Tick Bite FAQs

By Jamie Harms, M.D.

Warmer weather is here, and with it, ticks are back.  Here are some frequently asked questions about ticks and tick bites.

What should I do if I am bitten by a tick?

Use tweezers to grasp the tick as close to your skin as possible, then pull the tick off with steady pressure. Then wash your hands and the area of the bite with soap and water. Sometimes, the mouthparts of the tick will break off and stay in the skin. If you can remove them easily, use the tweezers to pull them out. If you can’t remove them easily, just let the skin heal. Your body will break down the remaining mouthparts over time.

What kind of tick bit me?

Lyme disease is carried by the deer tick, also known as the blacklegged tick. It is not carried by dog ticks, so you should try to identify the type of tick that bit you. The CDC has excellent illustrations of the ticks found in Maryland. The ticks that are out in the spring are nymphs. They are very small, about the size of a poppy seed.

What is my risk of getting Lyme disease from a tick bite?

Ticks need to be attached at least 36 hours to transmit Lyme disease. If you pull off a tick which is crawling on your skin or which is not engorged with blood, you will not get Lyme disease.

Should I take an antibiotic after a tick bite to prevent Lyme disease?

Researchers still don’t have a clear answer about this. There have been some small studies suggesting that a single dose of  doxycycline may  reduce your risk of getting Lyme disease after a tick bite, but only under these conditions:

• You are not allergic to doxycycline. No other antibiotics have been studied for preventing Lyme disease. Children must be at least 8 years old to take doxycycline. Pregnant women should not take doxycycline.
• The tick can be identified as a deer tick.
• The tick has been attached for more than 36 hours based on the time of exposure or the observation that the tick is engorged with blood.
• You can take the dose of doxycycline within 72 hours of removing the tick.

Experts do not recommend that people take antibiotics to try to prevent other tick-borne diseases, such as anaplasmosis, babesiosis, ehrlichosis or Rocky Mountain Spotted fever.

Do I have Lyme disease?

Most people with Lyme disease will get a rash around the site of the tick bite one to four weeks after the bite. The rash is often described as  “bullseye” rash, because it is often red on the outside and clear on the inside. Lyme disease rashes can also come in other patterns, though. A Lyme disease rash gets bigger each day, and it usually over two inches wide. Check out these photos from the researchers at Johns Hopkins Hospital.

When should I see my doctor?

If you were bitten by a tick and have an expanding red rash around the bite or have “summer flu” symptoms, you should see your primary care provider.