Tick Bites: Pictures, Symptoms, and Treatment

What Are Ticks?

Ticks are small bloodsucking parasites. Although people assume ticks are insects, they are actually arachnids (like spiders) with three pairs of legs and one pair of antennae.

They are the leading carriers of diseases to humans in the U.S., and second only to mosquitoes worldwide. Similarly to mosquitoes, toxins in the tick’s saliva cause the disease. Not only do ticks carry the very dangerous Lyme disease, but also Rocky Mountain spotted fever, Colorado tick fever, or a number of other diseases. They’re efficient carriers of disease because of the way they attach themselves to feed—and the fact that they’ll take several days to finish feeding.

There are both hard ticks and soft ticks but it’s the hard ticks which are associated with most diseases. Hard ticks have a tough back plate and tend to feed for hours to days. With hard ticks, disease transmission usually occurs near the end of a meal.

What Do Ticks Look Like?

Ticks are very tiny! At the nymph stage, a tick is about the size of a poppy seed and translucent. By the adult stage, it’s the size of a sesame seed.  Both nymph (young) and adult deer ticks will bite humans. Most cases of lyme disease are contracted when deer ticks are in the nymphal stage because they are so tiny and latch on to bodies unnoticed. 

If you look carefully, you can tell identify a tick not only by its number of legs but also by its scutum or “shield” on the top side.  In adult females, the scutum covers the front 1/3 of the body but in males it covers the entire body. 

Which Ticks Transmit Lyme Disease?

In the United States, Lyme Disease is transmitted by the black-legged tick, also called the deer tick; it’s found mostly in the Northeast and Upper Midwest of the United States. Along the Pacific coast,the Western Blacklegged Tick transmits Lyme disease. 

When an infected black-legged tick bite a human or pet or other animal, it transmits the bacterium Borrelia burgdorferi, which is transmitted to humans through the bite of infected black-legged ticks. The bacterium is spiral-shaped, which allows it to corkscrew its way from the bloodstream into soft tissue, tendons, joints, and bones. There is some controversy about how long the tick needs to be embedded to transmit the disease. The CDC says 24 hours, but some doctors claim only four hours or less will do it.

While it’s a regional affliction, with 95% of the cases occurring in 14 states in the Upper Midwest, New England, and the Mid-Atlantic, the only state that has had no reports of Lyme disease is Hawaii. Lyme disease is most common in children 5 to 15 years old and adults 40 to 60 years of age, and risk of infection is greatest from May to August.

What Does a Tick Bite Look Like?

Tick bites are also generally painless and may go completely unnoticed. On day 1, the typical bite reaction is a red spot. It may look similar to a mosquito bite with redness or a red bump. If it goes away in 1 to 2 days, there’s nothing to worry about. Only a small number of individuals will develop Lyme disease following a tick bite.

After 3 days, watch out for the telltale Lyme disease rash, called erythema migrans. This rash usually forms the shape of a bullseye around the location of the tick bite. (Note: The appearance can vary widely.) It is red and usually appears within 3 to 14 days of the tick bite. The rash will then grow larger, and sometimes more than one rash can develop. 

After 3 to 30 days, you may also start to have a fever, headache, chills, sore joints, and fatigue. Be aware that you may have these symptoms WITHOUT a bulls-eye rash. Either way, call your doctor. Other rashes can develop around tick bites that are not associated with Lyme disease, but it is best to be safe. 

Lyme disease can be treated successfully with a few weeks of antibiotics. Early diagnosis and treatment will usually lead to full recovery. So, it’s critical to identify Lyme disease early to get prompt and appropriate antibiotic therapy!

After 30 days, if left untreated, Lyme disease can be incredibly debilitating as infection can spread to joints, the heart, and the nervous system. Symptoms include neck stiffness, facial palsy (loss of muscle tone or droop on one or both sides of the face), arthritis with severe joint pain and swelling, pain in tendons, muscles, joints, and bones, shooting pains in the hands or feet, and more.

Tick Prevention is Worth the Effort!

Tick bites can lead to a range of diseases which can cause paralysis or even death. (See a list from the Centers for Disease Control of 15 tick-borne diseases.) Taking steps to avoid ticks is worth the effort.

