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Clinical Reference Systems: Pediatric Advisor 10.0
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Tick Bites


A tick is a small brown bug that attaches to the skin and sucks blood for 3 to 6 days. The bite is usually painless and doesn't itch. The wood tick (or dog tick) which transmits Rocky Mountain spotted fever and Colorado tick fever is up to 1/2 inch in size. The deer tick which transmits Lyme disease is the size of a pinhead.


  1. Tick removal

    The simplest and quickest way to remove a wood tick is to pull it off. Use tweezers to grasp the tick as close to the skin as possible (try to get a grip on his head). Apply a steady upward traction until he releases his grip. Do not twist the tick or jerk it suddenly because these maneuvers can break off the tick's head or mouth parts. Do not squeeze the tweezers to the point of crushing the tick; the secretions released may contain germs that cause disease.

    If you don't have tweezers, use fingers, a loop of thread around the jaws, or a needle between the jaws for traction. Tiny deer ticks need to be scraped off with a knife blade or the edge of a credit card. If the body is removed but the head is left in the skin, use a sterile needle to remove the head (in the same way that you would remove a sliver). Apply antibiotic ointment to the bite once.

    Wash the wound and your hands with soap and water after removal. A recent study by Dr. G.R. Needham showed that embedded ticks do not back out with the application of a hot match or when covered with petroleum jelly, fingernail polish, or rubbing alcohol. In the past, it was thought that petroleum jelly, fingernail polish, or alcohol would block the tick's breathing pores and take its mind off eating. Unfortunately, ticks breathe only a few times per hour.

  2. Prevention

    Children and adults who are hiking in tick-infested areas should wear long clothing and tuck the end of the pants into the socks. Apply an insect repellent to shoes and socks. (Permethrin products are more effective than DEET products against ticks.) During the hike perform tick checks using a buddy system every 2 to 3 hours to remove ticks on the clothing or exposed skin. Immediately after the hike or at least once a day, do a bare skin check. A brisk shower at the end of a hike will remove any tick that isn't firmly attached.

    Because the bite is painless and doesn't itch, the child will usually be unaware of its presence. Favorite hiding places for ticks are in the hair so carefully check the scalp, neck, armpit, and groin. Removing ticks promptly may prevent infection because transmission of Lyme disease requires 18 to 24 hours of feeding. Also the tick is easier to remove before it becomes firmly attached.


  • You can't remove the tick or the tick's head.
  • Your child has a fever or rash within the 2 weeks following the bite.


  • You think your child might have Lyme disease.
  • You have other questions or concerns.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems