What To Do If You've Been Bitten By A Tick

You always remember to pack sunscreen, bug spray, a water bottle, and trail mix when you go on a hike. But should you also bring some antibiotics? While taking in the views, are you also taking in bacteria from a tick bite and developing Lyme disease or some other infection?

Ticks are blood-sucking parasites that can make your life miserable. (Sound like your boss?) They live in wooded and grassy areas, waiting to pounce on you or your pet as you walk past. While attached to your skin, ticks feast on your blood and can transmit bacteria that cause infections responsible for Lyme disease and Rocky Mountain Spotted Fever. Your infection risk depends on where you live, the type of tick that latched on, and how long the tick slurped your blood.

If you or your dog spend a lot of time outside during the summer months, even if just in your backyard, you should check your body (including your scalp) each night for ticks. In addition, since many people diagnosed with Lyme disease don’t ever notice a tick bite, you should also monitor yourself for symptoms and rashes typical of tick-related diseases.

At the earliest signs of a problem, you can see your physician and begin appropriate antibiotic therapy if necessary, since antibiotics are highly effective at treating tick-related illnesses and can prevent long-term complications.

Are there ticks in my area?

Most likely yes. Ticks are everywhere. The CDC offers several maps that show where ticks like to live. The tick that transmits Lyme disease, known as the blacklegged tick (or Ixodes scapularis), resides primarily in the eastern and north central United States.

A close relative, known as Ixodes pacificus, spreads the disease in California and Oregon. Meanwhile, the tick that causes Rocky Mountain Spotted Fever is the American dog tick (Dermacentor variabilis), and it resides in the eastern and south central United States.

What should you do if you see a tick on your body?

The best way to remove a tick is with a pair of tweezers. Grab the tick as close to your skin as possible, then gently pull it off. Do not just crush the tick or try burning it off (unless you’re into that sort of stuff). You may want to save your tick (in a sealed container, not in a loose tissue), so your doctor can examine it and even test it for certain bacteria. The site of the tick bite may look red and mildly swollen. Just wash it with soap and water.

You should see your doctor if a large red area or rash develops near the bite, or if you develop fever, chills, nausea, vomiting, or headache. If, shortly after the bite, you experience shortness of breath, wheezing, lip tingling, or dizziness, you could be having a severe allergic reaction and should get to your nearest E.R.

After you remove the tick, should you take antibiotics?

After noticing a tick bite, call your doctor to determine if you need to take a single dose of antibiotics to prevent Lyme Disease. The Infectious Diseases Society of America suggests this approach when the following conditions are met:

• The tick is identified as the Ixodes tick that carries the bacteria responsible for Lyme disease
• The tick has been on your body for at least 36 hours (based on the time since you were outside, or the size of the tick)
• The antibiotics can be taken within 72 hours of tick removal
• At least 20 percent of the ticks in your area are infected with the bacteria that cause Lyme disease
• You are not pregnant, breastfeeding, or under 8-years-old

If all of the above are true, your doctor will likely prescribe a single dose of an antibiotic called doxycycline. The main side effects are nausea, vomiting, and diarrhea. Doxycycline can make your skin more sensitive to the sun, so wear sunblock and long sleeves while taking it.

Of note, preventative antibiotics after a tick bite aren’t so effective for preventing other tick-related illnesses, like Rocky Mountain Spotted Fever.

Regardless of whether you take antibiotics, you should keep monitoring yourself for rashes or other symptoms of infection, like fatigue and soreness.

What does the rash of Lyme disease look like?

About four out of five people with Lyme disease develop the classic rash known as erythema migrans. It looks like a bull’s eye with a large red spot, a ring of normal skin, and then a red circle (think the Target logo). It occurs at the site of the bite a few days to weeks later and, over the course of several days, the ring moves outward (hence migrans, for migrating). You may notice additional bull’s eye rashes elsewhere on your body. If Lyme disease is not treated, it can cause joint pain, nerve irritation, heart disease, and other complications.

What does the rash of Rocky Mountain Spotted Fever look like?

Most people with Rocky Mountain Spotted Fever develop a rash, which has a dot-like or splotchy appearance and usually begins on the ankles and wrists. Over several days, the rash then spreads to the rest of the body. Additional symptoms can include fever, headache, belly pain, leg swelling, bleeding, and confusion. Treatment with antibiotics should be started right away, since Rocky Mountain Spotted Fever can be lethal.

Christopher Kelly, M.D., M.S. and Marc Eisenberg, M.D., F.A.C.C. are cardiologists at Columbia University Medical Center and the authors of “AM I DYING?!: A Complete Guide To Your Symptoms and What To Do Next.”