Tick season is in full swing, and ticks can easily hitch a ride unannounced. The best course of action is prevention – treating your clothing, yard, and pets with tick repellant, and doing tick checks after being outdoors – but what do you do if you end up with a tick bite anyway?
Here is what all Lyme patients wish they had done if they saw the tick that infected them.
1. Do Not Put Anything on the Tick
There’s a viral video going around Facebook from Wilderness Lifestyle that recommends putting peppermint oil on an embedded tick to encourage it to back out. DO NOT DO THAT! If you put anything on a tick (Vaseline, nail polish, soap, a match), you will just irritate it and cause it to regurgitate all of its bacteria into you! It doesn’t matter whether it ultimately backs out.
2. Remove with Tweezers
The proper way to remove a tick is with fine-nosed tweezers, grasping it by the head, as close to the skin as possible. Pull it straight out, slowly and steadily. The goal is to get it out in one piece. If you twist it or grab from the body, you risk the head breaking off and staying in your skin. If you grab from the body, you could also end up squeezing it, again forcing it to expel its pathogens into you.
(The exception to the no-twist rule is tick removal tools that are designed to work that way. I think those are OK because the scoop goes all the way under the tick, so you’re actually twisting the entire thing, including the mouth. You can’t do that with tweezers.)
When the tick is out, seal it in a ziploc bag for testing, and then disinfect the bite mark.
3. Get the Tick Tested – It’s Free!
There are other posts going around Facebook attempting to correct the misconception promoted by the peppermint oil video, including a viral post by someone named Sarah DeGroff that uses the tweezers picture above.
Unfortunately, those posts aren’t accurate either, because they recommend saving the tick “in case” you need to get it tested later.
Just get it tested now! Take the guesswork out of figuring out what infections you’re at risk for.
You have nothing to lose, because testing is FREE through Bay Area Lyme Foundation. Their website will tell you more about the best way to store the tick before and during shipment.
Save the tick even if it was removed quickly and wasn’t engorged. It IS possible to get infected under those circumstances.
4. Don’t Wait for Results or Symptoms
At this point, many doctors will tell you not to worry. They’ll probably tell you to watch for flu-like symptoms, or maybe they’ll run some tests on you just in case.
This wait-and-see approach is a huge gamble! Tick-borne diseases can do a lot of damage very quickly, so by the time you’re symptomatic, the infection may have already progressed to the nervous system, including the brain, and that is more difficult to treat.
Besides the time-sensitive nature, human tests are often unreliable. The standard Lyme antibody test (called the ELISA) has a 50% false negative rate because there’s such a small window during which you can test positive, and it’s not easy to pinpoint. There are sensitivity problems with testing too, as well as limitations simply because of the doctor’s knowledge. You have to screen for every possible infection individually. Although other infections like Babesiosis and Bartonellosis are usually referred to as co-infections of Lyme, it is possible to get one or more of those without Lyme, so you need to check for everything and not just Lyme.
Treatment for these diseases is more successful the earlier you start it, so it’s better to treat automatically than waste time waiting for test results that may not be accurate anyway. You can still get tested (you may get lucky); just be aware that a negative result doesn’t rule out infection.
This means you shouldn’t postpone treatment while you wait for the tick testing either. Your treatment can be modified later based on those results, if necessary.
5. Don’t Expect a Rash
One thing Sarah’s post does get right is the information about the “classic” bull’s-eye rash. The rash doesn’t always look like a bull’s-eye, and many people don’t get a rash at all. The absence of a rash doesn’t mean you aren’t infected with Lyme or any other tick-borne disease.
However, if you DO find yourself with a bull’s-eye rash, even if you have no knowledge of a tick bite, that is supposed to be enough for a positive diagnosis and immediate treatment.
So what is the treatment?
6. Start Antibiotics ASAP
If a tick is attached for any length of time, Lyme experts recommend a minimum of 4-6 weeks of doxycycline (or amoxicillin for kids under 8). They use that time frame because Lyme has a long replication cycle, and you want to cover a full cycle so nothing gets left behind.
