Bit By A Tick and It’s Attached, Now What?

So you found a tick on you now what do you do? As much as you want to panic because they are ugly-looking critters. Don’t. First, is it attached? If the answer is no, and the tick is still moving around and not engorged, remove it, and you don’t have to worry. Only if the tick is attached do you need to take the necessary steps listed below.  

Once the tick is attached they are tenacious with not letting go, they have long mouthparts that dig deep into the skin, and the mouthparts have barb-like denticles making it hard to remove quickly. Also, they secrete a substance that glues them to the skin. They secrete a numbing agent. That is why you don’t feel them on your skin. If attached, you should try to remove them right away. Although many believe transmission does not occur until after 24 hours, this is debated.  

Removing The Tick

How NOT to remove a tick (because the tick will become irritated and inject more fluids into your body).:

• Do not use a smoldering match or cigarette
• Nail polish 
• Petroleum jelly (e.g., Vaseline),
• Liquid soap
• Kerosene 

The proper technique for tick removal includes the following:

1. Use fine tweezers to grasp the tick as close to the skin surface as possible. I recommend using tick ease tweezers,  
2. Pull backward gently but firmly, using even, steady pressure. Do not jerk or twist.
3. Do not squeeze, crush, or puncture the tick’s body since its bodily fluids may contain infection-causing organisms.
4. After removing the tick, wash the skin and hands thoroughly with soap and water.
5. If any mouthparts of the tick remain in the skin, these should be left alone; they will expel on their own. Attempts to remove these parts may result in significant skin trauma.

Once the tick is removed

1. Save the tick in a plastic bag. Dead or Alive.  
2. Take a picture of it or note the size and color of the tick, whether it was attached, if it was engorged (that is, full of blood), and how long it was attached.
3. Contact your doctor
4. Get your tick tested. You can call your town hall as they may have a testing center or go to.Igenix or Cutter.  

Treatment Options

Your doctor will help determine if you should be put on doxycycline right away. The doctor will review the tick’s description, along with any physical symptoms, to decide upon a course of action. The Infectious Diseases Society of America (IDSA) recommends preventive treatment with the antibiotic doxycycline only in people who meet ALL of the following criteria:

• The attached tick is an adult or nymphal deer tick.

• The tick is estimated to have been attached for ≥36 hours (based upon how engorged the tick appears or the amount of time since outdoor exposure).
• The antibiotic can be given within 72 hours of tick removal.
• The bite occurs in a highly endemic area, meaning a place where Lyme disease is common. In the United States, you can determine the incidence of Lyme disease by state on the CDC website.
• The person can take doxycycline (meaning there is no reason to avoid this particular antibiotic).

If the person meets ALL of the above criteria, the recommended dose of doxycycline is a single dose of 200 mg for adults, and 4 mg/kg, up to a maximum of 200 mg, in children. 

However, Lyme literate doctors may be more aggressive with preventively treating Lyme disease. Some would recommend doxycycline for 10 to 21 days, depending on the tick and how long it was attached. There are some anti-microbial supplements that my doctors have suggested to me as a preventative for Lyme. One of them was Lyme Nosod.

Types of Ticks

Deer ticks, also called black-legged ticks, can transmit B. burgdorferi (one of the bacteria that causes Lyme disease) and several other tick-borne infections, including (but not limited to) babesiosis and anaplasmosis. B. burgdorferi-infected deer ticks live primarily in the northeast and mid-Atlantic region (Maine to Virginia) and the midwest region (Minnesota, Wisconsin, Illinois, Michigan, Ohio) of the United States, and less commonly in the western US (northern California). Although, this is changing rapidly.

Dog Ticks do not carry Lyme disease but can rarely have another tick-borne infection called Rocky Mountain spotted fever that can be serious or even fatal.

Lone Star Ticks spread an illness called southern tick-associated rash illness (STARI). STARI causes a rash similar to the erythema migrans rash but without the other features of Lyme disease. This type of tick can also carry and transmit another infection called human monocytic ehrlichiosis.

What Next?

If you decided not to treat with doxycycline, please be very aware of your symptoms over the next few weeks. If you suddenly get a weird rash or a bullseye rash, spike a fever, or feel like you have a 24 hours flu, call your doctor immediately as these symptoms can indicate you have Lyme. Other symptoms can be ear ringing, plantar fasciitis (heel pain), joint pain, fatigue, or unexplained symptoms. If any of these symptoms develop, call your doctor immediately.  

You can not get tested right away for Lyme because it takes a few weeks for the Lyme to show up in blood tests. Also, note many lab tests are not accurate. If you find out you have Lyme, go immediately to a doctor that is well versed in Lyme protocols because timing is of the essence with Lyme. You do not want it developing into chronic Lyme.   

For more about Tick removal, listen to our podcast with Dan Wolfe, the tick man, HERE.