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Marlton Pediatrics

Tick Bite

Definition

  • A tick (small brown bug) is attached to the skin
  • A tick was removed from the skin

Call or Return If

  • You tried and can't remove the tick
  • Fever or rash happens in the next 4 weeks
  • Bite starts to look infected
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • A tick bite does not cause pain or itch. So, ticks may not be noticed for a few days.
  • After feeding on blood, ticks get quite swollen and easy to see.
  • Ticks fall off on their own after sucking blood for 3 to 6 days.
  • After the tick comes off, a little red bump will be seen.

Causes

  • The wood tick (dog tick) is the size of an apple seed. After feeding, it can triple in size. Sometimes, it can pass on Rocky Mountain spotted fever or Colorado tick fever.
  • The deer tick is the size of a poppy seed (pinhead). After feeding, it can triple in size. Sometimes, it can pass on Lyme disease.

Lyme Disease

  • The risk of Lyme disease after a deer tick bite is low. Even in a high risk area, the risk is about 2%.
  • Most infections (80%) start with a bull's eye rash. The medical name is erythema migrans (EM). The rash starts at the site of the tick bite. EM usually is solid red. Central clearing is present in 30%. EM starts on the average at 7 days. It grows larger quickly to more than 2 inches (5 cm) wide. It lasts 2 or 3 weeks.
  • Onset: On the average, Lyme disease starts 7 days after the bite. (Range: 3-30 days).
  • Treatment of erythema migrans with an antibiotic is advised. This almost always prevents the development of later stages of Lyme Disease. Arthritis, heart disease and neurologic disease can occur if Lyme Disease is not treated.
  • Giving an antibiotic after a deer tick bite to prevent Lyme disease depends on the risk. The risk is low with brief attachment. An antibiotic is not needed.
  • The risk is high if the deer tick was attached for longer than 36 hours. It's also high if the tick is swollen, not flat. An antibiotic may be needed. Your doctor will help you decide.

Prevention of Tick Bites

  • When hiking in tick-prone areas, wear long clothing. Tuck the ends of pants into socks.
  • Do tick checks at the end of each day. Early removal of ticks within 36 hours can prevent Lyme disease.

Tick Repellent for Clothing - Permethrin

  • Permethrin products (such Duranon or Permanone Tick Spray) are very good tick repellents.
  • An advantage over DEET is that permethrin is used on clothing. Put it on clothes, especially pants cuffs, socks and shoes. You can also put it on other outdoor items (mosquito screen, sleeping bags).
  • Do not put Permethrin on skin. Reason: It loses its ability to work once in contact with skin.

Tick Repellent for Skin - DEET

  • DEET is a good tick repellent. It can be used on the skin not covered by clothing.
  • Use 30% DEET for children and teens (AAP). Note: 30% DEET protects for 6 hours.
  • DEET is approved for use in children over 2 months of age. (AAP)

After Care Advice

Overview - Deer Tick Bites:
  • Most deer tick bites are harmless.
  • The spread of disease by deer ticks is not common.
  • Even in high risk areas, only 2% of deer tick bites cause Lyme disease.
  • Most people who get Lyme disease live in or have traveled to 14 high-risk states. Lyme disease mainly occurs in the Northeast and upper Midwest. Many states do not have Lyme disease.
Overview - Wood Tick Bites:
  • Most wood tick bites are harmless.
  • The spread of disease by wood ticks is uncommon.
  • If the tick is still attached to the skin, it needs to be removed.
  • Here is some care advice that should help.
Deer Tick - How to Remove:
  • If a deer tick is swollen, try to remove it with a tweezers.
  • If it is tiny, it needs to be scraped off.
  • Use the edge of a credit card.
Wood Tick Removal: Use a Tweezers
  • Use a tweezers and grasp the tick close to the skin (on its head).
  • Hold the tweezers sideways next 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 you don't have tweezers, you can use your fingers.
  • Other options. You can use a loop of thread around the jaws. You can also use a needle pushed between the jaws for traction. Jaws are the part of the head attached to the skin.
  • Not helpful: Covering the tick with petroleum jelly or nail polish doesn't work. Neither does rubbing alcohol or a soapy cotton ball. Touching the tick with a hot or cold object also doesn't work.
Antibiotic Ointment:
  • Wash the wound and your hands with soap and water after removal.
  • This helps to prevent catching any disease carried by the tick.
  • Use an antibiotic ointment such as Polysporin. No prescription is needed.
  • Put it on the bite once.
Tick's Head - When to Remove:
  • If the wood tick's head breaks off in the skin, remove any large parts.
  • Clean the skin with rubbing alcohol.
  • Use a clean tweezers or needle to uncover the head and scrape it off.
  • If a small piece of the head remains, the skin will slowly shed it.
What to Expect:
  • Tick bites normally don't itch or hurt.
  • That's often why they may not be noticed.
  • The little bump goes away in 2 days.
  • If the tick transferred a disease, a rash will occur. It will appear in the next 2 to 4 weeks.
Antibiotic Ointment:
  • Wash the wound and your hands with soap and water after removal.
  • This helps to prevent catching any disease carried by the tick.
  • Use an antibiotic ointment such as Polysporin. No prescription is needed.
  • Put it on the bite once.
What to Expect:
  • Tick bites normally don't itch or hurt.
  • That's often why they may not be noticed.
  • The little bump goes away in 2 days.
  • If the tick transferred a disease, a rash will occur. It will appear in the next 2 to 4 weeks.
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