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Tick Bites

Topic Overview

A tick

Ticks are small spiderlike animals (arachnids) that bite to fasten themselves onto the skin and feed on blood. Ticks live in the fur and feathers of many birds and animals. Tick bites occur most often during early spring to late summer and in areas where there are many wild animals and birds.

Most ticks don't carry diseases, and most tick bites don't cause serious health problems. But it is important to remove a tick as soon as you find it. Removing the tick's body helps you avoid diseases the tick may pass on during feeding. Removing the tick's head helps prevent an infection in the skin where it bit you. See Home Treatment for the best way to remove a tick.

Usually, removing the tick, washing the site of the bite, and watching for signs of illness are all that is needed. When you have a tick bite, it is important to determine whether you need a tetanus shot to prevent tetanus (lockjaw).

Some people may have an allergic reaction to a tick bite. This reaction may be mild, with a few annoying symptoms. In rare cases, a severe allergic reaction (anaphylaxis) may occur.

Many of the diseases ticks carry cause flu-like symptoms, such as fever, headache, nausea, vomiting, and muscle aches. Symptoms may begin from 1 day to 3 weeks after the tick bite. Sometimes a rash or sore appears along with the flu-like symptoms. Common tick-borne diseases include:

Tick paralysis is a rare problem that may occur after a tick bite. In some parts of the world, tick bites may cause other tick-borne diseases, such as South African tick-bite fever.

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Do you have a concern about a tick bite?
Yes
Tick bite concern
No
Tick bite concern
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
Could you be having a severe allergic reaction?
This is more likely if you have had a bad reaction to something in the past.
Yes
Possible severe allergic reaction (anaphylaxis)
No
Possible severe allergic reaction (anaphylaxis)
Yes
Symptoms of tick paralysis
No
Symptoms of tick paralysis
Are there any symptoms of infection?
Yes
Symptoms of infection
No
Symptoms of infection
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Are there red streaks leading away from the area or pus draining from it?
Yes
Red streaks or pus
No
Red streaks or pus
Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area?
"Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps.
Yes
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
No
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
Do you have a new rash or sore after being bitten by a tick?
The rash could be anywhere on the body. It may or may not be near the bite.
Yes
New rash or sore
No
New rash or sore
Does the rash cover a lot of your body?
Yes
Rash over much of body
No
Rash over much of body
Have you developed any flu-like symptoms after a tick bite, such as fever, muscle or joint pain, headache, nausea and vomiting, or a general feeling of illness?
This could happen within minutes of the bite or up to 3 weeks later.
Yes
Flu-like symptoms after bite
No
Flu-like symptoms after bite
If a tick or any part of a tick is still attached to you, can you remove it?
Yes
Able to remove entire tick
No
Unable to remove entire tick
Do you think you may need a tetanus shot?
Yes
May need tetanus shot
No
May need tetanus shot
Have you had symptoms for more than a week after a tick bite?
Yes
Symptoms for more than 1 week after tick bite
No
Symptoms for more than 1 week after tick bite

Symptoms of a severe allergic reaction (anaphylaxis) may include:

  • The sudden appearance of raised, red areas (hives) all over the body.
  • Rapid swelling of the throat, mouth, or tongue.
  • Trouble breathing.

A severe reaction can be life-threatening. If you have had a bad allergic reaction to a substance before and are exposed to it again, treat any symptoms as an emergency. Even if the symptoms are mild at first, they may quickly become very severe.

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Tick paralysis is a rare reaction to the venom that some ticks release when they bite. Symptoms usually start 4 to 7 days after a tick attaches to your body and may include:

  • Tingling, numbness, or loss of feeling or movement that starts in your hands or feet.
  • Trouble swallowing or talking.
  • Double vision.
  • Loss of movement in your face.

Removing the tick stops the release of the venom and reverses the problem.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

You may need a tetanus shot depending on how dirty the wound is and how long it has been since your last shot.

  • For a dirty wound that has things like dirt, saliva, or feces in it, you may need a shot if:
    • You haven't had a tetanus shot in the past 5 years.
    • You don't know when your last shot was.
  • For a clean wound, you may need a shot if:
    • You have not had a tetanus shot in the past 10 years.
    • You don't know when your last shot was.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

To remove a tick:

  • Use fine-tipped tweezers. If you don't have tweezers, put on gloves or cover your hands with tissue paper, and then use your fingers. Do not handle the tick with bare hands.
    • Grab the tick as close to its mouth (the part that is stuck in your skin) as you can. The body of the tick will be above your skin.
    • Do not grab the tick around its swollen belly. You might push infected fluid from the tick into your body if you squeeze it.
    • Pull the tick straight out until its mouth lets go of your skin. Do not twist the tick. This may break off the tick's body and leave the head in your skin.
  • Wash the bite area with soap and water. Then wash your hands.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Home Treatment

Most ticks don't carry diseases, and most tick bites don't cause serious health problems. The sooner ticks are removed, the less likely they are to spread disease.

