- Dr. Tania Dempsey
What To Do If You Find a Tick: Lyme Disease Prevention
Avoiding exposure to ticks is no easy task. In recent years, with warmer global temperatures and tick-carrying animals ranging into new areas, the population of ticks has exploded.
Along with the rising number of ticks comes an increase in tick bites. We know ticks carry many diseases and getting bit by a tick puts you at risk for infection.
One of the most common tick-borne illnesses, Lyme disease, has become a silent pandemic, with upwards of 30,000 reported cases each year. The CDC estimates the numbers are likely to be higher.
I work daily with patients recovering from Lyme disease and other tick-borne infections. While there are many effective protocols that support repair and healing, the best medicine is always prevention.
Tick-borne diseases may be preventable with a few simple measures that shouldn’t take much time to do. I hope everyone can learn to take precautions.
Today I’ll share:
The best steps to prevent tick bites
What do after you’ve been outdoors
Actions to take if you find a tick
Post-tick bite treatment options
Tick-bite Prevention
Prevention is where I wish more people would invest effort. Getting in the habit of taking the simple steps to avoid tick bites has a huge payoff.
Tick-borne infections can be debilitating, and the recovery process is often long and frustrating. After helping countless people recover from Lyme disease, I’ve seen firsthand what they experience in getting a diagnosis and returning their bodies to health.
I’d love to save you from that experience.
As we all know, “an ounce of prevention is worth a pound of cure.” The best choice is to maintain good health by adding tick bite prevention to your healthy habits.
#1 Be aware of areas likely to harbor ticks:
Being out in nature is absolutely good for your health. But, at the same time, you have to be aware of the risks around you. You wouldn’t go out on a hike without a water bottle. And if you hiked in bear country, you would probably take something like a noisemaker or repellant to ward off bears.
The same caution applies to time spent in areas where ticks are most likely. These include:
Wooded areas
High grass areas, including tall beach grass and even your backyard
Cool, wet, shady places
Specific plants such as Japanese barberry and bush honeysuckle
Certain areas of the country have higher tick populations. Check with your university extension or health department to assess your local risk.
While these are the most likely areas to encounter ticks, the reality is that ticks can be anywhere. I’ve heard of patients picking up ticks in some unlikely places, so constant vigilance is required anytime you step out your front door.
#2 Wear a repellant:
I know the idea of using chemicals does not appeal to everyone, but I would encourage a hard look at the risks vs. benefits. I have a front-row seat to how destructive tick-borne illnesses can be, so I do think a chemical repellant may be the right choice for many people.
While natural options are out there, it is not clear to me that they are as effective. I recommend being extra cautious when using natural tick-repellant products as you may not be getting the level of protection you expect.
If you choose a traditional chemical tick deterrent, here is what I recommend:
Spray or purchase clothes with Permethrin: You can buy clothes that have been pre-treated with this chemical which is a good option for convenience. If you choose to apply the spray yourself, follow the instructions and take precautions to prevent exposure:
Spray outside and allow the clothes to dry fully
Wear a mask
Avoid contact with skin while wet
Keep pets away from the area when spraying
In general, I’ve found Permethrin is generally well tolerated by most people and appears to be very effective at repelling ticks and immobilizing them by making them more sluggish and interfering with their ability to attach themselves to the skin and bite.
Apply a tick-repelling product: I highly recommend products made with picaridin to my patients, and I use them on my kids and on myself. Unlike products made with DEET, picaridin has a better safety profile, and I find most people are less sensitive to it.
Remember that reapplication is critical for whatever type of product you choose to apply. All of these products lose effectiveness over time, so read the instructions on the bottle and set a reminder on your phone for when you need to reapply.
#3 Protect yourself from tick-carriers
Unfortunately, your beloved pet is just as likely to pick up a tick as you, if not more. While you can try to avoid the tall grass, your pet may charge right in. You need a plan for how you will protect your pet and check them regularly for ticks.
One of the biggest risk behaviors I see patients doing is letting pets sleep in their beds. While you may love cuddling up with your dog at night, your chance of picking up a tick from them skyrockets. I strongly discourage sharing a bed with your pet.
After You’ve Been Outside
Hopefully, you took precautions before you walked out the front door. But, protecting yourself from a tick-borne illness doesn’t stop there. You need to take steps to ensure your proactive measures are effective.
Do a tick check
Before you even go inside, give yourself and your loved ones a once over to see if any ticks are trying to hitch a ride on your clothing or shoes. This is especially critical if you’ve been out in the woods or other high-risk areas. If you have a pet with you, give them a thorough check as well.
Once indoors, remove clothing and ideally wash and dry them right away.
Check your bare skin for ticks. Ticks like warm places and crevices, so give extra attention to some of the most likely body areas. These include the armpits, groin, and scalp.
Recheck for ticks
If you encounter a tick, it may not bite you right away. Ticks take time to crawl to a prime location, so if a tick slipped your notice, it might attach itself in the coming days.
