Yikes! I’ve Been Bitten by a Tick

Our medical columnist gives advice on how to handle a bloodsucker’s bite

Adam Rosenbluth, M.D.,

AARP

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Published July 15, 2024

a woman magnifying a tick under another woman’s leg

James Yates

I’ve been bitten by a tick. What do I do now?

If you can see the tick, you’ll want to remove it as soon as possible. To do it, take a pair of clean tweezers, grab the tick as close to the surface of your skin as you can and pull it up with even pressure.

Once you’ve pulled the tick out, dab the area with alcohol or soap and water to prevent infection. Don’t worry if some of the tick remains in your skin because it will come out on its own, usually within a few days.

Carefully place the tick you’ve just removed on a piece of gauze or paper towel, then slip it into a zippered plastic sandwich bag and seal it. You don't need to panic, but make sure to let your health care provider know about the bite. You can send the tick out for testing, or your doctor can. The nonprofit organization Project Lyme has a list of tick testing locations that test for Lyme and other tick-borne illnesses. It usually takes two to 10 days to get results.

I understand if you’re anxious, but if the tick has been on for less than 24 hours, the risk of getting a Lyme infection is extremely low. The risk grows higher the longer the tick feeds.

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That’s why I always ask my patients, “When was the last time you saw the part of your body where you found the tick?” If their answer is “Listen, Adam, I saw the tick on the top of my foot when I was putting on my sock this morning, and it wasn’t there when I took my socks off last night,” that’s good news. It means the tick has been on their body for less than 24 hours, and it’s unlikely the patient has Lyme disease.

But it’s also not uncommon for someone to say, “Adam, I found that tick on the back of my knee. I have no idea the last time I looked at the back of my knee.” Well, that’s more concerning because we don’t know how long the tick has been there.

While you’re waiting for the tick results to come back, you and your doctor might decide you don't want to take any chances. More than two decades ago, a study was published in The New England Journal of Medicine reporting that when a single 200-milligram dose of the antibiotic doxycycline is given within 72 hours of the tick bite, it’s effective in stopping any potential case of Lyme disease.

It’s perfectly OK to speak with your doctor about this preventative treatment. We don’t like giving unnecessary antibiotics, so this makes the most sense in areas where Lyme disease is common. There’s no guarantee, and the medication will need to be taken before you experience any symptoms. Your health care provider will likely offer a blood test for tick-borne diseases. It may take up to two weeks to get the results.

I find my patients who develop Lyme disease often experience fatigue and joint aches before the telltale bull's-eye lesion appears — and that only occurs about 70 percent of the time. Other symptoms include headache, maybe a low-grade fever, swollen glands, reduced appetite and chills.

Of course, it’s possible to be bitten by a tick without knowing it. If you live in an area where ticks are common and you have some of the symptoms I described, be sure to ask your doctor about the possibility of Lyme disease. These symptoms are generic signs of many types of infections, and if you spend time outdoors in a tick-zone area, you may need to be tested for Lyme. I’ve had patients who were never aware of being bitten by a tick but developed the symptoms of Lyme disease and tested positive.

In the future, prevention is your best action. If you’re in a tick area, wear long pants, high socks and a long-sleeved shirt. Spray yourself with an insect repellent that contains at least 20 percent DEET (if you are not sensitive to it). As soon as you come in from the outdoors, remove your clothes, put them in the laundry and head for the shower. It’s a great idea to give yourself a complete tick check, using a mirror for your back or having somebody take a look at you.

I tell people that outdoor pets need to take preventative medication and wear a tick-resistant collar. Dogs and cats can bring ticks into your house, and it’s even riskier if they sleep in bed with you, so be sure to check them when they come in.

Finally, if your doctor doesn’t agree to test you for Lyme disease and you’re experiencing symptoms, ask for a second opinion from an infectious disease expert.

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