Tick removal: First aid and prevention

by | Allergy, Dermatology, First Aid and Self-Care

Ticks are parasites that are found in moist bushland, parks and gardens, especially on the Eastern seaboard of Australia. There are about 70 different species of tick in Australia. The most common tick along the East Coast is the paralysis tick (Ixodes holocyclus).

Ticks feed on the blood of humans and animals, and can cause allergic reactions and transmit diseases to their hosts. They attach to the skin by piercing their mouthparts into it and like to attach to soft areas such as the armpits, groin and scalp.

Tick removal

Killing a tick safely as soon as possible after you notice it can help prevent tick-related illnesses, but be aware that symptoms can develop or worsen even after a tick has been removed.

Tick bites: Freeze it; Don’t squeeze it

Freeze it; Don’t squeeze it! That’s the latest advice from experts to Australians who have an attached adult tick.

Tick removal techniques that use tweezers or special hook-like tools run the risk of the tick being squeezed or agitated/disturbed, which can result in it injecting its saliva and potentially infectious contents into you, experts say. This could expose you to transmissible diseases from the tick, sensitise you to ticks or meat in the future (mammalian meat allergy), or if you suffer from tick allergy, risk you having a severe allergic reaction.

So Australian experts and ASCIA (the Australasian Society of Clinical Immunology and Allergy) now recommend you kill the adult tick on your skin with a freezing product such as Wart-Off Freeze or Elastoplast Cold Spray. These sprays contain ether which freezes the tick, thus immediately killing it and preventing it from injecting its saliva or regurgitating its contents into you.

You should then leave the tick in place until it drops off (taking care not to compress or squeeze it during this time) which it should do in the next 24 hours. Take care not to compress it or squeeze it during this time. Ether-containing sprays are available from pharmacies in Australia.

Once the tick has dropped off, clean the area with an antiseptic or soap and water.

Australian paralysis tick

The experts say freezing the tick may help reduce the risk of tick allergy developing, and also reduce the risk of an allergic reaction in someone who is allergic to tick bites. The risk of developing other tick-related illnesses is also reduced. Bear in mind, however, that currently available ether-containing spray products are not designed or intended to be used to kill ticks.

Note that the Department of Health is not recommending this freezing method until further research becomes available. Their information for non-allergic people states: “When removing a tick with fine tipped forceps (not household tweezers unless fine tipped forceps are not available), grasp the tick as close to the skin’s surface as possible. Pull upwards with steady pressure and avoid jerking or twisting the tick.”

If you are unsure what to do about tick removal, you can contact your doctor. The doctor may use liquid nitrogen to freeze the tick or use fine-tipped tweezers to remove it, or both. When the doctor uses fine-tipped tweezers, they will gently take hold of the tick as close to the skin as possible. They will then gently pull the tick straight up and out using a slow and steady motion so as not to crush or squeeze the tick. Once the tick has been removed, the doctor normally cleans the area with an antiseptic or soap and water.

Tick larvae or nymphs

For small tick larvae or nymphs, the experts recommend applying insecticide cream containing permethrin (e.g. Lyclear) to kill the larval or nymph stage ticks. These creams are available from the chemist – they are normally used for scabies. Permethrin is highly toxic to cats, so take care using it if you have a cat.

Tick mouthparts

It is not uncommon for the tick’s mouthparts to break off, with some part of them being left behind in the skin. However, the saliva glands that hold the tick’s toxin and potential allergens (substances that can cause an allergic reaction) are actually located in the body of the tick, so the mouthparts on their own are not dangerous. The mouthparts usually come out on their own with natural skin shedding.

What not to do

  • Avoid applying methylated spirits, kerosene, petroleum jelly, nail polish, oil or alcohol to the tick. These chemicals are generally ineffective in getting the tick to detach from the skin, and may even cause the tick to burrow deeper into the skin and inject more toxins.
  • Don’t use a lighted match or other hot object to try and kill the tick or detach it. Aside from the risk of burning yourself, this method does not effectively remove ticks.
  • Don’t use blunt-nosed household tweezers to remove a tick as they are more likely to squeeze the body of the tick.
  • Don’t handle a tick with bare hands as infective agents or allergens can enter your body through breaks in your skin or by rubbing your eyes. Wash your hands with soap and water if you have touched or handled a tick.

When to get help

See your doctor if:

  • you have trouble killing or with tick removal;
  • you have accidentally scratched off an attached tick;
  • you develop a rash or fever or any other symptoms following a tick bite;
  • you are concerned about tick-borne illnesses; or
  • you suspect you have developed a tick allergy. Your GP can refer you to an immunologist or allergy specialist for testing and treatment.

What to do for tick allergies

If you have a tick and are experiencing an allergic reaction for the first time, seek urgent medical attention. Call 000 for an ambulance or go to the closest hospital emergency department.

If you have a tick and have a history of allergic reactions to tick bites, you should follow your allergy action plan and seek medical attention. If you are allergic to ticks you should carry an adrenaline autoinjector (e.g. EpiPen or Anapen) for treating severe allergic reactions (anaphylaxis).

Tick-related illnesses

While most tick bites don’t cause any symptoms, ticks can cause problems. The following conditions can develop following a tick bite.

  • Local skin irritation (swelling and redness);
  • Allergic reactions (which can be life-threatening, although this is rare). Most allergic reactions involve itching, redness and swelling around the tick bite that lasts several days. Life-threatening anaphylactic reactions (which can cause widespread itching and swelling, throat swelling, trouble breathing and collapse) are uncommon;
  • Allergic reactions to red meat and gelatine can develop months after tick bites from the paralysis tick. This is known as tick-induced mammalian meat allergy.
  • Tick paralysis is a condition caused by neurotoxins in the saliva of ticks – this is rare in humans, and most cases are seen in children. Tick paralysis is more frequently seen in animals kept as pets.
  • Transmission of tick-borne illnesses (infections that can be transmitted to both humans and other animals via tick bites), such as spotted fever (which includes Queensland tick typhus and Flinders Island spotted fever), babesiosis and Lyme disease or Lyme-like disease. The existence of Lyme disease in Australia continues to be debated.

Preventing tick bites

If you live in a tick endemic area, make sure to keep some freeze spray and permethrin cream in your first-aid kit, so you are prepared should you get a tick or tick larvae.

When you’re out and about, the following precautions can help prevent you from being bitten by a tick.

  • Avoid known tick-infested areas.
  • Avoid bushland areas and long grass, especially after rain. Keeping your lawns mowed short can help to reduce risk of ticks.
  • Wear clothes that fully cover your arms and legs. Choose light-coloured clothes so that you can spot any ticks more easily.
  • Tuck your trousers into your socks, and your shirt into your trousers to reduce the amount of skin that is exposed.
  • Wear a wide-brimmed hat.
  • Apply insect repellent that contains DEET (e.g. RID, Heavy Duty Aerogard, Tropical Aerogard or Bushman) or picaridin (e.g. Aerogard) to your skin, clothes and hats. Make sure you follow the instructions on the product.
  • Apply an insecticide containing permethrin to your clothes (e.g. Equip Debugger). These are available from outdoor and camping shops.
  • When returning from the outdoors, brush off your clothes to remove any ticks before going inside.
  • Shower and check for ticks (including adult ticks and ticks in the larval and nymphal stages) soon after being outdoors in areas known to have ticks.
  • Clothes that have been worn outside in tick-infested areas can be placed in a hot dryer for at least 20 minutes to kill any ticks that may be on the clothes.
  • If you are very allergic to tick bites and live in an area known to have ticks, consider moving.