Patrick J. Skerrett

Matchless strategy for tick removal; 6 steps to avoid tick bites

My first tick sighting was a mixture of horror and fascination. It happened during my one and only experience with summer camp, on the shores of Alma Lake in north-central Wisconsin. One of my cabin mates discovered a big, fat tick burrowed into the skin of his belly. “Gross!” we chorused, unable to stop looking. Ideas for how to remove the tick swirled fast and furious. The leading contender was to light a match, blow it out, and touch the hot tip to the back end of the tick. As we scurried around looking for matches, cooler heads prevailed and the kid went off to the nurse for a more effective form of tick removal.

Knowing how to remove a tick is a useful skill for anyone who spends time outdoors, or who cares for someone who does. The sooner a tick is removed—correctly—the less likely the critter can deliver microbes that cause Lyme disease or other tick-borne diseases.

Don’t fall for the myths

There are several folk remedies for removing a tick. Touching it with a hot match is a common one. Others include covering it with petroleum jelly or nail polish (in theory to suffocate it), or freezing it off. These are all supposed to make the tick “back out” of the skin on its own. But they often have the opposite effect, forcing the tick to hold tight, burrow deeper, and possibly deposit more of its disease-carrying secretions into the wound, which increases the risk of infection.

The best way to remove a tick? Here’s what the Centers for Disease Control and Prevention recommend: Use a pair of fine-tipped tweezers to grasp the tick as close to the skin as possible. Then pull it out with a steady motion. Once the tick has been removed, clean the skin with soap and water. Dispose of the tick, which is probably still alive, by placing it in alcohol or flushing it down the toilet.

A tick feeds by way of a two-pronged mouthpart (hypostome) held in place with salivary cement and secured with tiny backward-pointing barbs. To remove the tick, use narrow-tipped tweezers and grasp it as close to the skin as possible; then pull upward slowly and steadily. If the mouthpart remains in the skin, try to remove it. If you can't, check with your clinician. Wash your skin and hands with soap and warm water. Try not to crush or squeeze an attached tick.

A tick feeds by way of a two-pronged mouthpart (hypostome) held in place with salivary cement and secured with tiny backward-pointing barbs. To remove the tick, use narrow-tipped tweezers and grasp it as close to the skin as possible; then pull upward slowly and steadily. If the mouthpart remains in the skin, try to remove it. If you can’t, check with your clinician. Wash your skin and hands with soap and warm water. Try not to crush or squeeze an attached tick.

For most people who are bitten by a tick, removal ends the saga. For others, though, it is just beginning.

Tick-borne diseases

In the United States, the most common tick-borne disease is Lyme disease. It is caused by Borrelia burgdorferi, a bacterium carried to humans by infected blacklegged ticks, also known as deer ticks. Most cases of Lyme disease follow the bite of an immature deer tick, which is about the size of a poppy seed. Adult deer ticks can also transmit Borrelia burgdorferi, but they are larger and more likely to be seen and removed before they’ve had time to infect a person.

Lyme disease continues to spread across the Northeast and upper Midwest, and is now found in most states. The CDC has an interactive map that shows its spread from 2001 to 2011.

Infection with Borrelia burgdorferi often—but not always—causes a rash that looks something like a red bull’s eye soon after the tick bite. Treatment with antibiotics can usually prevent any short- or long-term repercussions. If the infection isn’t treated, problems can develop in other parts of the body, including the joints, heart, and nerves. It can also cause arthritis that persists months or years after the tick bite.

Some people with Lyme disease and some community doctors have argued that Borrelia burgdorferi can somehow evade courses of antibiotics and become a chronic infection that needs long-term antibiotic treatment—even though conventional antibody tests are negative. Chronic Lyme disease has been blamed for causing pain, fatigue, muscle aches, loss of memory and thinking skills, and a host of other problems.

Most Lyme disease experts don’t believe active infection persists after antibiotic treatment and once blood tests are negative for antibodies. They’ve been critical of what they see as unreliable tests for infection and unwarranted, possibly harmful, long-term antibiotic therapy.

