Spending time outdoors in nature comes with so many benefits, and in many places of the world, it also means keeping vigilant for ticks. Unlike other insect bites, tick bites can be more than just a nuisance; they can carry serious health risks, including Lyme disease and other infections.
If you or someone you know has been bitten by a tick, we have created a clear guide to help give you the best chance of avoiding infection and chronic illness.
If you find a tick that has embedded into the skin:
- Remove the Tick Properly
Time is of the essence. Remove the tick as soon as possible using fine-tipped tweezers or a tick removal kit. Be careful not to pinch the tick’s body, squeezing or crushing the tick can expel the contents of the tick into you. Instead, grasp it close to the skin where the mouthparts are attached and pull straight out. Improper removal can increase the chance of infection. - Save the Tick for Testing
Place the tick (dead or alive) in a Ziploc bag or in a small container. There is no need to add anything inside the container. If possible, send the tick to a lab for testing. Laboratories like IGeneX, Inc, and TickReport can analyze the tick for Lyme disease and other infections it may be carrying. This helps identify any potential risk before symptoms arise. - Watch for Symptoms
Even if you didn’t see a tick, a bullseye-shaped rash or flu-like symptoms can be early signs of Lyme disease. A typical rash from a tick bite has the appearance of a bullseye, and not many other things really can cause that rash. Sometimes ringworm can get misdiagnosed as that rash, but if we see a bullseye, it’s pretty indicative that there was infection that got transmitted. Not everyone will develop a rash, but if you do, especially after being in tick-prone areas, it’s important to speak with a healthcare provider right away.
Understanding When to Test
If you’re planning to get tested after a tick bite but didn’t save the tick, timing matters. Antibody tests (like ELISA or Western blot) are more reliable about three weeks after the bite, as your immune system needs time to respond. Infectolab and IGeneX are two labs that perform full panels of PCR tests, which look for bacterial DNA. The amount of bacterial DNA in the bloodstream in these infections are usually very low but are more likely to be detectable during the first week or two of infection.
New studies and testing are constantly improving accuracy with diagnosing as well.
Considerations for Deciding When to Treat
There are a number of different opinions and ideas on what to do for a tick bite, because a tick bite does not necessarily mean an infection was transmitted. Consulting a Lyme literate practitioner is the best way to discuss the safest option for you, as there are many risks and benefits to treatment.
If you know you’ve been bitten, especially in a high-risk area, discuss preventive treatment with your provider. If you did not find a tick and have a suspected bullseye rash, you should talk with your provider about how to treat. The rash is considered to be diagnostic of acute Lyme disease.
The IDSA standard is a 10-14 day course of antibiotics. ILADS recommends a 4-6 week course of antibiotics. Which antibiotics, how long to take and whether to and how quickly to switch to herbal therapies is an individual choice to be decided after discussing your situation with your doctor.
“So again, this risk versus benefits. If we don’t treat the bite, what if infection was transmitted and we wait three weeks to get tested, it takes a week for the results to come back. Now we’re four weeks post the bite.
And so then we start treatment at that time, we’ve kind of lost those initial four weeks of treatment. If we treat a tick bite not knowing if infection is present, again, the risk of using an antibiotic not knowing that is the potential side effects. But as long as we’re careful, we watch the gut, we use probiotics, we watch about specific side effects, oftentimes the benefits outweigh the risk.” – Yvonne Sorenson PA-C
Know the Signs of Chronic Infection
Not all tick-borne infections are discovered early on, and sometimes the infection is diagnosed from the symptoms rather than a positive test when other possibilities have been ruled out.
If you’ve had symptoms persisting beyond six months, either without treatment or with ineffective treatment, you are considered subacute. If you’ve had mysterious symptoms for a year or more, especially without clear diagnosis, this may indicate a chronic or complex case of Lyme disease.
The patients who come in with a lot of symptoms that they’ve had for a while, at least for the patient population we see, the answer is often Lyme plus other things. Whether it’s a coinfection, mold toxicity, heavy metal toxicity, or other things that have compounded the illness, we’re looking beyond a simple borrelia infection.
At this stage, treatment often becomes more extensive.
Considering Coinfections in Testing and Treatment
Not all tick bites result in Lyme. In some cases, co-infections like Babesia or Bartonella are the culprits. Ideally, testing would include a full panel, but if budget is a concern, starting with Lyme is most important. The more information you have early on, the better your chances of avoiding long-term illness.
If you were recently bitten, you can expect treatment to be much shorter. Whereas with chronic patients, we need to treat longer. With any case we take on, we treat until symptoms are gone and many factors individual to your body could affect the course of that treatment.
Work With a Specialist
If you’ve had a tick bite and are unsure what to do, consult with a Lyme-literate doctor. Even if you feel fine after a tick bite, it’s wise to take preventive steps. A personalized approach, based on your exposure, symptoms, and testing, can help you stay ahead of potential complications.
Testing, observation, and early treatment can make a big difference in your long-term health.