Recheck the day after being in a high-risk area, and if you saw any ticks while out, consider checking over the next 2-3 days to be safe.
What To Do If You Find a Tick
In a perfect world, your prevention measures would mean you never find a tick on your person. But we all know our best efforts aren’t always 100% successful.
Don’t panic. Just because a tick bit you doesn’t mean all is lost. There is still plenty that can be done to manage your risk and protect your health.
Step 1: Remove the tick as soon as possible
Now, don’t freak out and start swiping at a tick you find attached. Ticks have a unique body structure, and it’s essential to carefully remove all of the tick and prevent it from breaking apart or becoming embedded.
I recommend everyone have a sturdy tick removal device designed to remove the entire body seamlessly. You can find these simple over-the-counter devices at most drugstores or online. You can also use a fine-tipped tweezer.
When you’re ready to remove the tick, keep these tips in mind:
Grasp the tick as close to the skin as possible
Pull upward with steady pressure, with no sharp twists or jerks
Place the removed tick in a sealed plastic bag
Thoroughly clean the bite area with soap and water
Check the spot carefully for any parts of the tick that became embedded
If you find a tick that has burrowed partly into the skin, don’t dig around yourself to try and remove it. This could cause an infection or cause the tick to break apart and become embedded. A medical professional will have the appropriate tools to remove a tick in that situation but sometimes removing the remainder of the tick will not be possible.
Step 2: Have the tick tested
You should always save a tick once you’ve removed it. While the CDC does not recommend routine testing of every tick, I highly recommend you have the tick tested. The results will help you understand your exact level of risk.
You may have heard that a tick needs to be attached for 48-72 hours to transmit Lyme disease. I question that information. No clear data proves a long attachment time is necessary for transmission.
In my experience, the time necessary for transmission is variable. I’ve seen patients who contracted Lyme disease in less than 4 hours with a tick.
And keep in mind, Lyme disease is by no means the only tick-borne infection. Some viruses can be transmitted in as little as 15 minutes.
So, don’t assume there is nothing to worry about just because you caught the tick early. I still recommend having the tick tested to know what you are dealing with.
If you pursue getting the tick tested, you have a few options:
Local health department - For free or for a small fee, most local health departments will have the tick tested for a shortlist of pathogens; usually Lyme disease, anaplasmosis, and babesia.
Commercial lab - Many commercial companies offer tick testing. But be aware that they may be more expensive. In addition, most commercial labs don’t offer comprehensive testing. Lyme disease isn’t the only tick-borne illness, and you need a test that will check for the full range of pathogens.
University testing - Some universities have labs that test ticks. While there are costs involved, they provide very reliable and comprehensive results. These labs can test for a tremendous number of bacteria, parasites, and viruses. The more thorough the lab panel, the better information you will get.
Step 3: Connect with a medical provider
Don’t wait for results from the tick testing to call your doctor. You should let them know right away that you have experienced a tick bite.
There are essentially two options at this point:
Watch and wait -
You and your doctor may choose to wait for the tick testing results or for you to exhibit symptoms. This is not my favorite approach because if there is an infection there, it could wreak havoc before the damage is noticeable.
Pursue prophylactic treatment -
Instead of waiting for an infection to present itself, it may be better to pursue some upfront treatment. Some doctors follow a protocol where they administer one to two dosages of Doxycycline. Doxycycline is an antibiotic commonly used to treat bacterial infections, including Lyme disease.
In my opinion, this is really a mistake and carries some dangers to the patient. Simply administering one or two dosages may falsely cover up an infection that is brewing underneath. I don’t advocate for this approach.
There is no right answer on this, but there are two options that we sometimes consider at the time of the tick bite: 1) a longer course of antibiotics or 2) an herbal protocol.
In my experience, an herbal approach is a better way to go, at least until we know if the tick is carrying any pathogens or unless we have a high index of suspicion that the tick transmitted infections. While there is no rigorous data clarifying this approach, anecdotally, I support this path for the right patient.
Some patients don’t feel comfortable with the wait-and-see approach. An herbal regimen makes sense in that case as it doesn’t carry the risk of masking an infection.
Other patients prefer to avoid antibiotics. In this case, pursuing preemptive herbal treatment is a better option to provide a measure of protection.
Deciding whether to pursue herbal treatment should be done on a case-by-case basis. When I consider this option for a patient, we thoroughly analyze their specific risk profile compared to possible benefits. If I feel the patient is a good candidate for an herbal regimen, we can initiate it right away while we wait for the tick test results.
Some herbs I might consider using include:
Once tick test results are in, the next steps become clearer.
Bottom Line
I’m a firm believer in prevention as the best thing we can do for our health. I love the work I do at my clinic, helping patients heal from multisystem illnesses. But I am also committed to helping everyone have the knowledge they need to keep from getting sick in the first place.
Ticks are everywhere, but you control the level of risk you face when you step into the tick's habitat. A few simple, smart actions can protect you and your loved ones from tick-borne diseases. Don’t take the risk.