Tick Bite and Tick Removal

Content reviewed against published CDC, AAP, IDSA guidelines

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Ticks can transmit serious diseases including Lyme disease, Rocky Mountain spotted fever, and ehrlichiosis. Prompt, proper removal reduces disease transmission risk. Most tick-borne illness transmission requires the tick to be attached for 36-48 hours, so early detection and removal are critical.

Immediate actions

  • May not require 911 — see guidance below
  • Remove the tick as soon as possible using fine-tipped tweezers
  • DO NOT: Do NOT squeeze the body of the tick — this can push infected fluids into the wound

Step-by-Step Response

1

Get fine-tipped tweezers

Use fine-tipped (pointy) tweezers, not household blunt tweezers. If you do not have tweezers, use a tick removal tool or see a doctor.

2

Grasp the tick

Grasp the tick as close to the skin surface as possible. Get between the skin and the tick's head/mouthparts. Do not grab the tick body.

3

Pull straight up

Pull upward with steady, even pressure. Do not twist, jerk, or squeeze. The tick should release. This may take a few seconds of steady pressure.

4

Inspect the bite

Check that the entire tick was removed (head and mouthparts). If small mouthparts remain, leave them — the skin will push them out. Clean the area with rubbing alcohol or soap and water.

5

Save the tick

Place the tick in a sealed plastic bag or tape it to an index card. Note the date. If symptoms develop, this helps identify the tick species and possible diseases.

6

Monitor for 30 days

Watch for: expanding rash (especially a "bull's eye" pattern), fever, headache, muscle/joint aches, fatigue, or swollen lymph nodes. Take a photo of the bite site daily.

7

Seek medical attention if needed

Contact your doctor if: tick was attached for 36+ hours, you are in a Lyme-endemic area, or any symptoms develop within 30 days of the bite.

What NOT to Do

  • Do NOT squeeze the body of the tick — this can push infected fluids into the wound
  • Do NOT use petroleum jelly, nail polish, heat, or matches to try to make the tick detach
  • Do NOT twist or jerk the tick — pull straight up with steady, even pressure
  • Do NOT crush the tick with your fingers — flush it or seal in a bag
  • Do NOT panic if mouthparts remain in the skin — the body can expel them naturally
  • Do NOT ignore a tick bite — monitor for 30 days for symptoms

When to Seek Help

Call 911 if:

  • Severe allergic reaction to tick bite (difficulty breathing, swelling of face/throat)
  • Tick paralysis symptoms: progressive weakness or paralysis starting in legs and moving upward (rare but emergency)

Go to ER if:

  • Signs of severe allergic reaction (anaphylaxis) to the bite
  • Tick paralysis: progressive weakness, difficulty walking, or breathing problems
  • Severe headache with fever and new rash (possible Rocky Mountain spotted fever — a medical emergency)
  • High fever with confusion after a known tick bite

Call your doctor if:

  • Tick was attached for more than 36 hours (prophylactic antibiotics may be indicated)
  • Bull's-eye rash (expanding ring with clear center) appears at bite site
  • Fever, headache, or flu-like symptoms within 1-30 days after a tick bite
  • Joint pain or swelling following a tick bite
  • Inability to fully remove the tick
  • You live in an area with high Lyme disease prevalence
  • Multiple tick bites

Age-Specific Guidance

0-6 months

DEET should not be used on infants under 2 months. Use physical barriers (netting, clothing) and avoid tick habitats. Infants are more susceptible to tick-borne illness. Any fever after a known tick bite warrants immediate evaluation.

6 months - 3 years

Children playing on the ground are at high risk for tick attachment on the scalp, neck, and hairline. Use DEET up to 30% (apply once per day). Do thorough body checks after outdoor play, especially in the hair.

3-8 years

Active outdoor children in wooded/grassy areas need consistent protection. Teach children to tell an adult if they find a "bug" on them. Apply repellent to exposed skin and treat clothing with permethrin.

Prevention

  • Use EPA-registered insect repellent (DEET 20-30% is safe for children over 2 months)
  • Treat clothing with permethrin (kills ticks on contact)
  • Wear long pants tucked into socks and long sleeves in wooded/grassy areas
  • Stick to the center of trails — avoid tall grass and leaf litter
  • Perform full-body tick checks after outdoor activities (scalp, ears, armpits, groin, behind knees)
  • Shower within 2 hours of coming indoors
  • Tumble dry clothes on high heat for 10 minutes to kill ticks
  • Keep yards mowed and create wood chip borders between lawn and wooded areas
  • Check pets for ticks — they can carry ticks into the home

Frequently asked questions

Should I call 911 for tick bite and tick removal?
Not always. Call 911 if: Severe allergic reaction to tick bite (difficulty breathing, swelling of face/throat)
What should I do first?
Remove the tick as soon as possible using fine-tipped tweezers. Grasp the tick as close to the skin surface as possible and pull straight up with steady pressure. Clean the bite area with rubbing alcohol or soap and water. Save the tick (in a sealed bag or taped to paper) for identification if possible
What should I NOT do?
Do NOT squeeze the body of the tick — this can push infected fluids into the wound. Do NOT use petroleum jelly, nail polish, heat, or matches to try to make the tick detach. Do NOT twist or jerk the tick — pull straight up with steady, even pressure. Do NOT crush the tick with your fingers — flush it or seal in a bag. Do NOT panic if mouthparts remain in the skin — the body can expel them naturally. Do NOT ignore a tick bite — monitor for 30 days for symptoms
How can I prevent this?
Use EPA-registered insect repellent (DEET 20-30% is safe for children over 2 months). Treat clothing with permethrin (kills ticks on contact). Wear long pants tucked into socks and long sleeves in wooded/grassy areas

Sources

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources

Related Emergency Guides

Bottom line

Stay calm and follow the steps above. When in doubt, call your pediatrician or go to the nearest emergency room.

You are doing the right thing by learning what to do in an emergency. Being prepared is one of the best things you can do for your child.