It is important to inspect the skin after being outdoors in wooded or grassy areas. Ticks often hide in obscured areas, such as around the hairline or elsewhere on the scalp. Ticks range in size from extremely tiny and difficult to see to being approximately the size of a pencil eraser. A tick, when filled with blood, can grow quite a bit in size.
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Tick Bites, First Aid 

Picture of Tick Bites, First Aid: It is important to inspect the skin after being outdoors in wooded or grassy areas. Ticks often hide in obscured areas, such as around the hairline or elsewhere on the scalp. Divider line
It is important to inspect the skin after being outdoors in wooded or grassy areas. Ticks often hide in obscured areas, such as around the hairline or elsewhere on the scalp.
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First Aid Guide
Ticks are 8-legged creatures (arachnids) that live in wooded and grassy areas. Ticks attach themselves to a human host as the person brushes past leaves, grass, etc – ticks do not jump or fall on a person. Once on a person, ticks move to a warm and moist location (eg, armpit, groin, back of the knee, hairline), where they burrow into the host's skin and feed off their blood.

While most ticks are harmless, some carry disease and may transmit illness (eg, Lyme disease, Rocky Mountain spotted fever, Colorado tick fever) to their host. Certain ticks can even inject venom that causes temporary paralysis in their host (called tick paralysis).

First Aid Guide
To remove an embedded tick:
  1. Wash your hands.
  2. Clean tweezers by boiling them or by pouring antiseptic solution (eg, isopropyl alcohol) over them.
  3. With tweezers, grasp the tick as close to its head or mouth as possible, and pull it straight out with a slow and steady motion. Be careful not to leave the head embedded in the skin, and make sure all parts of the tick are completely removed. Note: Be sure to not twist the tick body as you pull it out.
  4. Wash the area completely with soap and water.
After the tick has been completely removed, watch for approximately the next few weeks for signs of infection or illness, particularly if the tick was likely attached for over 24 hours. (See When To Seek Medical Care.)

The most important thing to consider regarding ticks is that prevention of tick bites is key. While in wooded areas, tall grass, or brush, consider doing the following:
  • Wear long pants and long sleeves.
  • Wear your socks over the outside of your pant legs.
  • Tuck your shirt into your pants.
  • Wear light-colored clothes so that ticks can easily be spotted.
  • Spray your clothes and exposed skin with insect repellant.
  • Frequently check your clothes and skin for ticks.
It is important to remove a tick within 24 hours, if possible. Once home, remove your clothes and thoroughly inspect all skin surface areas. Don't forget your scalp! As ticks can be quite small, carefully evaluate all black or brown spots on the skin.
Who's At Risk
People who work in or spend time in wooded or grassy areas, particularly those who wear clothing that doesn't fully cover the body, such as shorts and short-sleeved shirts, and those who don't wear insect repellant.
Signs and Symptoms
The tick itself can be quite small (almost impossible to see) or rather large (about the size of a pencil eraser). Fully developed ticks have 8 legs, but they may have only 6 visible legs early in its developmental stage. Ticks have a small head in comparison to their round body, which is usually covered by a hard, thick outer shell.

The site of the tick bite typically looks like a small, reddish area that may or may not be raised, similar to a mosquito bite.

Within days, weeks, or even months, tick bites may develop as a larger red ring (larger than 2 inches), often looking like a bull's-eye, indicating possible infection with Lyme disease (although the classic "bull's eye" lesion does not need to develop for a diagnosis of Lyme disease). In most cases, the infection can be eliminated with antibiotics, especially if treatment is started when symptoms are first noted.

When to Seek Medical Care
Seek emergency medical care if the person is experiencing any of the following:
  • Signs of paralysis (numbness, tingling, weakness, and incoordination)
  • Severe headache
  • Chest pain
  • Heart palpitations
  • Trouble breathing
  • There are any other serious symptoms
Typically, there is no need to see the doctor for a tick bite. However, if you attempt to remove a tick and part of it remains in its host, seek medical attention.

Additionally, illness caused by ticks may not develop for days, weeks, or even months after the bite occurred. Seek medical attention if flu-like symptoms occur within a day or a few days after the bite or if a pink to red bulls-eye-like ring around the bite develops.

Following a tick bite, keep a watchful eye for signs of infection, and seek medical care if any of these symptoms occur:
  • A rash
  • Increased pain
  • Swelling
  • Redness
  • Flu-like symptoms
  • Discharge or red streaks from the site of the bite
Treatments Your Provider May Prescribe
If self-care measures were taken as detailed above but not all of the tick was successfully removed, a physician can remove the remaining portion of the tick.

Depending on the overall situation, your physician may decide, after weighing the risks and benefits, to prescribe a course of antibiotic treatment such as oral doxycycline.

References/Trusted Links

Handal KA; American Red Cross. Part 2: first aid. In: The American Red Cross First Aid and Safety Handbook. 1st ed. Boston, MA: Little, Brown and Company; 1992:52-53.
Last Updated: 30 Sep 2010