By Dr. Suchita Kumar
Division of Infectious Diseases

Although ticks are small in size, they have the potential to cause serious health issues. It is important to both prevent tick bites and to know what to do if you find a tick on your skin.

You should be careful about ticks anytime you are outdoors! They often inhabit wooded and tall grassy areas but these small insects can be found right in your backyard. Avoid tick bites by following these basic guidelines:

• Wear long pants and long-sleeve shirts when outdoors.
• Tucking your pant legs into your socks or boots or wearing gaiters can prevent ticks from crawling up your legs.
• Wearing light-colored clothing makes it easier to spot ticks that have come into contact with you.
• Try to stay in the center of trails and away from long grass when walking or hiking to prevent ticks from coming into contact with you.

Repellants can be effective

Insect repellents that contains DEET (Diethyl-meta-toluamide) can be sprayed to help repel ticks. Products containing DEET can be used directly on your skin or clothing. Be sure to follow all instructions on the label carefully when applying DEET. Permethrin is another popular insect repellant and can be used on clothing, shoes and camping gear. It should not be applied to the skin. More information on choosing tick repellents and using them safely can be found in the MDPH Public Health Fact Sheet on Tick Repellents. If you are outside a lot with your pets, talk to your veterinarian about the best way to protect them from ticks, since they can also bring ticks into your home.

Make tick-checks a routine

A tick bite is usually painless. That’s why you should check yourself carefully each day for ticks if you have spent time outside. Follow these guidelines when checking for ticks:

• Ticks can move around your body once they are on you. Check all over your body, including your armpit and groin area, and even between your toes.
• If you were outside with your children or pets, be sure to check them too.
• Remember that finding a tick and removing it promptly is the best way to prevent disease transmission.

Know your ticks

The three most common ticks found in Massachusetts are:

• The black-legged tick (also known as a deer tick)
• The dog tick
• The lone star tick

You can learn more about identifying these ticks and the specific diseases they can carry here.

Practice proper tick removal

The best way to remove a tick is with a pair of fine-tipped tweezers.

• Grasp the tick near its mouth where it is attached to your skin.
• Pull straight up to remove the tick using firm, even pressure.
• Try to avoid squeezing the body of the tick which can increase the chance of pathogens getting into your bloodstream.
• After removal, clean the bite area with rubbing alcohol and wash your hands with soap and water.

If you are unable to completely remove the tick you should contact your medical provider. The Mass Department of Public Health has a video available on tick removal that you can watch here.

What to do after you are bitten by a tick

Note the date and time and where on your body the tick was removed. Taking a good photo of the tick can help in identification. It’s important to know the type of tick and when it bit you because your health care provider may choose to treat you if you were bitten by certain types of ticks to prevent illness.

Should I save the tick?

A tick can be tested at a lab to identify what diseases it may have been carrying when it bit you. This can aid in diagnosis if you become ill. You can save the tick in a sealable plastic bag or cup. (Never handle a live or dead tick with your bare hands.) There may be a fee for this testing as most insurance plans do not cover this type of diagnostic test. You can learn more about tick testing in Massachusetts here.

Watch for any symptoms

If you experience a tick bite – don’t panic, but contact your physician and inform them of the incident. Remember that not every tick carries disease and not every tick-bite leads to an illness. However, you should monitor your health carefully after being bitten since it can take days or even weeks for symptoms indicating an infection to appear. Please seek medical attention immediately if you have:

• A red or expanding rash
• A headache or fever
• Pain or blistering
• Flu-like symptoms such as sore or aching muscles
• Other signs and symptoms such as a change in skin color or oozing from the site of the tick bite

You should know that some tick-borne diseases can occur even if you don’t develop a rash. Early treatment is very important if you have been infected with a tick-borne disease, so don’t delay seeing your medical provider if you need to!