That's not a mole, that's a tick!
5/15/2023 by Joshua Luciew, MPAS, P.A.-C.
Tick bites tend to happen when it's least expected. It's important to know that some tick bites can cause an illness called Lyme disease. In the U.S., bites from infected blacklegged deer ticks are the most common type of tick bite to cause this illness.
However, when evaluating patients for Lyme disease, clinicians consider several things:
Where in the U.S. did the bite occur?
The chances of your tick bite causing Lyme disease depends on where in the U.S. the bite occurred. Not all ticks are infected with the bacterium that causes Lyme disease. To help you understand if your tick bite has a high chance of carrying the disease-causing bacteria, check out the Center for Disease Control and Prevention's information on Lyme disease. Their map will show you which states have a high incidence of the disease. If your tick bite occurs in one of these high-incidence states, you have a higher risk of developing Lyme disease.
How long was the tick attached to your body?
If an infected tick is attached to your body for 36 or more hours, it could put you at a higher risk of developing Lyme disease. However, if the tick is attached to your body for less than 36 hours, you have a lower chance of developing the disease.
What are the symptoms of Lyme disease?
If an infected tick is not removed early enough, Lyme disease can develop. The symptoms of Lyme disease are broad, and they can change depending on how long an infected tick was attached.
If infected for three to 30 days:
- You may notice a gradually expanding target-like rash at the site of the tick bite. This symptom occurs in most but not all patients.
- Flu-like symptoms also can occur, including a new headache, fever, chills, swollen lymph nodes, fatigue, muscle aches or joint aches.
If left untreated, more significant symptoms can develop:
- More target-like rashes on your body.
- Severe joint pain that can move to different joints.
- Inflammation of the heart that can cause palpitations or chest pain.
- Inflammation of the covering of your brain and spinal cord that can cause a stiff neck, headache and fever.
- Weakness of the muscles on one side of your face, which is caused by a condition known as Bell's Palsy.
How is Lyme disease diagnosed?
If you think you have Lyme disease, your health care clinician should evaluate you. Sometimes the disease can be diagnosed based on your history and physical examination alone. Blood tests can help diagnose Lyme disease as well. If blood tests are performed too soon, the results can sometimes be falsely negative. If a patient has a history and physical examination suggestive of possible Lyme disease and tests negative, they should be retested in two to four weeks.
How is Lyme disease treated?
If you are concerned about a recent tick bite, try to visit your health care clinician within 72 hours of the tick bite to see if you would benefit from preventive antibiotic treatment. If you see your health care clinician after 72 hours of a tick bite, you could be treated with a longer course of antibiotics if your clinician feels you would benefit from treatment for Lyme disease.
How can you prevent a tick bite?
If you spend time in wooded or grassy areas, take extra precautions to avoid a tick bite with these preventive measures:
- Wear bright-colored, long-sleeved shirts, with long pants tucked into your socks. Wear closed-toe shoes. These measures help prevent ticks from attaching to your skin.
- To stay cool and protected from the sun ― and from ticks ― wear sun-protective clothing.
- Apply permethrin to your clothing or purchase pretreated permethrin clothing. Do not apply permethrin directly to your skin. If you use permethrin clothing or gear, be sure to follow the product packaging labels for directions and precautions.
- Apply an Environmental Protection Agency-registered insect repellent containing DEET or picaridin to your skin to help repel ticks. Be sure to follow package instructions.
- Carefully inspect your body, clothes, pets and children after spending time outdoors.
- Shower with a washcloth as soon as you come indoors for the day. This is a good time to inspect your entire body for signs of ticks. Pay close attention to your armpits, groin, behind your knees and in your hair.
- Place dry clothing in your dryer on high heat after you come indoors for at least 10 minutes to help try to kill ticks that may be on your clothing. This practice may reduce your exposure to ticks brought into your home. If clothes are wet or damp, longer times in the dryer are needed.
- If you identify a tick on your body, have it removed as soon as possible. You can try removal on your own with tweezers. Be sure to grasp the tick as close to the mouth as possible. Carefully pull away from your body and dispose of it in isopropyl alcohol to kill it. Place the tick in a bag and bring it to your health care clinician for it to be examined. Be sure to clean the bite area with soap and water after removal. If you do not feel comfortable removing the tick, make an appointment with your health care clinician for assistance.
- If you remove a tick from your body – or if you think you have encountered a tick bite ― call your medical clinician.
Joshua Luciew, MPAS, P.A.-C., is a physician assistant in the Department of Family Medicine at Mayo Clinic in Rochester. He enjoys wilderness medicine and practices at Mayo Family Clinic Southeast.