Katie MacDonald, MSN, CPNP is a pediatric nurse practitioner for Inova Urgent Care and the Children’s Emergency Room at Inova Loudoun Hospital – Loudoun County’s only emergency facility solely dedicated to caring for children and adolescents. It is also the first and only sensory-friendly ER in Loudoun County.
Inova Urgent Care offers specialized pediatric urgent care services at the Dulles South, Reston, Tyson’s Corner, and West Springfield urgent care locations.
While tick exposure can occur year-round, ticks are most active during warmer months. Inova Urgent Care shares helpful tips to help protect and prepare your family for tick season.
Tips for preventing tick bites:
- When outdoors where ticks are prevalent (grassy, brushy or wooded areas), wear long clothing and tuck pants into socks.
- Take a shower after being outside to help remove unattached ticks.
- Always do a thorough tick check after being outdoors. Check armpits, backs of knees, the groin, scalp, hair lines and belly buttons. Ticks can be tiny (as small as 1 millimeter in diameter). They are less likely to transmit disease or infection when found early.
- Tumble dry clothing in a hot dryer for 10 minutes to kill any ticks on the clothes.
Tips for applying tick repellent:
- Apply to clothing and exposed skin outdoors in the open air. Avoid the face and open wounds.
- To minimize possible overuse or ingestion, do not allow children under 10 years of age to apply tick repellent themselves.
- Do not use combination sunscreen and insect repellent products. Sunscreen requires much more frequent application than insect repellent.
- Permethrin is tick repellent for use on external clothing. It will last through multiple wash cycles and is great for shoes, socks and outdoor items. Sweat changes the effectiveness of permethrin and therefore should not be applied to skin.
- DEET is an effective tick repellent for skin and clothing. Products containing 20 to 30% DEET is recommended for children and teens.
- Products containing DEET and Picaridin are safe and effective for use in children as young as 2 months of age. These ingredients have been proven to be the most effective, especially when compared to natural repellents.
- For a natural repellent, the CDC lists garlic oil and mixed oils that contain rosemary, lemongrass, peppermint, thyme, cedar and geraniol as acting tick repellents. However, studies have shown that these oils are not as effective as products containing DEET or Picaridin. It is important to note that there have been reports of babies – especially less than 6 months of age – who have exhibited skin sensitivity to oils. It may be best to avoid oils in young children and in those with sensitive skin.
Tips for tick removal:
It is safe to attempt tick removal at home. If you cannot remove it successfully or are concerned about the removal, please seek help from a professional.
- Use tweezers with a fine-tip or point.
- Grasp the tick as close to the skin as possible. With firm, steady and constant pressure, pull until the entire tick comes out. Avoid twisting or squeezing the tick too tightly. If the entire tick does not come out, try to also remove the parts that were left in the skin.
- Do not use petroleum jelly or ointment to smother the tick – it does not work.
- Never try to “burn out” a tick. It is very dangerous and ineffective. You will end up with a burn and still need to have the tick removed from the skin.
- Once the tick is removed, clean the skin well with soap and water or alcohol.
- Save the tick in a plastic bag or container if you plan to take it to your doctor.
- Closely monitor the site of the tick for 30 days. You may notice some local irritation, inflammation and redness a few days after removal. This does not indicate Lyme disease. If a rash or other concerning change develops, please have the area evaluated as soon as possible.
Are antibiotics required after a tick bite?
There is no exact answer to this question as every situation is unique. Some circumstances will require antibiotic treatment after a tick bite, and some will not. The best advice is to have the case evaluated by a clinician who is familiar with the most current evidence based research and protocols.
Antibiotics are only recommended for the prevention of potential Lyme disease, a bacterial infection spread by black-legged ticks. They are not recommended for the prevention of other tick borne illnesses such as anaplasmosis, babeosis, erlichiosis, Rocky Mountain spotted fever or other rickettsial diseases. If a person contracts Lyme disease, antibiotics are required for a longer course of time.
What are the guidelines for tick bite prophylaxis antibiotic use?
- The tick can be identified as a black-legged tick (deer tick) and was attached in an area that is endemic for Lyme disease.
- The estimated time of attachment is 36 hours. This is determined based on the degree of tick engorgement with blood or the likely time exposure to the tick.
- One single dose of doxycycline is the preferred antibiotic of choice to prevent Lyme disease. It should be started within 72 hours of tick removal. Benefits of giving the antibiotic outweigh the risks.
Is doxycycline safe for children?
The quick answer is yes. There is sufficient evidence that shows a short course of doxycycline can be administered to young children safely. It is reasonable to give children a dose of doxycycline antibiotic for prophylactic treatment of Lyme disease even if they are younger than 8 years old. Recent data from three studies showed 0 out of 127 children developed teeth staining when treated with doxycycline.
If you have questions regarding Lyme disease, are sick or have developed a rash following a tick or insect bite, please seek medical care from your primary care provider or an urgent care center.