How to remove a tick. Learn a little about bug sprays.

As a general pediatrician and a travel medicine physician, I am asked frequently to remove ticks in my office or to give advice over the phone about tick removal. I have receive quite a few calls over the last few weeks about tick bites, and it seems the ticks are out in large numbers this year.


Start with a pair  of tweezers. Clean the tweezers with alcohol, if possible.  Eye brow tweezers are probably fine, but you can buy tick removal tweezers at many outfitters.  Keep a pair in your first aid kit, in your back pack or car. Gently grab the tick very close to the skin and hold the tweezers still for a minute or two.  Very slowly draw the tweezers away from the skin over another minute or two. The tick will generally let go eventually and the head will not be stuck in the skin.  Clean the area with an alcohol prep pad, soap and water or use a bit of Hibiclens and water, if you have that in the house.


Watch any tick bites for signs of infection. Large dog ticks are less likely to spread disease (at least in notheastern US) Small deer ticks may spread Lyme disease. Look for a red ring, a central eschar or black scab, a fine ring of scaling, or an enlarging circle. Later symptoms of lyme disease may include large joint pain with swelling, facial palsy or neurologic symptoms. If any symptoms of early or late Lyme disease are noted, consult your physician immedicately. 


Insect  bites may be a nuisance, or (especially) in tropical areas, may spread life threatening diseases.  Diseases spread by mosquitoes around the world include Malaria, Dengue, Chichungunya, Yellow Fever, Lyme disease...


Prevention of insect bites is critical to international public health, and may make local hikes much more pleasant.


Permethrin is used to pretreat fabrics such as clothing ,shoes,  tents, headnets and bednets. A treatment may last through several washings. (Pajamas and sheets may be treated with permethrin to decrease chances of bed bug bites. )


DEET is generally applied only to the skin, and should not be applied to synthetic fabrics. Ultrathon is a long lasting DEET formulation frequently recommended by travel clinics. DEET should NOT be applied to climbing ropes, slings and harnesses.  30-50% DEET is generally safe for older infants, children  and adults. Babies below 2 months of age may be protected by netting , with close supervision. Do not apply repellant to hands, cuts, wounds or irritated skin. Do not apply repellant under clothing. Wash with soap and water when activity is finished, and insect bites are no longer a risk.  Do not spray aerosol or pump containers indoors, or near the face.  

Hikes may be scheduled for seasons or time of day when insects are least active.





For more information, consult the CDC "Yellow book", Health Information for International Travel, or log onto the CDC website.

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