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Tiny, Troublesome Ticks

In the summer 2014 issue of WakeMed’s Families First magazine, Michele Casey, MD, executive medical director for Primary Care and Urgent Care at WakeMed Physician Practices and Fellow of the Academy of Wilderness Medicine, shared tips to prevent health problems and what to do when you encounter some of the more common pesky problems that come up frequently in the summer. Here’s what she had to say about the pesky little tick.

Some ticks carry pathogens that cause disease in humans. It’s tough to know if a tick you find poses a problem. Even experts have difficulty identifying a specific tick species within a group. “The most important thing about ticks is knowing how to properly remove them and when you need to come in to be seen,” said Dr. Casey. “We started seeing tick bites this spring.”

If you find a tick, don’t panic. If it is loosely attached or is flat, it has probably only been on someone for a short amount of time. After removing the tick (see removal tips on page 7), Dr. Casey recommends monitoring the site and watching for symptoms for approximately 1-2 weeks. If nothing appears or symptoms do not develop, there is probably nothing to worry about.

“Remember, a small amount of redness without rash can be a body’s initial, normal inflammatory response to the tick bite,” said Dr. Casey. “However, if you develop a rash, significant redness or the area looks worse over time, get it assessed by a doctor.”

Other symptoms of concern include headache, joint aches, muscle aches and fatigue. If any of these occur and are new, get checked by a doctor. A trip to the emergency room is only necessary if symptoms progress rapidly, which is rare.

“If you do need to see the doctor and are able to bring in the tick at the time of your visit, it might be helpful for identifying the type,” said Dr. Casey. “However, keep in mind that the tick won’t necessarily be identifiable nor analyzed for specific diseases.”

Tips for Tick Removal
Avoid trying removal techniques that involve matches, nail polish remover, gasoline, etc. “Burns and other risks outweigh the benefits for most of these methods,” said Dr. Casey. They might even irritate the tick more, which could cause them to regurgitate pathogens into the wound.”

  • DO use fine-tipped tweezers.
  • DO wear gloves if available.
  • DON’T use your fingers.
  • DO grab the tick at the part that is stuck in your skin.
  • DON’T grab the tick around its bloated belly.
  • DO gently pull the tick straight out until it lets go of your skin.
  • DON’T twist and turn the tick.
  • DON’T crush it because you are expelling its pathogens.
  • DO consider putting the tick in a jar or sealed bag and place it in a freezer for possible identification later.

Note: Try to remove the entire tick. If most of it is removed, you generally do not need to have it checked unless other symptoms develop.

“It is normal to see a small crater or indention in the skin after tick removal,” said Dr. Casey. “Clean the area with basic soap and water. You can use peroxide initially to clean the area and add antibiotic ointment. If the area itches a lot, use a topical or oral Benadryl® (diphenhydramine). Make sure the dosage is appropriate for children.”

Learn more – Ticks – Removing a Tick