A recent front-page article in the Boston Globe highlighted the controversy around Lyme disease and its treatment.

Other tick-borne diseases include:

  • babesiosis
  • ehrlichiosis
  • Rocky Mountain spotted fever
  • tularemia
  • tickborne relapsing fever

Aim for prevention

The only foolproof method for staying tick free is avoiding areas where they lurk. That means staying out of brush and high grass in and around wooded areas.

If you like to be outdoors and find yourself frequenting those environments, the Connecticut Agricultural Experiment Station has published an excellent comprehensive handbook about tick management. If you don’t have the time to read all 80 pages, here are six tips for protecting yourself from ticks, culled mainly from that handbook.

1. Wear light-colored clothing. Light colors make ticks easier to spot, especially tiny deer tick nymphs.

2. Tuck your pants inside your socks. It may not be a flattering look, but it creates a physical barrier against ticks.

3. Use insect repellent. Most of the chemicals that repel mosquitoes are somewhat effective against ticks, although it may take a heavier concentration of DEET — between 30% and 40% — to really keep them away. Permethrin is a stronger chemical that kills ticks as well as repels them. Products containing permethrin should be sprayed on clothes, not on the skin. Picaridin repels mosquitoes and other insects but not ticks.

4. Stay in the middle of the path (or fairway). Ticks can’t fly or jump, so they can only get on you if you come into contact with the kind of environment they live in: moist, often shady, wooded areas, with leaves, low-lying plants, and shrubs.

5. Think sunny. Ticks don’t do well in dry, open areas. Lawn furniture and playground equipment should be set back from the edge of wooded, shady areas. If you’re picnicking, pick a patch of well-tended lawn or some open ground.

6. Inspect yourself and your children (and your pets), especially the legs and groin. Ticks usually get picked up on the lower legs and then climb upward in search of a meal. The odds of contracting Lyme or other tick-borne disease are minimized if a tick is removed soon after it’s attached, and there’s no risk if it’s still crawling around. The shower is a good place to conduct a tick check. Feel for any new bumps on soaped-up skin.

Comments:

  1. SASH

    Ticks are very dangerous if left alone and everyone in the household can also be infested with ticks. Also ticks can be present even in winter months, so it would be better if a great deal of prevention is being carried out.

  2. Quality Pest Control

    I Haven’t meet somewhere but i see and i read your article many things i’d learned to avoid tick bites of this pest. The tips are helpful with us. Thanks for your kind for sharing this information.

  3. piano removals

    We have the same problem in our house. No matter what we do on our dog it seems to catch this tick always and its getting insane very much. Since the ticks are all over the house! Do I need pest control or something? We already treated the dog with tick medicines- front line and some powders!

  4. Robi

    Awesome post about disease and some related major problem,like as “Some people with Lyme disease and some community doctors have argued that Borrelia burgdorferi can somehow evade courses of antibiotics and become a chronic infection that needs long-term antibiotic treatment—even though conventional antibody tests are negative. Chronic Lyme disease has been blamed for causing pain, fatigue, muscle aches, loss of memory and thinking skills, and a host of other problems”. great article .thanks

  5. Dr. Wahl

    We here in South Orange County California dont get many cases of ticks. As a Veterinarian prevention is the key. Take all necessary precautions when out in shaded woody areas. Avoid taking pet into these area as well.

  6. Carol Webster

    Thank you for publishing this article. The prevention of Lyme disease is so important because if you actually get Lyme disease most doctors will deny you have it.

  7. Dave

    Just like the majority of the other comments, the idea that Lyme is hard to catch and easy to treat is ridiculous. I wish that for just one week these non believers could experience the full list of our worst symptoms. Or watch one of their loved ones suffer for a week and then see if their opinions change.

  8. Pat T

    Your statement: Some people with Lyme disease and some community doctors have argued that Borrelia burgdorferi can somehow evade courses of antibiotics and become a chronic infection that needs long-term antibiotic treatment—even though conventional antibody tests are negative.

