antibiotic therapy should be given only 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. Prevention is key, and individuals should:
- Wear protective clothing in tick-prone areas
- Use insect repellents containing DEET or permethrin
- Perform thorough tick checks after outdoor activities Antibiotics like doxycycline may be prescribed as prophylaxis in high-risk areas if the tick was attached for more than 36 hours, as stated in the 2006 guidelines by the Infectious Diseases Society of America 1.
From the Research
Signs and Symptoms of Tick Bites
- Erythema migrans, a characteristic rash, is a common sign of Lyme disease, which can develop after a tick bite 2, 3, 4
- Other symptoms of Lyme disease include fever, malaise, fatigue, headache, myalgias, and arthralgias 2
- Neurologic manifestations, such as neuropathy or encephalopathy, may occur in some cases 2
- The disease can progress to early disseminated infection, with neurologic, musculoskeletal, or cardiovascular symptoms, and late disseminated infection, with intermittent swelling and pain of one or more joints 2
Care of Tick Bites
- Removing the attached tick from the skin as soon as possible can help prevent the transmission of Lyme disease 2, 3, 4
- A single dose of doxycycline (200 mg orally) can be used as prophylaxis to prevent Lyme disease after a tick bite, especially if the tick is identified as an Ixodes species 2, 3, 4
- Treatment with doxycycline or amoxicillin is usually effective in preventing the development of Lyme disease, while cefuroxime axetil or erythromycin can be used as an alternative 2
- Preventive measures, such as avoiding wooded areas and using insect repellents, should be emphasized to patients to help reduce the risk of tick bites and Lyme disease 2