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Tick removal

Ticks are small, insect-like creatures that live in woods and fields. They attach to you as you brush past bushes, plants, and grass. Once on you, ticks often move to a warm, moist location. They are often found in the armpits, groin, and hair. Ticks attach firmly to your skin and begin to draw blood for their meal. This process is painless. Most people will not notice the tick bite .

Ticks can be fairly large -- about the size of a pencil eraser. They can also be so small that they are very hard to see. Ticks can cause a number of health conditions. Some of these can be serious.

Considerations

While most ticks do not carry diseases, some ticks can cause:

First Aid

If a tick is attached to you, follow these steps to remove it:

  1. Grasp the tick close to its head or mouth with tweezers. Do not use your bare fingers. If needed, use a tissue or paper towel.
  2. Pull the tick straight out with a slow and steady motion. Avoid squeezing or crushing the tick. Be careful not to leave the head embedded in the skin.
  3. Clean the area well with soap and water. Also wash your hands thoroughly.
  4. Save the tick in a jar. Watch the person who was bitten carefully over the next week or two for indications of Lyme disease.
  5. If all parts of the tick cannot be removed, get medical help. Bring the tick in the jar to your doctor's appointment.

Do Not

  • Do NOT try to burn the tick with a match or other hot object.
  • Do NOT twist the tick when pulling it out.
  • Do NOT try to kill, smother, or lubricate the tick with oil, alcohol, Vaseline, or similar material.

When to Contact a Medical Professional

Call your doctor if you have not been able to remove the entire tick. Also call if in the days following a tick bite you develop:

  • A rash
  • Flu-like symptoms, including fever and headache
  • Joint pain or redness
  • Swollen lymph nodes

Call 911 if you have any signs of:

  • Chest pain
  • Heart palpitations
  • Increasingly severe headache which does not respond to medication
  • Paralysis
  • Severe headache
  • Trouble breathing

Prevention


  • Wear long pants and long sleeves when walking through heavy brush, tall grass, and thickly wooded areas.
  • Pull your socks over the outside of your pants to prevent ticks from crawling up your leg.
  • Keep your shirt tucked into your pants.
  • Wear light-colored clothes so that ticks can be spotted easily.
  • Spray your clothes with insect repellant.
  • Check your clothes and skin often while in the woods.

After returning home:

  • Remove your clothes. Look closely at all your skin surfaces, including your scalp. Ticks can quickly climb up the length of your body.
  • Some ticks are large and easy to locate. Other ticks can be quite small, so carefully¬†look at¬†all black or brown spots on the skin.
  • If possible, ask someone to help you examine your body for ticks.
  • An adult should examine children carefully.

References

Bolgiano EB, Sexton J. Tick-borne illnesses. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Elsevier Mosby; 2009:chap 132.

Traub, SJ, Cummins, GA. Tick-borne diseases. In: Auerbach, PS. ed. Auerbach: Wilderness Medicine. 6th ed. Philadelphia, PA. Elsevier Mosby; 2011:chap 51.

Updated: 1/1/2013

Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.


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