Tick bites: An Approach: ( 2015)
1. most tick bites are just annoying. Local irritation and itch with swelling which, if in the right area – head, groin for example – can look pretty impressive, especially around the eyes. Treatment for this can be nothing – ” just observe the sensations”; local topical treatment – lavender oil, “stingose”, I like to use
this rosemary and cedarwood cream, which our local vet sells.
1a. Removing the tick: There are varied opinions regarding the best approach but I recommend using tweezers, unless you have a history of allergy or anaphylaxis ( see below) : NSW Health recommends removing a tick as soon as possible after locating it. These ( TickEase ) are particularly good ones. Use fine pointed tweezers and grasp the tick as close to the skin as possible. Gently pull the tick straight out with steady pressure. Avoid squeezing the body of the tick during removal. If you have difficulties seek medical attention. They recommend you do not try to kill the tick with methylated spirits or any other chemicals. This may cause the tick to inject more toxins and possibly infectious agents. However if the tick is very small or cannot be removed with tweezers for other reasons ( like no tweezers!) then Lyclear is a good option according to the University of Sydney Department of Medical Entomology.
Note: In individuals with a history of allergic or anaphylactic reactions to tick bites, ticks should be removed as soon as possible, but only by a doctor and where resuscitation facilities are readily available. In particular if you have had a severe allergic or anaphylactic reaction from a tick bite in the past, you should have an Epipen and Aerostart and a written plan from your GP or immunologist or allergy specialist. TIARA is a useful resource for tick allergy information.
2. If you tend to get a lot of swelling from a tick bite, or other arthropod bites and stings, then an oral anti-histamine daily, from as early as you can after noticing the bite until you have no more symptoms would be appropriate. I have heard a few stories of homeopathic treatments ( Ledum 30C apparently) being helpful in this setting but cannot really advise on that score. You’ll have to formulate your own opinions on that…
3a. If you are particularly unlucky, the tick that bit you might have been harbouring some infection or another. ( Rickettsia, Borrelia, Bartonella, Babesia… for example) And it is possible that such micro-organisms might have got into you. AND it is possible that those little bugs are sequestering themselves in your tissues as you read this. Please remember that this is clearly a relatively rare event compared to the number of tick bites that occur. But it is possible. In my opinion, although I have no data outside my loose retrospective clinical anecdotal experience to support this) the better shape your whole being is in ( psycho-neuro-immunologically speaking, which includes toxic load etc…), the less likely you will be to succumb to an infection.
3b. Early local infection: If the local response includes a rash which looks like a bull’s eye, or looks “unusual” ( yes, I realise that this is a hard call) and more than a histamine-mediated response then this might be Erythema Migrans, if Borrelia is present. This is the effect of the bacteria making its way through the local tissues. It can be difficult to distinguish a local irritant or allergic reaction from an infective one. If you remain well with just some local swelling and irritation then it would be reasonable to do no more. If the rash is suspicious for infection then antibiotics would be a good next step
4. Early systemic infection: If you become unwell systemically unwell within a short period after the tick bite – a day, a week, a month or so – with fevers and flu-like symptoms, arthritic symptoms and/or neurological symptoms ( meningitic, encephalitic, peripheral neuropathic, perhaps paretic) then certainly antibiotics are warranted. Sometimes other systems are involved with “atypical” symptoms.
5. Antibiotics:
In general, I recommend treatment with doxycycline 400mg daily until symptoms have been absent for 4 weeks is considered enough. There is discussion amongst Lyme experts about whether to use other antibiotics ( for the other forms of the Borrelia organism) as well but to my knowledge to date, we don’t have enough data so if the doxycycline works, great. If it doesn’t, or you’re not sure, go back to your Lyme* Literate doctor to discuss other options.
6. If you do nothing now because you are well, just remember that you were bitten by a tick and, if you become unwell in the future with some odd illness, it might be a Tick Borne Illness.
Useful guidelines here from Dr Joe Burrascano. I hope you find that helpful.
* While there is no consensus on the presence of Borrelia burgdorferii, the organism that causes Lyme disease,in Australia, there is increasingly agreement that there is some Lyme-like disease syndrome in Australia which is likely related to infection with organisms for which ticks are one vector.