Some ticks are so small that it is hard to see them. This makes it hard to tell whether you have removed the tick's head. If you do not see any obvious parts of the tick's head in the bite site, assume you have removed the entire tick, but watch for signs of a skin infection.

  • Use fine-tipped tweezers to remove a tick. If you don't have tweezers, put on gloves or cover your hands with tissue paper, then use your fingers. Do not handle the tick with bare hands.
  • Do not try to smother a tick that is attached to your skin with petroleum jelly, nail polish, gasoline, or rubbing alcohol. This may increase your risk of infection.
  • Do not try to burn the tick while it is attached to your skin.
  • Put the tick in a dry jar or ziplock bag and save it in the freezer for later identification if necessary.
  • Wash the area of the tick bite with a lot of warm water and soap. A mild dishwashing soap, such as Ivory, works well.
  • If a bite becomes irritated, apply an antibiotic ointment, such as bacitracin or polymyxin B sulfate, and cover it with an adhesive bandage. The ointment will keep the bite from sticking to the bandage. Note: Stop using the ointment if the skin under the bandage begins to itch or a rash develops. The ointment may be causing a skin reaction.
  • After you remove the tick, wash your hands really well with soap and water.

When you return home from areas where ticks might live, carefully examine your skin and scalp for ticks. Check your pets, too.

Home treatment to help relieve pain and itching

  • Apply an ice pack to your bite for 15 to 20 minutes once an hour for the first 6 hours. When you are not using ice, keep a cool, wet cloth on the bite for up to 6 hours.
  • Try a nonprescription medicine for the relief of itching, redness, and swelling. Be sure to follow the nonprescription medicine precautions.
    • An antihistamine medicine, such as Benadryl or Chlor-Trimeton, may help relieve itching, redness, and swelling. Don't give antihistamines to your child unless you've checked with the doctor first.
    • A spray of local anesthetic containing benzocaine, such as Solarcaine, may help relieve pain. If your skin reacts to the spray, stop using it.
    • Calamine lotion applied to the skin may help relieve itching.
  • After the first 6 hours, if there is no swelling, try putting a warm washcloth on the bite for comfort.
Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your fever or pain:

Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips
Be sure to follow these safety tips when you use a nonprescription medicine:
  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

Prevention

To prevent tick bites:

  • Apply an insect repellent safely. Use insect repellents according to the directions on the label, particularly when applying repellent to children.
    • Use a lower-concentration repellent on children.
    • Do not put repellent on small children's hands, since they often put their hands in their mouths.
    • Wash the insect repellent off with soap and water after returning indoors.
  • Cover as much of your skin as possible when working or playing in grassy or wooded areas. Wear a hat, a long-sleeved shirt, and long pants with the legs tucked into your socks. Keep in mind that it is easier to spot ticks on light-colored clothes. If you think you may have a tick on your clothing, put your clothing in a clothes dryer for 10 to 15 minutes to kill the tick.
  • Wear gloves when you handle animals or work in the woods.
  • Take steps to control ticks on your property if you live in an area where Lyme disease is prevalent. Clearing leaves, brush, tall grasses, woodpiles, and stone fences from around your house and the edges of your yard or garden may help reduce the tick population and the rodent population that the ticks depend on. Remove plants that attract deer, and use barriers to keep deer—and the deer ticks they may carry—out of your yard. Treating yards with chemicals that kill ticks (ascaricides) is sometimes effective but exposes you and your pets to chemicals that may not be safe. You may choose to treat your lawn for ticks with nonchemical or environmentally safe methods instead. Call your local landscaping nursery or county extension office for more information.
  • Stay away from tick-infested areas.

For information on how to specifically prevent Lyme disease, see the topic Lyme Disease.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • When were you bitten? How many times were you bitten? If you saved the tick, bring it with you to your doctor's appointment. If not, be prepared to describe the tick.
  • What are your main symptoms?
  • When did your symptoms begin? How have your symptoms developed, progressed, or changed since the bite?
  • What home treatment have you tried? Did it help?
  • When was your last tetanus shot?
  • Have you traveled in the wilderness or in another country recently?
  • Do you have any health risks?

Related Information

Credits

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
Last Revised July 5, 2013

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