See More Appropriate Topic (instead of this one):

• Spider Bite
• If NOT, try one of these: Insect Bite
• If NOT, try one of these: Insect Bite

Is this your child’s symptom

• A tick small brown bug is attached to the skin
• A tick was removed from the skin

Symptoms of a Tick Bite

• The tick bite does not cause pain or itch. So, ticks may not be noticed for a few days.
• After feeding on blood, ticks get quite swollen and easy to see.
• Ticks fall off on their own after sucking blood for 3 to 6 days.
• After the tick comes off, a little red bump will be seen.
• The red bump or spot is the body’s response to the tick’s saliva spit.
• While it’s sucking blood, some of its spit gets mixed in.

Causes of Tick Bites

• The wood tick dog tick is the size of a watermelon seed. Sometimes, it can pass on Rocky Mountain spotted fever or Colorado tick fever.
• The deer tick is between the size of a pinhead and an apple seed. Sometimes, it can pass on Lyme disease.

Lyme Disease

• Almost all infections start with a bull’s eye rash called erythema migrans. The rash starts at the site of the tick bite. Treatment of this rash with 14 days of an antibiotic is advised. This almost always prevents the later stages of Lyme Disease. Arthritis, heart disease and neurologic disease can occur with Lyme Disease that isn’t treated.
• Giving antibiotics after deer tick bites to prevent Lyme Disease is not advised.
• The risk of Lyme Disease after a deer tick bite is low. But, in high risk areas, 2% of deer tick bites cause Lyme Disease.
• It has become a big problem in the Northeast and upper Midwest. The CDC reports over 30,000 cases per year. 2013

Call Doctor Now or Go to ER

• Can’t remove the tick after trying this care advice
• Can’t remove the tick’s head that broke off after trying this care advice. Note: If the tick is moving, all of it was removed.
• Rash starts 2 to 14 days after the bite
• Fever or severe headache starts 2 to 14 days after the bite
• Fever and bite looks infected spreading redness
• Weak, droopy face or crooked smile
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

• New redness starts more than 24 hours after the bite. Note: Infection is rare. It does not start until at least 24-48 hours after the bite
• Over 48 hours since the bite and redness now getting larger
• Red-ring or bull’s eye rash occurs around a deer tick bite. Note: The rash of Lyme disease starts 3 to 30 days after the bite
• You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

• You have other questions or concerns

Self Care at Home

• Tick bite with no complications

Care Advice

Treating Tick Bites

1. What You Should Know About Tick Bites:
   • Most tick bites are harmless.
   • The spread of disease by ticks is not common. But, in high risk areas, 2% of deer tick bites cause Lyme Disease.
   • If the tick is still attached to the skin, it needs to be taken out.
   • Using petroleum jelly or nail polish to cover the tick doesn’t work. Neither does rubbing alcohol or a soapy cotton ball. Touching the tick with a hot or cold object also doesn’t work.
   • Try one of the methods described below to take out the tick.
2. Wood Tick – How to Remove With Tweezers:
   • Use a tweezers and grasp the tick close to the skin on its head.
   • Hold the tweezers sideways next to the top of the skin.
   • Pull the wood tick straight upward without twisting or crushing it.
   • Keep a steady pressure until the tick lets go of its grip.
   • If you don’t have tweezers, you can use your fingers.
   • Other options. You can use a loop of thread around the jaws. You can also use a needle pushed between the jaws for traction.
3. Deer Tick – How to Remove:
   • Tiny deer ticks need to be scraped off.
   • You can remove them with the edge of a credit card.
4. Tick’s Head – How to Remove:
   • If the wood tick’s head breaks off in the skin, take it out.
   • Clean the skin with rubbing alcohol.
   • Use a clean needle to find the head and lift it out.
   • If a small piece of the head remains, the skin will slowly shed it.
   • If most of the head is left, call your doctor for help.
5. Antibiotic Ointment:
   • After the tick is removed, wash the wound with soap and water. Also, wash your hands after you are done.
   • This helps to prevent catching any tick disease.
   • Use an antibiotic ointment such as Polysporin. No prescription is needed.
   • Put it on the bite once.
6. What to Expect:
   • Most often, tick bites don’t itch or hurt.
   • That’s why they may not be noticed.
   • The little bump goes away in 2 days.
   • If the tick transferred a disease, a rash will occur. It will appear in the next 2 to 4 weeks.
7. Call Your Doctor If:
   • You tried and can’t remove the tick or the tick’s head
   • Fever or rash happens in the next 4 weeks
   • Bite starts to look infected
   • You think your child needs to be seen
   • Your child becomes worse

Prevent Tick Bites

1. Prevent Tick Bites:
   • After being outdoors in deer tick areas, scrape off any suspected ticks. Also, take a shower soon after coming inside.
   • When hiking outside where there are ticks, wear long clothing. Tuck the ends of pants into socks. Apply a bug repellent to shoes and socks.
   • Permethrin products can be put on clothing. Because of this, it is a better choice against ticks than DEET.
2. Tick Repellent for Clothing – Permethrin:
   • Permethrin products such as Duranon work well to repel ticks.
   • Unlike DEET, these products are put on clothing instead of skin. Use it on pant cuffs, socks and shoes. You can also put it on other outdoor items bug netting, sleeping bags.
   • Do not put it on skin. Reason: Sweat changes it so it does not work.
3. Tick Repellent for Skin – DEET:
   • DEET also works well to repel ticks. It can be used on the skin not covered by clothing.
   • Use 30% DEET for children and teens AAP. Note: 30% DEET protects for 6 hours.
   • DEET is approved for use in children over 2 months of age. AAP

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Copyright 1994-2015 Barton D. Schmitt, MD. All rights reserved.