From the Guidelines
If a tick's head remains embedded in your skin after removal, it's best to leave it alone and not attempt to remove it, as the body will typically expel it naturally over time and the remaining parts do not continue to transmit disease once the body is removed. According to the 2024 American Heart Association and American Red Cross guidelines for first aid 1, first aid providers should remove an attached tick as soon as possible by grasping the head of the tick as close to the skin as possible with tweezers or a commercial tick removal device and pulling upward with steady, even pressure. However, if the head remains embedded, you can clean the area with soap and water or rubbing alcohol and apply an antibiotic ointment to prevent secondary infection. Some key points to consider when dealing with a tick bite include:
- Monitoring the site for signs of infection such as increasing redness, warmth, swelling, pain, or pus
- Seeking medical attention if these symptoms develop, or if you experience fever, rash, or flu-like symptoms in the weeks following a tick bite, as these could indicate a tick-borne illness
- Avoiding attempting to dig out the remaining tick parts yourself, as this can cause more tissue damage and increase infection risk, as recommended by the clinical practice guidelines by the Infectious Diseases Society of America, American Academy of Neurology, and American College of Rheumatology 1. The body's immune system will generally work to break down and expel the foreign material through normal healing processes.
From the Research
Lyme Disease and Tick Bites
- Lyme disease is the most common tick-borne disease in the United States, with approximately 20,000 cases reported annually 2.
- The disease is transmitted to humans through the bite of the Ixodes tick, and typically, the tick must feed for at least 36 hours for transmission of the causative bacterium, Borrelia burgdorferi, to occur 2.
Removal of Tick and Prevention of Lyme Disease
- There is no direct evidence in the provided studies that specifically addresses what happens if the head of the tick is left inside the body.
- However, the studies suggest that prompt removal of the tick and antimicrobial therapy can prevent Lyme disease 2, 3, 4.
- Single-dose doxycycline after high-risk tick bites can also prevent Lyme disease, especially in children 5, 4.
Treatment and Prophylaxis
- Treatment of Lyme disease is usually accomplished with doxycycline or amoxicillin, and late or severe disease requires intravenous ceftriaxone or penicillin G 2, 3.
- Antibiotic prophylaxis, such as single-dose doxycycline, can be used to prevent Lyme disease after a tick bite, especially in areas where Lyme disease is endemic 4.
- Clinical practice guidelines recommend prevention, diagnosis, and treatment of Lyme disease, including the use of antibiotics for prophylaxis and treatment 6.