John Bordiuk, M.D.
Ginette LaFleur, ANP
Staci Montori, L.M.T.

65 Walnut Street, Suite 380
Wellesley Hills, MA 02481
781.239.9900 • fax (781) 239-9953

Ticks and Our Recommended Tick Bite Protocol

There is a lot of controversy surrounding the treatment of tick bites and Lyme disease.  What is not controversial is that prevention is the best defense. When heading out for any outdoor activity where you’re likely to encounter ticks, here are some ways you can safeguard yourself against tick bites:

  • wear long sleeves and light colored clothing that makes them easy to spot
  • wear closed shoes with socks, instead of sandals
  • wear pants tucked into your socks (better to offend the fashion police than risk infection!)
  • apply natural tick repellent

Even when taking these measures, it is important to check for ticks daily.  They can attach anywhere but seem to prefer certain parts of the body, like: anywhere the skin creases, places where clothing fits tightly, hairlines, behind the ears, underarms and groin area.

If you do get a tick bite, the amount of time the tick is attached is important.  There is virtually universal agreement that if the tick has been attached for 24 hours or less, there is no concern about infection and you can just dispose of the tick.  There may still be some redness, firmness of the skin, and even some itching at the site but this is just the skin’s local reaction to the bite, similar to what happens with a mosquito bite.

If the tick is attached more than 24 hours, things get a little less clear.  We say this because the Infectious Disease Society of America says if the tick has been attached for more than 36 hours and treatment can be begun in less than 72 hours from when the tick was removed, a single dose of antibiotic is sufficient.

The problem we have with this recommendation is this:  What if the tick has been attached for 4 days and you were to treat 3 days (72 hours) later with a single dose?  Then you’re treating someone who had a tick attach to them a full week earlier.

What we have chosen to do at Inner Balance is this:  if a tick is known to have been attached more than 24 hours but less than 72, we treat with a single dose of antibiotic.  If it has been attached more than 72 hours or if we cannot determine how long it has been attached, we favor 21 days of twice daily antibiotic.

What to do if an embedded tick is found

Don’t panic and methodically remove it.  This is best done with fine-tipped tweezers or a tick removal tool.

Grasp the tick as close to the skin surface as possible pull slowly and gently.  It may take awhile, but the tick will usually detach.  Try not squeeze the abdomen of the tick as this can cause its bodily fluids to transfer into the host.

While there are lots of rumored strategies for tick removal that include things like dish soap, hot needles and Vaseline, none of these are proven to be reliable.

Symptoms of Lyme Disease without knowledge of a bite

Things to look for include: a red expanding rash known as erythema migrans which is present in about 80% of cases of Lyme, fatigue, chills, fever, headache, muscle and joint pain, and swollen glands.  These are things associated with early infection.

If the infection goes undetected for more than a month, other symptoms that can occur include: Bell’s palsy (a drooping of either side of the face), severe headache and neck stiffness due to meningitis, pain and swelling in large joints like the knees.

If you have any question whether or not an antibiotic is needed, please do not hesitate to make an appointment.

 

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