How to do a tick check and safely remove ticks

May 28, 2021
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With the weather warming up, many New Englanders are ready to get outside. Whether it’s having a picnic in a grassy field or or exploring a woodsy backyard, you’ll want to look out for deer ticks.

The Centers for Disease Control and Prevention (CDC) says illnesses like Lyme disease from the small blood-sucking insects known as ticks is on the rise. It says the peak season for ticks runs from April through September.

Yet there’s another reason for concern this year – ticks in the era of COVID-19.

“Similar to people rushing back into society and not taking precautions after being shut in for so long because of COVID-19, those who love exploring the great outdoors may be casting tick safety aside as they rush to enjoy hiking and other outdoor fun,” says Dr. Donna Fisher, chief of the Division of Pediatric Infectious Diseases at Baystate Children’s Hospital.

Why are ticks a health concern?

Ticks are small, blood sucking, spider-like insects that make their homes in wooded or grassy places where they can attach themselves to your skin.

They can carry diseases such as babesiosis, anaplasmosis, Powassan disease, and Lyme disease—the most common tick-borne infection. The latter is spread by blacklegged ticks when they bite mice or deer that are infected with the bacteria called B. burgdorferi.

The infected tick then passes the disease onto humans with their bite.

Length of Attachment

“Ticks must be attached to the skin for at least 36 to 48 hours before they are able to pass along bacteria to humans that can cause infections like Lyme disease and anaplasmosis,” says Dr. Fisher.

A report called Vital Signs, published by the Centers for Disease Control and Prevention (CDC), notes illnesses transmitted by blood-feeding ticks and insects capable of transmitting pathogens – bacteria, viruses, or parasites – from one host to another, have more than tripled nationwide.

Dr. Fisher recommends “tick checks” for both adults and children when returning indoors after being out in wooded and grassy areas, and especially leaf piles, while playing, gardening, hiking in the countryside or camping.

How to do a tick check

The deer tick can be very difficult to spot, ranging in size from a small poppy seed to an apple seed. They are easier to identify, however, after becoming very swollen while feeding on the blood of their host. Many tick identification charts exist –a good resource is the Massachusetts Department of Public Health.

While checking for ticks, it’s important to look at everyone and everything that may have come along for your outdoor adventure.

Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later.

Once you’ve done that, do a tick check on yourself and your children.

Begin with Clothing

“Check clothing for any visible signs of ticks, then as an additional precaution you can tumble them in the dryer set to high heat for at least 10 minutes before throwing them in the wash,” DR. Fisher says.

Take a Shower

Showering in warm water can also be a good way to gently wash off unattached ticks that have made it from clothing to you or your child’s skin. You don’t want to vigorously scrub the skin and risk breaking in half a tick that might have become embedded in the skin,” says Dr. Fisher.

Check Tick “Hot Spots”

“While children are undressed, it’s a good opportunity to check their bodies for any sign of an attached tick. Checking your own body may be a little more difficult and require the use of a mirror, unless you have a partner who can check for you,” she adds.

Tick “hot spots” to check include under the arms, inside the belly button, behind the knees, in and around the ears, waist and back, pelvic area, and in-between the legs.

Removing the Pesky Bug

If you do find a tick on the skin, avoid using petroleum jelly and hot matches, which are not effective or can cause injury. These methods may make matters worse by triggering the tick to release more of its bodily fluids, and that could cause further infection.

The CDC offers the following tips on how to remove the pesky bug:

  • Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
  • Pull upward with steady, even pressure. Don’t twist or jerk the tick, which can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal. These will not cause harm and cannot transmit disease. Your body will expel these parts in a few days.
  • After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol or soap and water.
  • Dispose of a live tick by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet. Never crush a tick with your fingers.

“Testing of any given tick found and removed for infection in the tick is not predictive of transmission and is not recommended for treatment decisions,” says Dr. Fisher.

When To Call the Doctor

“Most of the time the site will heal on its own. Medical attention should be sought if the tick bite site develops redness, swelling, or tenderness to the touch, which could be a sign of a secondary bacterial infection,” Dr. Fisher says.

Tick-borne illnesses can exhibit some symptoms not unlike COVID-19, notes Dr. Fisher, including fever, muscle aches, headache and fatigue.

“While breathing problems can occur with some infections, it is rare and more of a sign of the novel coronavirus. A typical symptom of Lyme disease that occurs in most, although not all cases, is a rash around the tick bite resembling a bull’s-eye,” says Dr. Fisher.

If illness develops within a few weeks of a tick bite, seeing a doctor is recommended immediately.

Know the symptoms of Lyme disease

You can catch Lyme disease early by looking out for early symptoms.

Within the first two weeks of being bitten by a deer tick, you may see:

  • One or more rashes which may or may not resemble a classic bulls-eye (may appear within 3-30 days, typically before the onset of fever)
  • Chills
  • Fever
  • Headache
  • Fatigue
  • Achiness

If left untreated, Lyme disease, in its later stages, can:

  • Affect the heart
  • Spread to the nervous system, resulting in facial paralysis (a loss of muscle tone or “drooping” of one or both sides of the face)
  • Cause meningitis

In this later stage, children can also develop arthritis, most often affecting the knees, which can become inflamed and swollen. This is most frequently swelling in a single joint – usually the knee (often referred to as Lyme arthritis).

“In certain situations, a single dose of doxycycline can be given to children after a tick bite to help prevent development of Lyme disease. No other antibiotic has been studied for this purpose. The American Academy of Pediatrics has endorsed a single dose in any age pediatric patient is safe. A dose of antibiotic could be considered to be given if it has been within 72 hours of removal of an engorged black-legged tick (not flat, or loosely adhered tick),” Dr. Fisher says.

Lyme disease in its early phases is easily treated and completely cured by a two week oral antibiotic treatment.

But, the best treatment for Lyme disease is prevention.

How To Dress

If you or your children are going to be out hiking in the woods or playing in bushy or tall grassy areas, make sure you’re prepared.

  • Wear long sleeves and long pants if you will be outdoors in or near a grassy or wooded area, or gardening in the vicinity of a bird feeder (that can attract mice which can carry Lyme disease bacterium).
  • Tuck your pant legs into your socks to keep ticks from crawling up along exposed skin.
  • Wear a hat.
  • Light colored clothing will show the dark colored, tiny deer ticks more clearly if they are on your clothing.
  • Apply repellents that contain 20% or more DEET (N, N-diethyl-m-toluamide) on the exposed skin. This protection can offer protection that lasts up to several hours.
  • Spray your clothes with Permethrin, an insecticide that kills ticks instead of just repelling them. Buying a spray that has a 0.5 % concentration of permethrin and properly treating your clothes can give you protection anywhere from weeks to even year.

“For those concerned with the chemicals found in insect repellents, there are some natural alternatives available including oil of lemon eucalyptus, which is approved for kids 3 years and older, and others made with natural plant oils,” says Dr. Fisher.

  • Don’t apply your protection out of order. The U.S. Center for Disease Control and Prevention recommends that sunscreen go on first, followed by insect repellent.
  • Don’t apply on cuts, wounds, or irritated or sunburned skin.
  • Don’t spray in enclosed areas. Spray outdoors.

Always follow product instructions on repellents, avoiding hands, eyes, and mouths.

Make An Appointment

To make an appointment with an adult infectious disease specialist, call 413-794-7394, or for pediatric appointments, call 413-794-KIDS.

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