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How do I remove ticks from my child?
Q: It’s summertime, and my kids love playing in the meadows. But I’ve already found a few ticks on them. What’s the best way to remove them? When I was young, people always talked about burning them off with a match, cigarette or hot nail. Is this the right way?
A: Joanna, burning off ticks has been a very popular idea, but it’s actually one of the worst ways to remove them. A research study from Spain found that people who removed a tick by burning, squeezing or crushing it were more likely to develop Lyme Disease, a serious disease carried by some ticks. Trying to destroy the tick while it was still attached to the skin seemed more likely to make it release the infection into the skin.

Even though most ticks are not infected, they can carry a number of different diseases including Lyme Disease, Rocky Mountain Spotted Fever, Ehrlichosis, Babesiosis, and others. Different diseases are more common in different regions. To cause infection, a tick needs to be attached to the skin and take a blood meal (engorging the tick), which usually takes at least 24 to 48 hours. For this reason, it’s important to try to prevent tick bites and, in case of bites, find the ticks as soon as possible and remove them properly.

To prevent tick bites:
  1. Try to keep your children from playing in wooded and meadow areas where the ticks live, especially at the peak of “tick season” in the summer and early fall.
  2. When they play outdoors, dress your children in long pants tucked into socks and long sleeve shirts to keep ticks off their skin. Light-colored clothing can make it easier to spot ticks.
  3. Consider applying low concentrations of DEET insect repellent to clothing and skin.
To find ticks early and remove them:
  1. After coming in from playing outdoors, have your children take off their clothes and throw them in the laundry. Then have them take a bath or shower, and check them for ticks. Check the whole skin, especially the warm areas: the neck, hairline, scalp, armpits and groin.
  2. Do not try to kill the tick before removing it. Do not puncture, crush or squeeze the tick; burn it with a match or hot nail; or try to smother it with petroleum jelly, mineral oil, nail polish, alcohol or gasoline.
  3. Remove the tick using a fine-point tweezers or a commercial tick removal tool. Don’t use your hands because you could become infected from the tick. If you must use your hands, protect them with rubber gloves or plastic wrap and wash your hands well afterwards.
  4. With the tweezers or tick removal tool, grab the tick as close to the skin as possible. With a slow and steady motion, pull it straight away from the skin or slide the removal tool along the skin (follow the specific directions for the tool). Do not twist or jerk the tick.
  5. Clean the site of the bite thoroughly with soap and water. Apply antibiotic ointment.
  6. Place the tick directly into a sealed container or plastic bag in the refrigerator for a month in case symptoms of a tick-borne disease develop. Label the container or bag with your child’s name and date.
  7. Wash your hands and disinfect the tweezers.
  8. Call your child’s doctor to ask whether antibiotics are recommended. Antibiotics may be given in areas at high risk for tick-borne disease, if the tick is engorged and has been attached for a longer time or if your child has symptoms.
  9. Within the next one to three weeks, watch your child for symptoms of tick-borne disease. These include a red ring or bull’s eye (target-like) skin rash at the site of the bite, fever and chills, headaches, joint and muscle aches, and fatigue. If your child develops any symptoms, contact your doctor immediately. The doctor may examine your child, do blood tests and test the tick; and may also give your child antibiotic treatment.

For more information, visit http://patients.uptodate.com/topic.asp?file=inf_immu/7714 .
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician