What to Do if You Get a Tick Bite

Do you know what happens if a tick bites you and what tick bite symptoms to watch out for?

Although tick bites can be harmless, ticks can expose humans to serious diseases caused by viruses, bacteria, or parasites, which are commonly carried by many tick species. The most common disease transmitted to humans via tick bites is Lyme disease.

In this article, you'll learn what happens if a tick bites you, how to know if a tick bit you, and ways to treat a tick bite on a human. You'll also learn what tick bite symptoms look like and how to prevent getting bit by a tick.

Detecting Tick Bites

Identifying tick bites may be more difficult than detecting other types of parasites or insects—such as mosquitos—that cause itching or skin irritation. Biting insects usually introduce saliva containing proteins that keep the bite wound from clotting. This results in itching, swelling, redness or discoloration, and irritation, alerting the host that a bite has occurred.

Ticks, however, have immunosuppressants that work to repress any reaction. This means that the only way to detect a tick is to spot one crawling on the skin or see its bite once the tick has dropped off.

Ticks vary in size, ranging from as small as the head of a pin to as big as a pea. In the larval stage, ticks are so small they are difficult to see. Even in the adult stage, many ticks are challenging to spot because of their small size.

Various types of ticks range in color from black to shades of brown or reddish-brown. The color may change to a reddish brown or a greenish-blue shade after a tick has fed on its host (a human, a mouse, a bird, or other animals) for a few days and they become engorged with blood.

One way to identify ticks is to run your hands through the body to palpate (feel) for small, hard nodules on the skin. Do this after being outdoors, especially in tick-prone areas. Pay special attention to these parts of your body:

• In and around the hair
• In and around the ears
• Under the arms
• Inside the belly button
• Around the waist
• Between the legs
• Back of the knees
  

Identifying Tick Bites After the Tick Drops Off

Once the tick drops off, there is sometimes (but not always) a welt that is red or darker than the surrounding skin, or an itchy lesion left behind. The lesion can vary in size and appearance.

If you don't have any immediate signs of tick-borne disease, the affected area will look like a mosquito bite and will fade away quickly. Sometimes symptoms of tick-borne diseases do not appear right away or at all. Anywhere from 1.6% to 7% of people infected with Lyme disease may not show any symptoms whatsoever.

Tick Bite Symptoms

If a tick bite does not result in transmission of a disease, usually there are no lasting symptoms. However, some people are allergic to tick bites and may have symptoms such as:

• Swelling or pain at the site of the tick bite
• A burning sensation
• A rash or blisters
• Difficulty breathing (indicated a severe allergic reaction that requires emergency medical intervention)

Signs of a Tick-Borne Infection

A tick-borne infection, such as Lyme disease or Rocky Mountain spotted fever, will cause various symptoms (depending on the disease). Symptoms begin within a few days to a few weeks after the tick bite occurs. Symptoms of a tick-borne infection may include:

• A lesion that lingers more than a few days
• A large bull’s eye-shaped skin lesion (a red or dark-colored welt surrounded by one or more rings of inflamed skin)—a hallmark sign of Lyme disease, which is transmitted by the western black-legged tick along the Pacific coast and the black-legged tick (commonly referred to as the deer tick) in the northeastern U.S.
• Fever and chills
• Nausea
• Weakness
• Headache
• Neck stiffness
• Swollen lymph nodes
• Aches and pains, fatigue, and muscle aches (Joint pain may indicate Lyme disease.)
• A rash that may occur from three to 30 days after being bitten by a tick
• Various types of skin rashes (distinctive in specific types of tick-borne diseases such as Rocky Mountain spotted fever, which can result in flat, pink macules or round-shaped raised spots on the wrists, forearms, or ankles)
• Other skin rashes—such as those seen in ehrlichiosis—that may include a petechial rash (pinpoint round spots that appear in clusters on the skin)
• A rash that covers the entire body
• Skin ulcers where the tick bite occurred (In tularemia, the ulcer is accompanied by swelling in the armpit or groin area.)

Removing a Tick

Before Lyme disease can be transmitted via a tick bite, the tick must be attached for at least 36 hours. However, other diseases can be passed to the host within a few hours (or less). 

If you find a tick attached to your skin, remove it as soon as possible. There are tick removal tools commercially available, but a common pair of tweezers will also do the trick.

Follow these steps to remove a tick attached to your skin:

1. Use clean, fine-tipped tweezers to grasp the tick. Get as close to the skin's surface as possible.
2. Pull upward using steady, even pressure. Avoid twisting and jerking because this can cause mouth parts to break off and stay in the skin. If you notice mouth parts in your skin, remove them with tweezers if you can. If you can't, leave them and let the skin heal.
3. Once you've removed the tick, thoroughly clean the area and your hands using rubbing alcohol or soap and water.
4. Dispose of a live tick by putting it in alcohol, placing it in a sealed bag or container, wrapping it tightly in tape, or flushing it down the toilet.

