When Ticks Attack: You’ve Been Bitten, Now What?

By Cora Rivard, Naturopathic Doctor (N.D.) in Derry, NH. www.seasonsnatural.com

Tick bites are already happening at increased rates, especially in the northeast and all along the east coast, and it is predicted that a large number of adults and children will be affected this year. But there is a lot that you can do to prevent them, as well as to significantly decrease your risk of contracting a tick-transmitted infection. (You can also check out my other article in this series, “Plants vs Ticks: Lyme-free Landscaping” to learn about landscaping strategies to repel and prevent ticks from migrating into your yard.)

My personal story: I used to use tweezers to remove them from us and our pets…until four years ago when I had a deer tick attached to the back of my arm. It was attached less than 24hrs, not visibly engorged. It wasn’t my most efficient removal, and it got squeezed and slightly messy as I took it out. It wasn’t considered a “high risk” bite due to the less than 24 hr attachment rule, so my doctor decided it was not worth treating. I did elect to do a 2 dose “prophylactic” doxycycline treatment within 48 hrs of the bite (only a single dose is recommended, but I really wanted to be careful.) However, it appears that evidence is scant for effectiveness unless used on the same day of the tick removal, and after that, it could even be harmful.  In mice, prophylactic treatment has been shown to reduce appearance of the rash, but was not shown to decrease infection. Having the prophylaxis was a big mistake for me, even with the double dose. Long story short: within a couple months I developed a mean case of Lyme, affecting the joints of the bitten arm first and then the rest of me. I consulted with an infectious disease specialist in Boston who helped me understand that early treatment of certain types of acute infection with antibiotics can actually interrupt your body’s natural development of immunity to the organism.  If the treatment is inadequate or incomplete- this leads simultaneously to a more resistant bug and a decrease in your effective immune defense to that bug. In my case, taking the prophylaxis instead of a full treatment likely made my disease that much harder to treat later.  It took consulting with Lyme specialists,  a whole lot of antibiotics over a couple of years, and a lot of stress and side effects to kick the infection. And thankfully, I was finally (hopefully) able to kick it with the guidance I received. But I don’t want you and your loved ones to ever have to go through any of this. So here’s what to do:

Let’s start with a quick review to help prevent tick bites:
1. Wear lght colored pants tucked into socks when in the woods and when doing yardwork.
2. Tick repellent sprays, herbal or chemical, to shoes, pants and legs prior to walks in the woods. For children, I recommend parents use safer, non-DEET repellants whenever possible. Formulations with essential oils like lemongrass, cedar, rosemary can be great to repel ticks (but should be re-applied often):Botani Organics Tick Guard Repellant Spray — 4 fl oz

(by the way- for mosquitoes, the best natural product I have used is lemon eucalyptus: Repel 94109 Lemon Eucalyptus Natural Insect Repellent, 4-Ounce Pump Spray. But I don’t know how well it works to repel ticks.)

3.  As soon as you come indoors from an outing in the woods, remove your clothes and toss them in the dryer for 5-10 minutes, then wash if desired. Ticks don’t drown in the washing machine, and the hot water of the wash will kill them, but a spin through the dry heat of the dryer will.

4. Nightly tick checks. Ticks are not polite- they will crawl up until they hit a crease, fold, or simply can’t climb up anymore. Always check the nether regions, back, neck, under breasts, armpits, legs, belly button, and go through the hair and scalp carefully. Another important spot to always check (especially in children) is within the curves and folds of the ears. Do this every single evening whenever snow is not covering the ground, even if you or your children have not been outside, ticks can still migrate indoors on pets.

If you find one attached:
**Use a tick remover. I have tested out many styles, but my favorite by far is the notched spoon, such as “Ticked Off” sold by Amazon. It can safely remove ticks of any size, even nymphs and larval sizes, with head and mouth intact every time. Get one now. I  keep 3 of them, so that there is always one on hand- backpack, travel bag, bathroom, etc. One stays packed in a travel bag- it goes everywhere with us. When using it, always use your other hand to provide traction- pulling the skin tight around the area of the tick, as you gently press in and slowly “scoop” out the tick with the notch.

Never try to burn, squeeze, or otherwise irritate the tick by putting anything on it, like essential oils or vaseline. This can cause the tick to disgorge its stomach contents into the wound, along with infectious organisms.

If you are concerned about infection, save the tick and have it tested. Pack the live tick in a piece of moistened paper towel and place inside a ziploc bag. You can send it to a lab for testing, follow this Univ. of RI link for a list of available testing facilities in the Northeast. They can screen for Lyme and other common tickborne infections (Lyme is still the most common disease present in tested ticks- the others tend to be more common as coinfections to borrelia), identify the type of tick, as well as the level of engorgement and assumed attachment time, and report back to you within a few days. This information can be very helpful for you and your doctor to decide whether treatment is necessary in the absence of signs and symptoms. I’ve used the one at the University of CT several times for my family members, and often recommend it to patients. But any of them should be helpful.

After removal, treat the site of the tick bite with hydrogen peroxide or essential oil. I like using oregano oil as a heavy duty topical antimicrobial for spot treatment, it kills a lot of infectious things.

Call your doctor with concerns, they might suggest preventve treatment depending on the circumstances of the tick bite, even without symptoms. “Preventive” treatment should mean full treatment time-I often recommend to patients to complete 4 weeks of antibiotic treatment in early disease. This is longer than the guidelines set forth by the Infectious Disease Society of America (IDSA). Signs and symptoms of Lyme disease and other infections may include any of the following: spreading rash, fever, head aches, stomach aches, flu-like symptoms, swollen lymph nodes, and joint aches and pains. However, it is also possible to have no signs or symptoms for weeks or months during the initial infection. It is common for the skin surrounding tick bites to get a little red and even scabby- this is because your immune system becomes activated with the mechanical irritation of the bite, and also may react strongly to the proteins in the tick’s saliva. This is not the same as an erythema migrans- the typical Lyme rash. Show your doctor immediately if you have any kind of rash or reaction, they can help to distinguish the two.

Testing for Lyme disease in humans: generally, you must wait at least a month to get tested, as it takes a while for antibodies to mount diagnostic levels. Therefore if it is likely that you might have contracted a tick transmitted illness, either by symptoms, history of deer tick bite, or by an unusual rash (since many people who contract Lyme disease never discovered an attached tick)- your doctor may opt to go ahead and treat you.

If you do go through treatment, remember to talk to your doctor about taking probiotics (take at a separate time from antibiotics) throughout your treatment period and for at least 2-3 months beyond. Antibiotics will help to kill tick-borne diseases, but they will also wreak havoc on your intestinal ecology. Probiotics can help to protect you from getting a serious intestinal infection while your defenses are down during and post treatment.

About the Author: Dr. Rivard is a licensed naturopathic doctor and owner of Seasons Natural Healthcare, LLC in Derry, NH. She consults with both adult and pediatric patients regarding nutrition, natural treatments and effective alternatives to medications for a wide range of common health concerns.  Any informational content should not be taken as medical advice, or to replace the advice of your doctor in any way.