Preventing Tick Bites
Removing Ticks
Saving the Tick
What to do after removing a Tick
When to Call

With the arrival of Spring flowers, green grass, and outdoor play, comes the risk of tick bites.  In Massachusetts, Lyme Disease is the most common disease spread by ticks.   The best way to avoid Lyme Disease is to avoid tick bites and to remove ticks that have bitten as soon as possible.  The best way to avoid tick bites is to cover the skin as much as possible when in areas that have ticks.  Ticks spend time in grassy and wooded areas. Ticks generally cling to plants near the ground in brushy, wooded, or grassy places. The edges of woodlands and leaf litter are high risk areas. The ticks climb from the plants onto people who brush against the plants.

Preventing Tick Bites

If your child is playing outside in a grassy or wooded area, try to dress him in light weight, long-sleeved shirts, and long pants, tucked into socks.  Spraying clothes with a tick repellant containing permethrin can add further protection.  Repellents containing DEET can be applied to the skin to help prevent tick bites. Neither of these repellents should be used on infants.

When your child comes in from outside, or at least before bedtime, check his whole body for ticks.  Not all kinds of ticks spread Lyme Disease.  In our area, only deer ticks of the species Ixodes scapularis transmit Lyme.  In the spring these ticks are dark brown and can be as small as 1 mm in size.  In the summer, at their adult size, they can be as large as 4 mm and have a reddish brown rim around a dark brown back.  They tend to attach in hard to find places like the scalp, behind the ears, under the arms, between the toes, and in the groin folds.  Look everywhere!

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Removing Ticks

If you find a tick, remove it as soon as possible.  The best way to do this is to grasp it firmly with a tweezer as close to your child’s skin as possible and pull out with a steady motion.  Do not squeeze or twist the tick. Try to remove the tick in one piece.  If the mouth piece is left behind, the tick can no longer transmit Lyme Disease, but it can act like a splinter and cause pain and irritation.  Try to remove it with a sterile tweezer or sterilized pin.  Wash the area with soap and water and apply an antibiotic ointment like Bacitracin or Neosporin.

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Saving the Tick

There is no need to save the tick, whether it is dead or alive after you remove it.  It is not helpful for us to send the tick to the laboratory to be tested for Lyme.  Dispose of it safely.  You can put it in alcohol to make sure that it is dead.

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What to do after removing a Tick?

Ticks do not transmit Lyme Disease unless they have fed for over 36 hours. A tick that is removed on the same day that it attached is very unlikely to transmit Lyme Disease.  You can estimate how long the tick has fed by thinking about when that area of the skin was last checked, when an exposure was likely to have occurred, and the degree of engorgement of the tick.  A tick that appears full of blood is engorged and is  likely to have been feeding for a significant amount of time.

If it appears that your child has had a tick which has fed for more than 36 hours, you will need to watch carefully for signs of Lyme Disease. For children 8 years or older who have had deer tick attached for more than 36 hours (or an engorged deer tick) and fewer than 3 days have passed since it was removed, a single dose of a preventative antibiotic can be prescribed, which is very effective at preventing Lyme Disease.  Unfortunately, there is not a preventative antibiotic available for children under 8 years old.

Any child who has been found to have a tick should be watched carefully for signs of Lyme Disease.  Watch for a rash developing most commonly at the site of the tick bite, but it can occur elsewhere on the body.  It looks like an expanding area of redness, sometimes with clearing of the redness in the center.  It will usually grow to greater than two inches within a day or so.  Also watch for fever, headache, muscle aches and joint aches.  Watch for this rash and these symptoms for up to a month after the tick bite.  Sore throat, cough, diarrhea, and runny nose are not symptoms of Lyme Disease.

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You should call us if:

1. Your child is 8 or older and has a tick which has been attached for more than 24 hours or appears engorged.  We may prescribe a preventative antibiotic. If more than 3 days has passed since the tick was removed, you do not need to call us unless your child develops a rash, fever, headache, muscle aches or joint aches.
2. Your child of any age has had a tick removed and then develops an expanding red rash, or fever, headache, muscle aches or joint aches within a month of the tick bite.
3. Your child of any age with or without a tick bite, develops a suspicious rash or other symptoms of Lyme Disease during the Spring, Summer or Fall.

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