If you find an embedded tick in your skin, what do you do? The longer a tick is left to feed, the higher the chances are that it will pass on any diseases it’s carrying. Incorrect removal will also increase the chances of disease transmission. So whilst it is important to remove the tick as soon as possible, it is equally as important that the tick is removed correctly.
Incorrect removal can result in:
- The tick’s mouth parts being left behind in the skin.
- Compression of the tick’s body.
- Puncturing of the tick’s body.
- Injury and irritation to the tick.
Why is this a problem?
Leaving behind the tick’s mouth parts may result in a localised infection, which in severe cases can lead to abscesses and even septicaemia. Compressing the tick’s body or causing injury or irritation to the tick may its saliva and gut contents to be regurgitated back into the bloodstream of its host (the person or animal it’s attached to). These fluids may contain infections. Puncturing the body of the tick may cause spillage of infected fluids onto the host or on to the person removing the tick.
You must never burn, freeze, suffocate or cover a tick in any substance.
The only safe methods of removal are by using fine pointed tweezers or a special tick removal tool.
Method one: fine pointed tweezers
Blunt-nosed tweezers (like the ones used to pluck eyebrows) are too broad and are more likely to squeeze the body of the tick. Fine-tipped tweezers should be used as they are slim enough to get close to the tick’s mouth parts without coming into contact with the body of the tick, which avoids compressing it.
Tweezer tick-removal technique
- Grasp the tick as close to the skin as possible and pull upwards with steady, even pressure.
- Do not twist or jerk the tick as this may leave its mouth parts embedded, or cause it to regurgitate infected fluids. If any mouth parts do break off, they may be removed with a sterilised needle or tweezer points.
- Do not squeeze or crush the body of the tick, because its fluids (saliva and gut contents) may contain infections and leak into the host’s bloodsteam or into the skin.
- Do not handle the tick with bare hands, because certain disease-causing organisms may enter through breaks in the skin, or through mucous membranes (if you touch eyes, nostrils or mouth).
- After removing the tick, disinfect the bite site with an antiseptic wipe or wound wash and wash your hands with soap and water.
- You may want to save the tick for identification in case the person or animal the tick was attached to becomes ill within several weeks. Write the date of the bite on a piece of paper and put it with the tick in a sealed plastic bag either dead or alive and store it in a freezer. Your doctor / vet can then be certain that a tick bite has occurred and use this information to assist in making an accurate diagnosis. Public Health England run a tick surveillance scheme. You can send the tick in but will not receive results on whether the tick is carryina pathogens. For private laboratory tick testing which does give you results, please see here.
If you don’t want to keep the tick, the best way to dispose of it is to place it in a tissue and squash it, wearing medical gloves. Then flush away the tissue or dispose of it in the dustbin. This will prevent the tick from going on to bite another person or animal. Although not every tick carries disease, immediate removal of an attached tick is recommended.
Method two: tick removal tool
There are a few tick removal tools on the market and one of the devices favoured by professionals, is the O Tom Tick Twister ®. It is designed to cradle the body of the tick and doesn’t exert pressure on either its mouth parts or its abdomen. It can therefore be safely twisted in one direction (either clockwise or counter-clockwise – the tick is not screw-threaded), which allows the barbs on the tick’s proboscis to be freed from the surrounding tissue. The twisting action also helps to crack the special saliva cement that most hard-tick species secrete in order to firmly attach themselves. The tool doesn’t cause any compression to the body of the tick and so it minimises the risk of back-flow of the tick’s saliva and gut contents, and therefore helps to avoid disease transmission.
You should NEVER twist with tweezers.
If you use this tool to lever as you would a crow bar, the mouth parts are likely to break off. If you twist the tick one way and then the other, the mouth parts are also likely to break off. Twist in one direction only.
- Choose the most suitable O’Tom Tick Twister ® tool, according to the size of the tick (each pack contains two sizes, one for adult ticks and one for the tiny nymph ticks).
- Engage the tool by approaching the tick from the side (the body of the tick is flat when unfed) until it is held securely.
- Lift the tool very lightly and TURN IT (clockwise or counter-clockwise). The tick detaches itself after 2-3 rotations.
- After removing the tick, disinfect the bite site and wash hands with soap and water.
- You may want to save the tick for identification in case the person or animal the tick was attached to becomes ill within several weeks. To save the tick, write the date of the bite on a piece of paper and put it with the tick in a sealed plastic bag and store it in a freezer. Your doctor / vet can then identify that a tick bite has occurred and use this information to assist in making an accurate diagnosis.
- Public Health England run a tick surveillance scheme. You can send the tick in but will not receive results on whether the tick is carryina pathogens. For private laboratory testing which does give you results, please see here.
If you don’t want to keep the tick, the best way to dispose of it is to place it in a tissue and squash it. Then flush the tissue down the toilet or dispose of it in a dustbin. This will prevent the tick from going on to bite another person or animal.
Lifesystems® offer some slightly different tick removal tool options such as this credit card sized tick removal card which has a magnifying lens and a choice of two sizes of tools.
Or, these special Tick Remover tweezers
Suspect Lyme disease?
If you notice an EM rash or become unwell following a tick bite, see your GP immediately and mention your concerns about Lyme disease. Draw around the rash with a pen to monitor any changes and take photos. Please note that around one third of Lyme disease patients never experience an EM rash and so it is important to look out for symptoms as well and keep a symptom diary.
Please see the RCGP Lyme disease toolkit here.
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