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Tick removal

Ticks are small, insect-like creatures that live in woods and fields. They attach to you as you brush past bushes, plants, and grass. Once on you, ticks often move to a warm, moist location. They are often found in the armpits, groin, and hair. Ticks attach firmly to your skin and begin to draw blood for their meal. This process is painless. Most people will not notice the tick bite.

Ticks can be fairly large, about the size of a pencil eraser. They can also be so small that they are very hard to see. Ticks can transmit bacteria that can cause disease. Some of these can be serious.

Images

Lyme disease
Deer and dog tick
Tick imbedded in the skin

Considerations

While most ticks do not carry bacteria that cause human diseases, some ticks do carry these bacteria. These bacteria can cause:

First Aid

If a tick is attached to you, follow these steps to remove it:

  1. Use tweezers to grasp the tick close to its head or mouth. DO NOT use your bare fingers. If you don't have tweezers and need to use your fingers, use a tissue or paper towel.
  2. Pull the tick straight out with a slow and steady motion. Avoid squeezing or crushing the tick. Be careful not to leave the head embedded in the skin.
  3. Clean the area well with soap and water. Also wash your hands thoroughly.
  4. Save the tick in a jar. Watch the person who was bitten carefully over the next week or two for symptoms of Lyme disease (such as rash or fever).
  5. If all parts of the tick can't be removed, get medical help. Bring the tick in the jar to your doctor appointment.

Do Not

When to Contact a Medical Professional

Call your doctor if you have not been able to remove the entire tick. Also call in the days following a tick bite if you develop:

Call 911 if you have any signs of:

Prevention

To prevent tick bites:

After returning home:

References

Bolgiano EB, Sexton J. Tickborne illnesses. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 126.

Cummins GA, Traub SJ. Tick-borne diseases. In: Auerbach PS, Cushing TA, Harris NS, eds. Auerbach's Wilderness Medicine. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 42.

Diaz JH. Ticks, including tick paralysis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 298.

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Review Date: 1/3/2019  

Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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