Skill Checkup: Tick Removal

Richard H. Sinert, DO

Disclosures

September 23, 2019

For simple, uncomplicated tick removal, anesthesia is generally unnecessary. The use of lidocaine (subcutaneously or topically) may actually irritate the tick, causing it to regurgitate its stomach contents.

Although routine use of either antimicrobial prophylaxis or serologic testing after a tick bite is not recommended, some experts recommend antibiotic therapy for patients bitten by Ixodes scapularis (Ixodes dammini) ticks that are estimated to have been attached for longer than 48 hours (on the basis of the degree of engorgement of the tick with blood), in conjunction with epidemiologic information regarding the prevalence of tick-transmitted infection. However, accurate determination of the species of tick and assessment of the degree of engorgement are not possible on a routine basis, and the data are insufficient to demonstrate the efficacy of antimicrobial therapy in this setting. Testing of ticks for tick-borne infectious organisms is also generally not recommended, except for research purposes.

Animal and human studies have shown that the risk for Lyme disease transmission increases significantly after 24 hours of attachment and is even higher after more than 48 hours of attachment. Testing of ticks for tick-borne infectious organisms is generally not recommended, except for research purposes.

Read more about tick removal.

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