Tick bites and Lyme disease

Now that it’s warm out, people are heading out to camp and hike, and do lawn/yardwork.  We have recently seen an increase in calls about tick bites to our office.  So, now is a good time to tell you about it.

Good news:  The risk of acquiring a tick-borne infection is quite low. 

Ticks that are brown and pencil-point-sized are deer ticks. These can transmit the bacteria that causes Lyme disease.

Ticks that are brown with a white collar and about the size of a pencil eraser are more likely to be dog ticks.  These ticks do not carry Lyme disease.


  • Use fine tweezers to grasp the tick as close to the skin surface as possible.
  • Pull backwards gently but firmly, using an even, steady pressure.
  • Do not squeeze, crush, or puncture the body of the tick, since its bodily fluids may contain infection-causing organisms.
  • After removing the tick, wash the skin and hands thoroughly with soap and water.
  • If any mouth parts of the tick remain in the skin, these should be left alone; they will be expelled on their own.

More good news:  A tick that was not attached, was easy to remove or just walking on the skin, and was still flat and tiny and not full of blood when it was removed could not have transmitted Lyme disease.

Even if a tick is attached, it must have taken a blood meal to transmit Lyme disease. At least 36 to 48 hours of feeding is required for a tick to have fed and then transmit the bacterium that causes Lyme disease….that’s a long time.  After this, the tick will be engorged (full of blood).

WHEN DO WE TREAT?? The Infectious Diseases Society of America recommends preventive treatment with antibiotics only in people who meet ALL of the following criteria:

  • Attached tick is a deer tick
  • Tick has been attached for ≥36 hours (based on how engorged the tick appears or the amount of time since outdoor exposure)
  • Antibiotic treatment can begin within 72 hours of tick removal
  • The person can take doxycycline (this excludes children and pregnany women)

If the person meets ALL of the above criteria, can start doxycycline as a single dose.  This has been shown to prevent tick-borne illness.


Observe bite area for expanding redness.  The rash is usually a salmon color and uniform. The rash expands over a few days or weeks.  As it expands, it can become skin-colored in the center. The rash usually causes no symptoms.

Generally, Lyme disease can cause fatigue, fever, headache, muscle pain, joint pain, and swollen lymph nodes.

Early Lyme disease — occurs days to weeks after the tick bite.

  • Inflammation of the heart –  may interfere with the normal conduction of electrical impulses through the heart, causing heart block. Heart block can cause a slower than normal heart rate, or lightheadedness and fainting.
    Inflammation of meninges – causes meningitis.
  • Inflammation of nerves – causing weakness, pain, or numbness.

Late Lyme disease — occur months to years after a tick bite.

  • Muscle and joint symptoms like arthritis.
  • Neurologic symptoms like difficulty with memory or thinking, and numbness.

Post-Lyme disease syndrome — Nonspecific symptoms such as headache, fatigue, and joint pain may linger for months after the treatment of Lyme disease has ended. These symptoms gradually resolve.  

If you have concern about a tick bite, contact your medical provider for evaluation.



About cschaffer78

I'm a family practice physician in Evansville, IN. My practice is described as "full-spectrum" family practice, meaning I see patients "from cradle to grave". I care for men and women of all ages, I deliver babies, and even follow my patients when they are hospitalized. Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider
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