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The Do’s and Dont’s of Ticks

Screen shot 2013-06-07 at 10.01.45 AMTick bites, especially from deer ticks, are of special concern in the northeastern United States because deer ticks are known carriers of Lyme disease. This malady starts with a rash on the skin that appears, on average, ten days after the tick bite. If unnoticed and untreated, the illness can progress into a wide range of other symptoms, such as fever and joint pain. In endemic regions, a recent increase in awareness of the disease has in some cases spilled over into hysteria, resulting in countless unnecessary prescriptions and blood tests, not to mention anxiety.

There are a few salient points to remember about Lyme disease: Only deer ticks transmit the disease; even if a deer tick is infected with Lyme disease, the probability of getting the illness after a bite is low, unless the tick has remained on the skin for more than a day; and the disease is treatable with a simple antibiotic, especially when diagnosed early. To clear up any confusion about what to do and what not to to do to prevent Lyme, follow these guidelines:

Do: Daily inspections

In heavily-infested areas do careful daily inspections, use insect repellents and dress to minimize exposed skin.

Do: Remove the tick.

Use tweezers or scrape it off with a blade or a credit card. You don’t need a doctor to do this.

Do: Throw the tick away.

No need to bring it anywhere or analyze it.

Do: Observe the site for skin changes.

In the early days you may see an inflammatory reaction that resolves quickly, like any insect bite. If the spot becomes infected—it becomes red and painful—treat it with an over-the-counter antibiotic cream. If the characteristic Lyme disease rash were to develop, it would show up 1-3 weeks later. It is circular and red, and the center gradually clears, forming what looks like a bull’s-eye with a red and scaly edge. Lyme rashes vary in intensity and appearance, so any redness that appears after a few days in a spot where you removed a tick is suspect and requires medical attention.

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Don’t: Dig deep to remove every bit of the tick.

No matter how precise you are, it’s almost impossible not to leave a little bit of the tick in the skin. These suckers don’t let go easily. That’s okay, though, because the part of the tick that’s left in the skin doesn’t increase the chance of transferring Lyme disease; for that, the tick has to be alive and actively sucking blood. What bits remain will eventually disintegrate, just like a splinter, and digging around could cause an infection.

Don’t: Save the tick

Once you’ve removed the tick, throw it out; there’s no need to analyze it. The lab could tell you whether or not it’s a deer tick, but your course will be the same in either case.** A simple tick bite warrants neither preventive antibiotic treatment nor blood tests, which are unreliable.

Don’t: Rush in to get a blood test 

Blood tests for Lyme are notoriously inaccurate and may give you a sense of false security or a false alarm. They should be used in the case of a diagnostic challenge. Yearly blood tests to detect Lyme infection, despite the absence of any symptoms, are especially unhelpful. In addition, a recently introduced Lyme vaccine was discontinued almost immediately due to lack of efficacy. There is a new lab test to determine if a tick carries Lyme disease. However, this is not actually that useful. Even if the tick does carry Lyme disease, this certainly does not mean that its bite will be (or has been) infectious. Also, final test results take between 6-8 days. By this time we may have already seen the characteristic Lyme disease rash and treated it.
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