Tick Bite

When To Call

Call Your Doctor Now (night or day) If

• Your child looks or acts very sick
• You can't remove the tick after trying topic advice
• You can't remove tick's head that broke off in the skin after trying topic advice (Note: if the removed tick is moving, it was completely removed).
• Widespread rash occurs 2 to 14 days following the bite
• Fever or severe headache occurs 2 to 14 days following the bite
• Fever and bite looks infected (spreading redness)
• You think your child needs to be seen urgently

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• You think your child needs to be seen, but not urgently
• New redness starts more than 24 hours after the bite (Note: infection is rare and doesn't start until at least 24-48 hours after the bite.)
• Over 48 hours since the bite and redness now becoming larger
• Red-ring or bull's eye rash occurs around a deer tick bite (Lyme disease rash begins 3 to 30 days after the bite)
• Weak, droopy face or crooked smile

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns

Parent Care at Home If

• Tick bite with no complications and you don't think your child needs to be seen

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information. For more information, click here.

Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.
Last Review Date: 8/1/2011
Last Revised: 8/1/2011 3:29:35 PM
Content Set: Pediatric HouseCalls Symptom Checker
Version: 2012
Copyright 1994-2012 Barton D. Schmitt, M.D.

Care Advice

Treating Tick Bites

1. Reassurance:
• Most tick bites are harmless.
• The spread of disease by ticks is rare.
• If the tick is still attached to the skin, it will need to be removed.
• Covering the tick with petroleum jelly, nail polish, rubbing alcohol, or a soapy cotton ball doesn't work. Neither does touching the tick with a hot or cold object.
• Try one of the following techniques
2. Wood Tick Removal: Use a Tweezers
• Use a tweezers and grasp the tick close to the skin (on its head).
• Hold the tweezers parallel to the skin surface.
• Pull the wood tick straight upward without twisting or crushing it.
• Maintain a steady pressure until it releases its grip.
• If tweezers aren't available, use fingers, a loop of thread around the jaws, or a needle between the jaws for traction.
3. Deer Tick Removal: Tiny deer ticks need to be scraped off with a finger nail or credit card edge.
4. Tick's Head: If the wood tick's head breaks off in the skin, remove it.
• Clean the skin with rubbing alcohol.
• Use a sterile needle to uncover the head and lift it out.
• If a small piece of the head remains, the skin will eventually shed it.
• If most of the head is left, call your doctor.
5. Antibiotic Ointment: Wash the wound and your hands with soap and water after removal to prevent catching any tick disease. Apply antibiotic ointment such as Polysporin to the bite once (no prescription needed).
6. Expected Course: Tick bites normally don't itch or hurt. That's why they often go unnoticed.
7. Call Your Doctor If:
• You can't remove the tick or the tick's head
• Fever or rash in the next 2 weeks
• Bite begins to look infected
• Your child becomes worse

Preventing Tick Bites

1. Prevention:
• When hiking in tick-infested areas, wear long clothing and tuck the ends of pants into socks. Apply an insect repellent to shoes and socks.
• Permethrin products applied to clothing are more effective than DEET products against ticks.
2. Tick Repellent for Skin - DEET:
• DEET is an effective tick repellent.
• Use 30% DEET for children and adolescents (AAP recommendation 2003) (30% DEET protects for 6 hours)
3. Tick Repellent for Clothing - Permethrin:
• Permethrin-containing products (eg, Duranon or Permanone Tick Spray) are highly effective tick repellents.
• An advantage over using DEET is that they are applied to and left on clothing instead of skin. Apply it to clothes, especially pants cuffs, socks and shoes. You can also put it on other outdoor items (mosquito screen, sleeping bags).
• Do not apply Permethrin to skin (Reason: it's rapidly degraded on contact with skin)

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms. 

To find a pediatrician, click here.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information. For more information, click here.  

Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.
Last Review Date: 8/1/2011
Last Revised: 8/1/2011 3:29:35 PM
Content Set: Pediatric HouseCalls Symptom Checker
Version: 2012
Copyright 1994-2012 Barton D. Schmitt, M.D.

Photos

Adult Deer Tick

This adult Deer tick is about the size of an apple seed. The tick is flat and has not yet begun feeding.

Source: USDA

This work is in the public domain because it is a work of the United States federal Government (USDA). Photographer: Scott Bauer.

Deer Tick (Black-Legged Tick) 

Source: CDC PHIL
From the CDC's Public Health Image Library, ID#1669, in the public domain.

Content Providers: CDC / Michael L. Levin, Ph.D.

Erythema Migrans Rash

The majority of cases of Lyme disease start with a bull's eye rash ("erythema chronicum migrans") at the site of the tick bite. The rash can occur days to weeks (typically 7-10 days) after a tick bite.

Treatment with antibiotics is indicated if this rash appears.

It is thought that Lyme Disease can be prevented if the tick is removed within 24 hours of attachment.

Source: CDC PHIL
From the CDC's Public Health Image Library, ID#9875, in the public domain.

First Aid - Removing a Tick

Wood Tick Removal:

• Use a pair of tweezers and grasp the wood tick close to the skin (on its head). See image.
• Pull the wood tick straight upward without twisting or crushing it. Maintain a steady pressure until it releases its grip.
• If tweezers aren't available, use fingers, a loop of thread around the jaws, or a needle between the jaws for traction.

Tiny Deer Tick Removal:

• Needs to be scraped off with a knife blade or credit card edge.
• Place tick in a sealed container (e.g., glass jar, zip lock plastic bag), in case your doctor wants to see it.

Note: Covering the tick with petroleum jelly, nail polish or rubbing alcohol doesn't work. Neither does touching the tick with a hot (like a match) or cold object.

Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.
 

Wood Tick (Dog Tick)

This is a picture of a female American brown Wood Tick.

The Wood Tick (or dog tick) is the size of a watermelon seed and can sometimes transmit Rocky Mountain spotted fever and Colorado tick fever.

Source: CDC PHIL

From the CDC's Public Health Image Library (http://phil.cdc.gov), ID#170, in the public domain.

Content Providers: CDC / Gary O. Maupin.

Wood Tick in Scalp

This photos shows an engorged (full with blood) wood tick hiding in the hair on the back of the head.

Source: Barton Schmitt

Copyright Barton Schmitt MD, Self Care Decisions LLC. Used by Permission.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information. For more information, click here.

Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.
Last Review Date: 8/1/2011
Last Revised: 8/1/2011 3:29:35 PM
Content Set: Pediatric HouseCalls Symptom Checker
Version: 2012
Copyright 1994-2012 Barton D. Schmitt, M.D.