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Tick Bites: What To Do & When To Worry

Updated: Jan 18, 2021

Tick Bites. No fun for anyone.

Beautiful weather. The great outdoors. Family fun. And...TICKS!. With all the blissful benefits of outdoor activities, unfortunately come a plethora of biting critters, including ticks. So let's talk about ticks, what to do if a tick has bitten your child, and when to worry about a tick bite.


Where do ticks come from?

Ticks are very common in the United States, especially if you live in one of the top 10 states for tick bites according to the U.S. News & World Report, which include:

  • Maryland

  • Virginia

  • Minnesota

  • Wisconsin

  • Pennsylvania

  • New York

  • New Jersey

  • Connecticut

  • Massachusetts

  • New Hampshire

While these are the top tick states, most states have at least one type of tick known to live there. Ticks are typically at their highest numbers in the spring, summer, and early fall, and usually peak from April through September.


Ticks live outdoors, but not just in wooded areas. They live in grass, trees, shrubs, and leaf piles, and even on your beloved pets. Ticks can move between you and your pets. They may attach to your pet and then migrate to you while you’re touching or holding your pet. Conversely, ticks can also leave you and attach themselves to your pets.


What do ticks look like?

Ok, no more itch-inspiring pictures! Ticks are small, blood-sucking insects. They can range in size from as small as the head of a pin to as large as a pencil eraser. Ticks are arachnids, like spiders, and have eight legs. They can range in color from shades of brown to reddish-colored to black.


As a tick feeds, it becomes engorged with blood and actually may turn a bluish-gray or silvery white color as it fills up with blood. Ticks also grow in size as they feed and can grow to the size of a small marble.


Some of the most common types of ticks are:

  • Deer Ticks, also known as Black-Legged Ticks: These ticks have a reddish-brown body, black "shield" appearance on their backs, and black legs (pictured above). They are common in areas where white-tailed deer live and can be active year-round (any time when temperatures are above freezing, even in the winter). Deer ticks are well known for being the primary transmitter of Lyme disease among other tickborne illnesses and are common in the state of Maryland and the eastern U.S. in general.

  • American Dog Ticks: These ticks have a dark brown body with an off-white "shield" on their backs. American dog ticks can cause Rocky Mountain Spotted Fever among other tickborne illnesses. These ticks are mostly found in areas with little to no tree cover and are the most common tick found in Minnesota and much of the Midwest. However, they are also prevalent in the eastern U.S. and coastal California.

  • Wood Ticks, also known as Rocky Mountain Wood Ticks: These ticks resemble American dog ticks. They are reddish-brown and may have an off-white "shield" on their backs as well. They can be found in similar areas as the American dog tick but are generally restricted to higher elevations (above 4,000 feet) and their activity diminishes during the summer. The wood tick can lead to tick paralysis in humans and pets, among other tickborne illnesses. The tick toxin that causes paralysis can take 24-72 hours to dissipate after removal of the tick.

  • Brown Dog Ticks: These ticks are a reddish-brown color with a more narrow body compared to other ticks. Brown dog ticks prefer feeding on dogs, but can occasionally be found around your home if you have a dog. They can transmit Rocky Mountain Spotted Fever and other tickborne illnesses to both humans and dogs.

  • Lone Star Ticks: These ticks are a reddish-brown color with a white dot or "lone star" on their backs. These ticks are most prevalent in the South but exist across the eastern United States. They are notoriously aggressive biters and may lead to a delayed allergic reaction, known as "alpha-gal" allergy, in the human host after the consumption of red meat. Lone star ticks can also cause Southern tick-associated rash illness, or STARI, which is similar to Lyme disease, among other tickborne illnesses.


Unlike other bugs that bite, ticks usually remain attached to your body after they bite and you will usually find the tick on your skin. If not found, ticks can remain attached for up to 10 days and continue to draw blood from your body. After this period, an engorged tick will detach itself and fall off.


What problems can ticks cause?

Most tick bites are harmless and may not cause any noticeable symptoms.

However, some ticks carry diseases, which can be passed on when they bite.

Some of these tick-borne illnesses include:

  • Lyme disease

  • Rocky Mountain Spotted Fever

  • Ehrlichiosis

  • Babesiosis

  • Tularemia

  • Anaplasmosis

  • Tick paralysis

  • Colorado Tick Fever

  • STARI (Southern tick-associated rash illness)

  • Powassan virus disease

  • Tick-borne relapsing fever

These tick-borne illnesses can cause a variety of symptoms that usually develop within several days to a few weeks after a tick bite. Potential symptoms of tick-borne illnesses may include:

If you or your child is exhibiting any of these symptoms after a tick bite, be sure to seek medical attention as soon as possible.



What do I do if my child has been bitten by a tick?

It is a good rule of thumb to check your child's skin thoroughly after being outdoors in any grassy or wooded areas, especially for prolonged periods of time. This can be done during bathtime for younger children. For older children, pay close attention to and teach them to check and tell you if they notice any new dark spots on their skin. Also be sure to check your child's skin if they are complaining of new pain to a certain part of their body.

If you find a tick on your child's body, the most important thing to do is to remove it. The best way to remove a tick is with tweezers and by following these steps:

  1. Grab the tick firmly with the tweezers and as close to the skin as possible.

  2. Then, pull away from the skin in one steady motion. Try not to twist while pulling. You may be surprised at how firmly you have to pull (remember that this little critter has clamped and bitten down and is sucking away underneath the surface of the skin).

  3. After removing the tick, check the area again and make sure the tick’s head is not still attached. If it is, repeat steps 1 and 2 to remove the head as well.

  4. It is recommended to submerge the tick and any tick parts in rubbing alcohol after removal and to place in a sealed container, if possible, to ensure that the tick is dead and cannot bite again.

  5. Lastly, clean the area of the skin where the bite was with gentle soap and water.

A tick usually has to be feeding on a person for 24 hours or more in order to infect that person with a tickborne disease. So, the sooner you find the tick and remove it, the better.


Even if your child is not showing any of the symptoms listed above, it is still a good idea to make an appointment with your child's pediatrician to be evaluated for any potential tickborne illnesses. Sometimes treatment or laboratory tests are recommended, depending on the circumstances around your child's tick bite, such as how long the tick may have been attached and what part of the country you live in.


Your doctor will take a thorough history, examine your child, and may decide to test or treat your child for potential tickborne diseases. They can also advise you on what symptoms to look for going forward and if your child will need to follow-up.


How can I prevent tick bites? Although there is no way to guarantee prevention of tick bites, there are several precautions you can take to reduce the risk of your child being bitten.

  • Have your child wear a long sleeve shirt and pants when walking in the woods or grassy areas. Dry-wicking or other light-weight clothing options can make this practical, even on hot days.

  • Stay on trails and walk in the center of trails, rather than wandering into woods or brush.

  • Use an insect repellent that has at least 20% DEET (but no more than 30% DEET for) on your children 2 months of age or older. Make sure to follow the instructions for application on the container.

  • Bathe your child or have them take a shower within two hours of being outdoors.

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Sources:

All content on this website, including medical opinion and any other health-related information is for informational purposes only and should not be considered a specific diagnosis or treatment plan for any individual situation. Use of this website and the information contained does not create a doctor-patient relationship. Always seek the direct advice of your own doctor before starting any specific treatment plan.

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