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Tick Bite - Allied Physicians Group - Pediatric Medicine
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  • Tick Bite


    • A tick (small brown bug) is attached to the skin
    • A tick was removed from the skin


    • The tick bite does not cause pain or itch. So, ticks may not be noticed for a few days.
    • After feeding on blood, ticks get quite swollen and easy to see.
    • Ticks fall off on their own after sucking blood for 3 to 6 days.

    Pain Scale

    • The wood tick (dog tick) is the size of a watermelon seed. Sometimes, it can pass on Rocky Mountain
    • spotted fever or Colorado tick fever.
    • The deer tick is between the size of a pinhead and an apple seed. Sometimes, it can pass on Lyme disease.

    • The risk of Lyme disease after a deer tick bite is low. Even in a high risk area, the risk is only about 1.4%.
    • Almost all infections start with a bull’s eye rash (called erythema migrans). The rash starts at the site of the tick bite. Treatment of erythema migrans with 14 days of an antibiotic is advised. This almost always prevents the development of later stages of Lyme Disease. Arthritis, heart disease and neurologic disease can occur with untreated Lyme Disease.
    • Giving antibiotics after deer tick bites to prevent Lyme disease is not advised.

    When to Call Us for Tick Bite

    Call Us Now (night or day) If:

    • Your child looks or acts very sick
    • Can’t remove the tick after trying this care advice
    • Can’t remove the tick’s head that broke off after trying this care advice. (Note: If the tick is moving, all of it was removed).
    • Rash starts 2 to 14 days after the bite
    • Fever or severe headache starts 2 to 14 days after the bite
    • Fever and bite looks infected (spreading redness)
    • Weak, droopy face or crooked smile
    • You think your child needs to be seen urgently

    Call Us Within 24 Hours (between 9 am and 4 pm) If:

    • You think your child needs to be seen, but not urgently
    • New redness starts more than 24 hours after the bite. (Note: Infection is rare. It does not start until at least 24-48 hours after the bite.)
    • Over 48 hours since the bite and redness now getting larger
    • Red-ring or bull’s eye rash occurs around a deer tick bite. (Note: The rash of Lyme disease starts 3 to 30 days after the bite.)

    Call Us During Weekday Office Hours If:

    • You have other questions or concerns

    Parent Care at Home If:

    • Tick bite with no complications

    Care Advice for Tick Bites:

    What You Should Know:

    • Most tick bites are harmless.
    • The spread of disease by ticks is rare.
    • If the tick is still attached to the skin, it needs to be removed.
    • Covering the tick with petroleum jelly or nail polish doesn’t work. Neither does rubbing alcohol or a soapy cotton ball. Touching the tick with a hot or cold object also doesn’t work.
    • Try one of the methods described below to remove the tick.

    Wood Tick Removal: Use a Tweezers

    • Use a tweezers and grasp the tick close to the skin (on its head).
    • Hold the tweezers sideways next to the skin surface.
    • Pull the wood tick straight upward without twisting or crushing it.
    • Maintain a steady pressure until it releases its grip.
    • If you don’t have tweezers, you can use your fingers.
    • Other options. You can use a loop of thread around the jaws. You can also use a needle pushed between the jaws for traction.

    Deer Tick Removal:

    • Tiny deer ticks need to be scraped off.
    • You can remove them with the edge of a credit card.

    Tick’s Head:

    • If the wood tick’s head breaks off in the skin, remove it.
    • Clean the skin with rubbing alcohol.
    • Use a sterile needle to uncover the head and lift it out.
    • If a small piece of the head remains, the skin will slowly shed it.
    • If most of the head is left, call your doctor for help.

    Antibiotic Ointment:

    • Wash the wound and your hands with soap and water after removal.
    • This helps to prevent catching any tick disease.
    • Use an antibiotic ointment such as Polysporin. No prescription is needed.
    • Put it on the bite once.

    What To Expect:

    • Tick bites normally don’t itch or hurt.
    • That’s often why they may not be noticed.

    Call Your Doctor If:

    • You tried and can’t remove the tick or the tick’s head
    • Fever or rash happens in the next 2 weeks
    • Bite starts to look infected
    • Your child becomes worse

    Preventing Tick Bites


    • When hiking in tick-prone areas, wear long clothing. Tuck the ends of pants into socks. Use an insect repellent to shoes and socks.
    • Permethrin products can be put on clothing. Because of this, it is a better choice against ticks than DEET.

    Tick Repellent for Clothing – Permethrin:

    • Permethrin products (such Duranon or Permanone Tick Spray) are very good tick repellents.
    • An advantage over DEET is that permethrin is used on clothing. Put it on clothes, especially pants cuffs, socks and shoes. You can also put it on other outdoor items (mosquito screen, sleeping bags).
    • Do not put Permethrin on skin. Reason: It loses its ability to work once in contact with skin.

    Tick Repellent for Skin – DEET:

    • DEET is an good tick repellent also. It can be used on the skin not covered by clothing.
    • Use 30% DEET for children and teens (AAP 2003). Note: 30% DEET protects for 6 hours.

    Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

    Author and Senior Reviewer: Barton D. Schmitt, M.D.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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