How to Remove a Tick
Remove the tick immediately using fine-tipped tweezers by grasping the tick's head as close to the skin as possible and pulling upward with steady, continuous pressure perpendicular to the skin. 1, 2
Proper Removal Technique
Use fine-tipped tweezers or forceps to grasp the tick's mouthparts as close to the skin surface as possible, then pull upward with steady, even pressure without twisting or jerking. 1, 2, 3 The International Liaison Committee on Resuscitation (ILCOR) 2022 consensus guidelines strongly recommend mechanical removal methods over all other approaches. 1
Step-by-Step Removal Process
- Position the tweezers perpendicular to the skin and grasp the tick's head (not the body) as close to the skin as possible. 2, 4
- Apply steady, continuous upward traction without rotating or twisting the tick. 1, 3
- Avoid squeezing or crushing the tick's body, as this may force infectious material into the wound. 2, 4
- If mouthparts remain embedded after removal, clean the site thoroughly and leave them alone—the body will expel them naturally without increasing infection risk. 5
What NOT to Do
Do not use heat, chemicals, petroleum jelly, nail polish, gasoline, kerosene, or burning methods to remove ticks. 1, 2 The ILCOR guidelines issue a strong recommendation against these methods based on evidence showing they are completely ineffective and potentially harmful. 1
- Do not apply lit matches, hot objects, or any heat source to the tick. 1, 2
- Do not coat the tick with petroleum jelly, nail polish, alcohol, or other chemicals. 1, 2, 6
- Do not handle the tick with bare fingers or crush it after removal. 2
- Do not twist or jerk the tick during removal, as this increases the risk of breaking off mouthparts. 3, 7
Immediate Post-Removal Care
- Clean the bite site thoroughly with soap and water, rubbing alcohol, or iodine scrub immediately after removal. 5, 2
- Wash your hands thoroughly after handling the tick, especially before touching your face or eyes. 5, 2
- Preserve the tick in alcohol for potential species identification if prophylactic treatment decisions are needed. 5, 7
Evidence on Removal Devices
The 2022 ILCOR systematic review found that rotating devices (particularly slit-and-rotation devices like Tick Twister) result in significantly fewer damaged mouthparts compared to pulling with standard forceps (RR 0.16-0.27). 1 However, standard fine-tipped tweezers remain acceptable and are more readily available for immediate removal. 1
Device Performance Data
- Slit-and-rotation devices (Tick Twister) vs. standard forceps: 79-84% reduction in damaged mouthparts. 1
- Any mechanical removal method is superior to hand removal (RR 0.35 for broken mouthparts with tweezers vs. hand removal). 1
- Commercial devices should be used according to manufacturer instructions if available. 1
Critical Timing Considerations
Remove ticks as soon as possible—transmission risk for Lyme disease increases significantly after 36 hours of attachment and rises to approximately 70% by 72 hours. 5, 8 The degree of tick engorgement can help estimate attachment duration, with engorged ticks indicating prolonged feeding. 5, 4
Common Pitfalls to Avoid
- Delaying removal while searching for "better" tools—immediate removal with any appropriate forceps is more important than waiting for specialized devices. 1, 3
- Attempting aggressive excision of retained mouthparts, which causes unnecessary tissue damage without reducing infection risk. 5
- Using methods that may induce the tick to regurgitate (heat, chemicals), which can increase pathogen transmission. 4, 3