By BitMED Provider: Randy Anselmo, Physician
When removing ticks, it’s not uncommon for them to get broken off in your skin, leaving some of their mouthparts behind. Proper technique helps prevent this – and I’ll get to that later – but that only helps the next time. You’ve got a piece of a tick in your skin now…so what to do?
First, don’t freak out! The mouthparts of the tick usually do not contain any of the bacteria that cause tick born illnesses, like Lyme disease, Ehrlichia, anaplasma, babesia or Miyamotoi. Those are generally in the tick’s gut, and once you’ve pulled the body off, the risk of getting one of these infections is minimal, especially if you’ve removed it within 36 hours of the tick attaching to you.
Next, clean the area by putting an alcohol-soaked cotton ball or tissue on it for a few minutes. You should avoid putting anything like alcohol on a whole, live tick because it might agitate the tick and cause it to regurgitate the bacteria from its gut into your skin. But when part of the tick is gone already, it’s fine to do.
Grasp the tick parts as close to the skin as possible using the kind of tweezers that people pluck their eyebrows with. You know, the ones with wide, flat tips that come nicely together. Give a steady pull straight up, and don’t twist.
Don’t worry if you don’t get everything out. And don’t spend too much time digging around trying, as you are liable to make things worse by causing a skin infection. You can just leave the tick parts in your skin, and your body will eventually break them all down and dispose of them. Sometimes, the bite area will get itchy, which is a natural indication of the healing process. Try to avoid scratching it, and feel free to dab it with some 1% hydrocortisone cream (over-the-counter) if needed.
If it’s really making you uncomfortable, either because of the itch, or just the idea of having tick parts in your skin creeps you out, your doctor can remove the piece of skin containing the parts. It won’t likely alter your risk of getting a tick born disease, but it can relieve the itching or anxiety. It’s done by injecting the area with a local anesthetic, then using a biopsy punch (sort of like a tiny cookie cutter) to cut out a little core of skin, then putting in a stitch or wound closure strip. While it’s a simple process, it’s not without risk. Even in the best of hands, it can get infected, or you could have an allergic reaction to the anesthetic. Depending on where the bite is, a biopsy could cause bleeding or damage to a nerve.
As with any tick bite, whether or not the tick is completely removed, you should be on the lookout for any signs of tick born disease over the next month. These include symptoms like unexplained fever, head or body aches, bull’s-eye rash, significant fatigue, etc. You should visit your doctor promptly if any of these occur. If you go a month without symptoms, there’s almost no likelihood of developing them later.
Removing a tick properly helps reduce the chance of it breaking off in your skin. There are some great little tools out there like tick spoons that work really well, but if you don’t have one on hand when you need it, a tweezer works well. Using either tool, grasp the tick as close to the skin as possible. Once again, hold tight, and slowly, steadily pull upward until the tick releases. Don’t twist. That’s all there is to it.
Of course, no conversation about tick bites would be complete without mentioning that avoiding them in the first place is the best plan. When ticks are in season in your area, curtail activities in the brush. When you do get out there, though, wear light colored clothes so you can see the little buggers, and tuck your pants into your socks, and your shirt into your pants. Ticks crawl upward, and this keeps them from finding a path to your skin. Use an insect repellent containing 30% DEET. And as soon as you get home, put those clothes in the wash (or leave outside until it’s time to do the wash). While you’re standing there naked, get in front of a mirror or a trusted friend or family member, and do a thorough visual check of your body. Where my family lives, there are lots of ticks, and we love the outdoors, so in tick season, this is a daily ritual, just like brushing our teeth.
Tick bites aren’t that big of a deal if you can remove the tick early. Take your time, and do your best to use good technique, but don’t worry if you don’t get everything out. Usually, the best thing to do is leave it alone and let your body handle it.