It’s a minimum because if you become symptomatic, treatment shouldn’t be stopped after an arbitrary number of weeks. And if the tick turns out to have other infections, you may need additional medications for those, which could add to your treatment time.
I know people are concerned about misuse/overuse of antibiotics, but the alternative could be a lifetime of illness. And if you don’t treat and end up getting sick, you’ll just need antibiotics then anyway, except for more than 4-6 weeks, and possibly IV. Trust me, I wish I could’ve taken pills for 4-6 weeks and called it a day.
You can protect the good bacteria in your body by taking probiotics; just keep them 2-3 hours away from your antibiotic doses or the effects will get canceled out.
Share to Spread the Word
Wilderness Lifestyle has since edited the description of the video to say that the peppermint oil trick is harmful, but the video has over 15,000 shares and a million views. How much damage was done before they made that correction?
Sarah’s post is better, but could’ve done so much more. She’s had over 7,000 shares – who knows how many views and people that is.
Please share this with anyone who shared those posts! I don’t expect to reach everyone who saw them, but even a small portion is helpful.
I’m not trying to incite panic with this post – just urgency that’s often missing when people talk about tick bites – but if you’re afraid of getting sick from a tick bite, this knowledge is the best way to avoid that.
This is also relevant to this viral Facebook video by Amanda Lewis. Her 4 year old daughter experienced paralysis after a tick bite, and everyone is assuming she’s fine now that the tick is out because she’s walking again. I’d hate to see a little girl dealing with chronic illness later when there was a simple preventative.
ILADS Treatment Guidelines by Joseph J. Burrascano Jr., MD. (Links to a PDF.)
- Page 7, paragraph 4: “After a tick bite, serologic tests (ELISA. IFA, western blots, etc.) are not expected to become positive until several weeks have passed. Therefore, if EM is present, treatment must begin immediately, and one should not wait for results of Borrelia tests. You should not miss the chance to treat early disease, for this is when the success rate is the highest.”
- Page 12, paragraph 1: “After a tick bite, Bb undergoes rapid hematogenous dissemination, and for example, can be found within the central nervous system as soon as twelve hours after entering the bloodstream. This is why even early infections require full dose antibiotic therapy with an agent able to penetrate all tissues in concentrations known to be bactericidal to the organism. It has been shown that the longer a patient had been ill with LB prior to first definitive therapy, the longer the duration of treatment must be, and the need for more aggressive treatment increases.”
- Page 16, last paragraph: “As the spirochete has a very long generation time (12 to 24 hours in vitro and possibly much longer in living systems) and may have periods of dormancy, during which time antibiotics will not kill the organism, treatment has to be continued for a long period of time to eradicate all the active symptoms and prevent a relapse, especially in late infections. If treatment is discontinued before all symptoms of active infection have cleared, the patient will remain ill and possibly relapse further. In general, early LB is treated for four to six weeks, and late LB usually requires a minimum of four to six months of continuous treatment. All patients respond differently and therapy must be individualized.”
- Page 17, paragraph 3: “It has been observed that symptoms will flare in cycles every four weeks. It is thought that this reflects the organism’s cell cycle, with the growth phase occurring once per month (intermittent growth is common in Borrelia species). As antibiotics will only kill bacteria during their growth phase, therapy is designed to bracket at least one whole generation cycle. This is why the minimum treatment duration should be at least four weeks. If the antibiotics are working, over time these flares will lessen in severity and duration. The very occurrence of ongoing monthly cycles indicates that living organisms are still present and that antibiotics should be continued.”
Note: I used this source because it was the most thorough one I found, but it is from 2008, so it isn’t entirely up-to-date (and this particular doctor is unlikely to revise it because he retired). Some experts now recommend a minimum of 6-8 weeks of antibiotics, but I couldn’t find a source for that that wasn’t subject to copyright laws.
Dr. Burrascano also advises taking location into account when deciding to treat a fresh bite, but Lyme is now the fastest growing vector-borne illness in the US. Reports are finally reflecting what Lyme patients have known for years: that tick-borne disease is not limited to the East Coast. Please take the threat seriously wherever you live!