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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• Tick facts
• What are ticks?
• What are tick bite symptoms and signs?
• What diseases do ticks transmit (act as vectors) to humans?
• How is a tick bite diagnosed?
• What are the symptoms and signs of diseases transmitted by ticks?
• What is the treatment for a tick bite?
• How is a tick removed from the skin?
• What is the prognosis (outlook) for people who get a tick bite?
• What are the risk factors for tick bites?
• How are bites from ticks prevented?
• Where can I find more information about ticks?
• Patient Comments: Ticks - Bite Symptoms
• Ticks Index

For all tick bites, local cleansing and antibiotic cream may be applied. If the bite area develops itching, preparations containing diphenhydramine (Benadryl) are recommended. These Benadryl compounds can be applied directly to the skin for itching or administered orally by tablets. This is usually the only treatment needed.

However, treatment of the pathogens that the tick may pass to a person depends on other factors, such as the type of tick, length of time of attachment to the host, diseases in the community, and symptoms developed by the patient. Specific treatment is based on the identity of the pathogen transmitted. For example, oral antibiotics may be prescribed for some diseases. With more significant symptoms, antibiotics may need to be given intravenously and the patient may need to be hospitalized. The best approach to treatment is to diagnose which pathogen has been transmitted to the patient (for example, Borrelia species of bacteria) and then use the specific treatment to reduce or kill the pathogen.

The following is a step-by-step method that is suggested for safe and effective removal of all types of ticks. Web citations 2 and 3 show a diagram of how to place tweezers to remove a tick.

Picture of how to safely remove a tick

1. Use a small pair of curved forceps or tweezers. Wear some sort of hand protection such as gloves so you don't spread pathogens from the tick to your hands.
2. Using the tweezers, carefully flip the tick over onto its back. Grasp the tick firmly with the tweezers as close to the skin as possible. Apply gentle pulling until the tick comes free. Twisting or turning the tick does not make removal easier because the mouthparts are barbed; in fact, such actions may break off the head and mouthparts, thereby increasing the chances for infection. The second web citation illustrates the proper removal of a tick.
3. Once the tick is removed, don't crush the tick because it may release pathogens. Rinse it down a sink or flush it down a toilet. Consider keeping it in a tightly closed jar or taped to a piece of paper. Show the tick to the doctor if the person bitten becomes ill after the tick bite.
4. The area of the bite should leave a small crater or indentation where the head and mouthparts were embedded. If portions of the head or mouthparts remain, they should be removed by a doctor.
5. After removing the tick, thoroughly cleanse the bite area with soap and water or a mild disinfectant. Observe the area for several days for development of a reaction to the bite, such as a rash or signs of infection. Apply antibiotic cream to the area. Application of an antibiotic to the area may help prevent a local infection but usually does not affect the chance of developing diseases transmitted by the tick.
6. Remember to wash your hands thoroughly after handling any tick or instruments that touched a tick. Clean and disinfect any instruments that were used.

Other ways to remove ticks, such as using a hot match head or painting the tick with nail polish, gasoline, or other materials, are not advised. Such treatments can cause the tick to release more fluids back into the bite and increases the chance to transmit disease before the tick releases itself from the skin.