Do not crush a tick with your fingers. Don't try "painting" the tick with nail polish or petroleum jelly. And do not use heat to detach the tick from the skin.

Also, don't worry about how hard you squeeze the tick when you are removing it. Despite what people may commonly believe, mashing the tick or killing it during the extraction process will not cause it to excrete more fluid into the host.

When to See a Healthcare Provider

It’s important to see a healthcare provider or healthcare provider as soon as possible after a tick bite when the following occurs:

• A bulls-eye-type rash appears at the tick bite site.
• The rash from a tick bite or unknown source is bigger than the localized (in one area) red or dark-colored raised region.
• Flu-like symptoms accompany a tick bite (or unknown source of a bite) such as muscle aches, fever, or chills within 10 days of the tick bite.
• You are unable to remove the entire tick (including the head).
• The rash (which usually appears within three to 14 days of getting bitten by a tick) gets bigger.
• The bite site appears infected (reddened or discolored, swollen, or oozing pus).
• You think you may have been bitten by a black-legged tick (deer tick).

If you still have the tick, bring it with you to your appointment. The healthcare provider will want to visually inspect the tick.

Even if signs and symptoms like rash disappear, you could still be at risk of Lyme disease and other tick-borne illnesses. Symptoms of Lyme disease can appear anywhere from days to months after the tick bite.

When to Seek Emergency Care

Call 911 or visit a local emergency medical facility if symptoms include:

• A severe headache
• Problems breathing
• Paralysis
• Heart palpitations

Other Tick-Borne Illnesses

Other than Lyme disease, several other serious conditions are commonly spread to humans and other mammals by tick bites.

• Babesiosis: Caused by a parasite that lives on the black-legged tick
• Ehrlichiosis: Transmitted by the Lone Star tick, which is primarily in the south-central and eastern regions of the U.S.
• Rocky Mountain Spotted Fever: Transmitted by several species of ticks including the American dog tick, Rocky Mountain wood tick, and the brown dog tick
• Anaplasmosis: Transmitted primarily by the black-legged tick
• Southern Tick-Associated Rash Illness (STARI): Transmitted from tick bites from the Lone Star tick found in the southeastern and eastern regions of the U.S.
• Tick-Borne Relapsing Fever (TBRF): Transmitted from infected soft ticks (associated with ticks in rustic cabins or vacation homes) in 15 states across the U.S.
• Tularemia: Transmitted by the dog tick, the wood tick, and the Lone Star tick; prevalent throughout the U.S.

Other less common tick-borne illnesses in the U.S. include:

• Colorado Tick Fever: Caused by a virus transmitted by the Rocky Mountain wood tick, which is found in the Rocky Mountain states
• Powassan Encephalitis: Transmitted by the black-legged tick (deer tick) and the groundhog tick; found in the Great Lakes region of the northeastern states

Treatment 

Antibiotics may be used to prevent some tick-borne illnesses after a tick bite and to treat others. These medications may be given by mouth or possibly intravenously (through a vein). A single dose of antibiotics may be given after a black-legged tick (deer tick) bite to prevent Lyme disease in areas where Lyme disease is highly endemic (regularly found within a specific area). 

Other types of tick-borne illnesses are not treated prophylactically (before an illness occurs) with antibiotics. However, antibiotics can help treat tick-borne illnesses caused by bacteria. There is no treatment for some illnesses, like Powassan virus, but medication can help reduce symptoms and prevent complications.

Prevention

The best method of preventing tick-borne illnesses is to stay away from outdoor habitats where ticks live and breed like grassy, bushy, or wooded areas—particularly during the warm months (April to September). Other preventative measures, when you do go outdoors, include:

• Spraying a chemical tick repellent that has DEET, permethrin, or picaridin
• Wearing light-colored protective clothing
• Tucking pant legs into socks
• Wearing a hat to cover the head
• Performing self-checks (and checking kids, pets, and gear) to inspect for ticks daily, then removing any ticks right away
• Ensuring that pets are treated regularly with a veterinarian-approved tick preventative agent
  

Summary

Knowing what happens if a tick bites you is important because ticks can carry disease. The tick needs to be attached for at least 36 hours for Lyme disease to be transmitted, or for less time for other illnesses. Tick bite symptoms include a welt, burning sensation, rash, pain, and swelling at the site of the tick bite.

Signs of an infection can include rash, fever, and achiness. See a healthcare provider if you develop a rash, can't fully remove the tick, or have severe symptoms or symptoms that are getting worse or aren't going away. Next to staying away from habitats where ticks live, checking yourself thoroughly after coming in from the outdoors and using tick repellent can help prevent tick bites.