    Interesting. My bloodwork is negative; however a spinal tap shows that my cerebral spinal fluid is high positive for lyme. Do I have chronic lyme & need long term antibiotics occasionally? You betcha. Take away my treatment & I will be on disability and/or welfare.

  9. Rico

    Thank you for mentioning that some people and their doctors believe that Lyme can evade even extended antibiotics and can persist in spite of negative antibody tests. It is great to see this view acknowledged.

    However, the statement that “most” experts do not believe in chronic Lyme is misleading. It is an opinion, not a fact, as the number of “experts” who deny persistence has never been quantified. Neither have the number of doctors who treat Lyme, knowing that it’s tough to kill and knowing they can experience negative consequences in their field should world get out they’re treating past the guidelines. Such treating physicians have become self-taught experts, who know far more about the disease than a government health official who has never seen a patient, or an Ivy League researcher who only sees carefully pre-screened patients who fit in a narrow definition for a study.

    There are at least 77 different scientific articles and peer reviewed studies showing persistence in animals and in humans. The scientific evidence of persistence after infection and without positive antibody tests has been in the public domain for years. The “experts” have chosen to ignore or dismiss all of this evidence in order to maintain their orthodoxy. I imagine it would be extremely difficult for these “experts” to admit they’re wrong given the extent to which they’ve gone to defend their position, including testifying against dissenting physicians (in lawsuits and in front of medical boards) and leaving patients to a life of misery without adequate treatment.

    Instead of responding to the available scientific evidence, or aggressively pursing better tests (such as Advanced Labs Culture test or the new method developed by Norwegian professors), they call the chronic Lyme proponents “Loonies” and insist their treating physicans are all ripping them off with unnecessary treatment. How can tens of thousands of patients and hundreds of doctors be so wrong? How can the number be growing so fast if it’s all a fraud? It’s time for a new batch of “experts” who aren’t beholden to past opinions, and who can look at available evidence to find the truth.

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  11. Beth Fleming

    Most Lyme disease experts don’t believe active infection persists after antibiotic treatment and once blood tests are negative for antibodies. They’ve been critical of what they see as unreliable tests for infection and unwarranted, possibly harmful, long-term antibiotic therapy.
    …..
    I think perhaps this might be more accurate if it said, “Most Infectious Disease experts…”
    Certainly Lyme experts are critical of many of the tests, but most Lyme experts are treating many people who are not recovering after standard courses of antibiotics.

  12. Beth Fleming

    My mastitis was not cured by a standard course of abx. I nearly died.
    Lyme is not a magic disease where all people are cured by a standard course of abx.
    I became very ill with Lyme Disease . A standard course of abx again, did not cure me. Many people are like me.
    There are so many coinfections that must be treated too. Most doctors do not treat Lyme and Coinfections adequately , so people remain ill, and the disease progresses.
    To believe that Lyme is a miracle disease where all people are easily cured by standard courses of abx is insanity.

  13. Phyllis Mervine

    According to a research study published in the Annals of Internal Medicine (2002) only 9% of the 10,936 patients enrolled had the classic “bull’s-eye” rash that is diagnostic of Lyme disease. Over-emphasis on the rash – which granted, is the easiest sign to recognize – has led to over-reliance on this marker and a misperception that most people with Lyme develop the rash.
    Since few doctors recognize Lyme without objective signs like the rash, it becomes a self-fulfilling prophecy that almost everyone gets a rash. Steere himself reported on early Lyme with no rash (American Journal of Medicine, 2003).
    It is important not to rely too heavily on a sign that has been part of the case definition almost since day one, since there is no way to verify its prevalence without indulging in circular logic.

  14. Beth Fleming

    Unfortunately with all diseases there are people who do not respond to a standard course of antibiotics. I nearly died from Mastitis. I needed hospitalization and IV for the treatment of my mastitis.
    I was long term, untreated, after being bitten by a tick.
    I became chronically ill. A standard course of abx was insufficient to treat my Lyme, just as it was with the mastitis.
    Unfortunately it is the same for many people.
    Lyme Disease is not a magic illness where everyone is cured by a standard course of abx.