• Avoid tick-friendly areas such as tall grasses, brush, woods, meadows, and leaf litter. Ticks like moist areas with thick vegetation; they are rarely in your garden, dry pastures, or cornfields.
• If you live in an area known to have ticks, wear the right clothes: long pants tucked into socks, a long-sleeved shirt, and a hat
• Wear light-colored protective clothing so you can more easily see the tiny ticks.
• Use an insect repellent containing 20-30% DEET; take care to cover exposed skin such as hands, wrists, ankles, and neck. Always follow label directions.
• Campers and hikers: If you’re going outdoors, stick to the main trail. Treat all clothing, gear, and shoes/boots with 0.5% permethrin in advance and let dry on clothing. It will repel ticks for up to six washings. Ticks can survive the wash cycle — but not 30 minutes in the dryer. Buying pre-treated permethrin clothing can repel insects for up to 70 or more washings.
• Tall rubber boots are too slippery for ticks. Wear long sleeves and long pants to keep them off your skin.
• Before you come inside, do a “tick check” on all people and pets. Here are places ticks like to hide:
  • In and around the ears
  • Back of knees
  • Around waist
  • In and around hair
  • Under the arms
  • Inside belly button
  • Between the legs
• Shower within two hours of coming indoors to reduce risk of ticks.
• Wash any clothes in HOT water and dry clothes on high heat for 10 minutes until completely dry to kill ticks.

Ticks on Dogs

Dogs are especially susceptible to tick bites as well as tick diseases.

• It’s very important to use a tick preventive product on your dog because there are no vaccines for tick disease. Do NOT use tick products on your cat without speaking to your vet as cats are very sensitive to chemicals.
• Check your pets for ticks daily during tick season. If your dog is bitten, symptoms may not appear for 7 to 21 days so watch very carefully for any changes in behavior. Check around the ears, tail, eyelids, and toes. Also check under the collar, under the front legs, and between the bag legs. 

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Tick Removal

If you find a tick on your skin, fine-tipped tweezers or a tick key will remove a tick quite effectively. To use a tick key, simply place it over an attached tick and slide it gently along the skin, removing the tick. Tweezers require a more delicate touch: 

• Use the tweezers to firmly grasp the tick as close to its head and as close to your skin as possible. Avoid squeezing the tick’s abdomen; crushing a tick may transmit diseases.
• Pull gently upward until the tick comes free. Do not twist and turn the tick, as the head or mouth parts may break off and stay in the skin, increasing the chances for infection. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
• After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.

When removing a tick with tweezers, be sure to remove the entire tick and leave no parts in the skin. (Photo Credit: University of Maine.) 

• Disinfect the tweezers with rubbing alcohol, and wash your hands thoroughly.
• Observe the bite area for several days. Illnesses transmitted by the tick often begin only days or weeks after the tick is gone. If symptoms occur, tell the physician if you have been outdoors.
• Symptoms may include fever, numbness, rash, confusion, weakness, pain and swelling in the joints, shortness of breath, nausea, and/or vomiting. Blood tests are needed to diagnose any illness.

What to Do with a Removed Tick

• Dispose of a live tick by submersing it in alcohol, placing it in a sealed bag, and wrapping it tightly in tape. Never crush a tick with your fingers.
• When disposing of a tick that has not attached yet, drop it into a sealed plastic bag and throw it into the trash. Or, you can drop it into a jar of rubbing alcohol; with this method, you can save it for later identification, although it is better not to do this if you want to have it tested for disease. 
• Do not flush a live tick down the toilet. Ticks do not drown in water and have been known to crawl back up out of the toilet bowl.
• If you are bitten, it is recommended that you save the tick for identification and send it to a lab to test if the tick is carrying a disease. In this case, place the tick in a tightly closed container, such as a vial or a zippered plastic bag (doubled, if the tick is alive). Do not soak the tick in alcohol. If the tick is alive (which is preferable for testing), some labs ask that you place a cotton ball moistened with a few drops of water in the container. Label the container with the date, your name and contact information, the bite’s location on the body, and your general health at the time. If known, also list the geographical location from which the tick may have originated. Send live ticks as soon as possible to a lab; some labs accept dead or damaged ticks as well. If the tick is dead and you don’t want to have it tested, you can store the container in the freezer for later tick ID in case symptoms develop.

Do you often deal with ticks? How do you keep yourself tick-free? Please share with the Almanac community in the comments section below!