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Tick Bites

What is a tick bite?

A tick is a small brown bug that attaches to the skin and sucks blood for 3 to 6 days. The bite is usually painless and doesn't itch. The wood tick (or dog tick) which transmits Rocky Mountain spotted fever and Colorado tick fever is up to 1/2 inch in size. The deer tick that transmits Lyme disease is the size of a pinhead. After feeding on blood, both of these ticks become swollen and easy to see.

How do I remove the tick?

The simplest and quickest way to remove a tick is to pull it off. Use tweezers to grasp the tick as close to the skin as possible (try to get a grip on his head). Apply a steady upward pull until he releases his grip. Do not twist the tick or jerk it suddenly because it may break off the tick's head or mouth parts. Do not squeeze the tweezers to the point of crushing the tick; the secretions released may contain germs that cause disease. If you don't have tweezers, use fingers, a loop of thread around the jaws, or a needle between the jaws to pull it out. Some tiny ticks need to be scraped off with the edge of a credit card.

If the wood tick's head breaks off in the skin, remove any large parts. Clean the skin first. Then use a sterile needle to uncover the head and scrape it off. If a very small piece of the head remains, the skin will eventually shed it.

Wash the wound and your hands with soap and water after removal. Then apply antibiotic ointment to the bite once.

Lyme Disease: Antibiotics or Not after Deer Tick Bites?

Most deer tick bites are harmless. Even in high risk areas, only 2% of deer tick bites cause Lyme disease.

The risk is higher for deer tick bites attached longer than 36 hours (or when the deer tick appears swollen). In these situations, call your healthcare provider for advice. He or she will decide if prophylactic antibiotics might be helpful for your child. Most healthcare providers only prescribe antibiotics if the child develops the rash of Lyme Disease.

How can I help prevent tick bites?

  • Be aware of the areas where ticks live. Be very careful if you walk, camp, or hunt in the woods of tick-infested areas.
  • Try to stay near the center of trails and away from underbrush.
  • When outdoors, have your child wear long-sleeved shirts tucked into his pants. The pants should be tucked into socks or boots. A hat may help, too. Wear light-colored clothing to make it easier to spot ticks before they reach the skin.
  • Use an insect repellent containing permethrin to repel ticks and other insects. Permethrin is more effective than DEET against ticks. Examples of these products include, Duranon or Permanone Tick Spray. Put it on CLOTHES (especially pant cuffs), shoes, and socks. You can also put it on other outdoor items (mosquito screen, sleeping bags). Do NOT put this kind of repellent on the SKIN because it quickly loses its effectiveness on skin.
  • During the hike do tick checks using a buddy system every 4 hours. Remove ticks on the clothing or exposed skin. Immediately after the hike or at least once a day, do a bare skin check. A shower at the end of a hike will remove any tick that isn't firmly attached.

    Because the bite is painless and doesn't itch, your child will probably not know it is there. Favorite hiding places for ticks are in the hair so carefully check the scalp, neck, armpit, and groin. Removing ticks promptly may prevent infection because transmission of Lyme disease requires at least 24 hours of feeding. Also the tick is easier to remove before it becomes firmly attached.

  • Check pets for ticks after they have been outdoors.

When should I call my child's healthcare provider?

Call IMMEDIATELY if:

  • You can't remove the tick.
  • Your child has a fever or rash within the 2 weeks after the bite.

Call during office hours if:

  • You think your child might have Lyme disease (your child has a rash that looks like a bull's-eye near the bite).
  • You have other questions or concerns.
Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books.
Pediatric Advisor 2018.1 published by Change Healthcare.
Last modified: 2017-06-05
Last reviewed: 2017-06-05
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2018 Barton D. Schmitt, MD FAAP. All rights reserved.
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