If you or a loved one is bitten, remove the tick promptly. Here’s how:
- Grasp the tick’s mouthparts against the skin, using pointed tweezers.
- Be patient; the long mouthpart is covered with barbs, so removing it can be difficult and time consuming.
- Pull steadily until you can ease the tick out of the skin.
- DO NOT pull back sharply; this may tear the mouthparts from the body of the tick and leave them embedded in the skin.
- If this happens, don’t panic! Embedded mouthparts do not transmit Lyme disease.
- DO NOT squeeze or crush the body of the tick; this may force infected body fluids from the tick into the skin.
- DO NOT apply substances such as petroleum jelly, nail polish, or a lighted match to the tick while it is attached. They may agitate the tick and force more infected fluid into the skin.
- Once you have removed the tick, wash the wound site and your hands with soap and water.
- Observe the bite site over the next two weeks for any signs of an expanding red rash.
- Tick attachment time is important; removing ticks within 36 hours of attachment reduces the risk of infection.
- Testing ticks for infection is possible, but not recommended on a routine basis. You should consult your physician to see if you should save; the tick after removal for further evaluation.
Recognizing the Rash
If you are bitten by a tick, a small red bump may appear in a few days to a week, usually at the site of the bite — often in the groin, belt area or behind the knee. This bump may feel warm and tender when touched.
However, The majority of tick bites do not transmit Lyme disease. If this tick bite has transmitted Lyme disease, the redness may expand over the next weeks and form a round or oval red rash, usually bigger than 5 centimeters in size. It may resemble the classic bull’s eye, with a red ring surrounding a clear area and a red center. More often the rash lesion is uniformly red or reddish-blue, is minimally tender and minimally itchy (much less itchy than poison ivy). This rash, called erythema migrans, is a hallmark of Lyme disease and appears in about 70-80% of infected people.
- If the rash is Lyme disease, it will continue to grow over days or weeks and will not fade in a few days.
- The Lyme rash is often confused with a spider bite.
- Tick bite reactions are often confused with the rash of Lyme disease.
- Only 2% of tick bites result in Lyme disease.
- Tick bite reactions are small, less than 1-2” in size.
- Surrounding redness does not expand when observed over 24-48 hrs.
- Reaction at site of tick bite can last days, even weeks.
- Lyme rash occurs at the site of the tick bite in 80% of people with early Lyme disease.
- Incubation period from tick bite to rash is 3-30 days (usually 3-10 days).
- Lyme disease rash is:
- Round or oval, enlarges in size over days/weeks
- Red, sometimes warm.
- Usually greater than 2” inches in diameter, often 6-8”
- Rarely bull’s eye, usually uniformly red
- Often confused with spider bites
The Lyme rash can spread through the bloodstream to other areas of the skin:
Sometimes blisters develop in the center of the rash:
Requesting and Receiving Care
Diagnosing Lyme Disease:
- Lyme disease is a clinical diagnosis made by a doctor or nurse by examining the patient
- Acute Lyme disease is not a laboratory diagnosis; a negative Lyme blood test does not exclude Lyme disease in the first few weeks of the illness.
- 20% of people have a flu-like illness and NO rash.
- Fever, aches, and abrupt severe fatigue can be the main symptoms of acute Lyme.
- Lyme disease is different from respiratory “cold”.
- A runny nose and prominent cough are NOT symptoms of Lyme disease.
- Blood tests do not accurately diagnose Lyme disease in the first few weeks of infection, so being vigilant about looking for symptoms is a more reliable way to identify an early case of Lyme disease. Blood tests do become positive in most people after three to four weeks of infection, and they can be performed at that time if infection is suspected.
If you have a tick bite, watch for an expanding red rash or lesion at the site of the tick bite or an unexplained feverish, achy, fatiguing illness within 1 to 4 weeks after the tick bite. If this doesn’t happen, you are probably among the 98% of people who don’t develop Lyme disease after a tick bite. If you are concerned about any of these findings, take a picture of the rash and contact your physician.