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الجمعة، 21 يوليو 2017

How to Remove a Tick Safely—and the One Thing You Should Never, Ever Do

tickTicks in the summer are as certain as death and taxes. It’s important to know your enemy, so learning the 13 things that make a tick, um, tick is crucial. Considering that there are at least 15 tick-borne diseases (of which Lyme disease is the most common in the United States), the Centers for Disease Control and Prevention recommend a zero tolerance policy for allowing ticks to feed on us.

The process in which the tick delivers its pathogens is not for the faint of heart, according to the University of Alabama at Birmingham (UAB) in its most recent news release regarding ticks and tick-borne illness. A tick uses incisor-like claws to tunnel beneath the skin, often in seconds, latching on with two legs and cutting open the skin with a mouth that resembles a reciprocating saw. After injecting its long, jagged mouth, it begins to draw blood up slowly before it reverses the flow, releasing saliva into the wound.

There are two main concerns after getting a tick bite, says Pat Salber, MD. One is an infection arising from the breaking of the skin, itself, which allows bacteria from the skin to contaminate the open wound. The other is disease. But for a tick to actually transmit a tick-borne illness, it needs to be attached for about 24 hours, says Walter Schrading, MD, director of the UAB’s Office of Wilderness Medicine and associate professor in UAB’s School of Medicine. To protect yourself from ticks, Dr. Schrading recommends using insect repellents containing DEET or permethrin and wearing long pants and socks if tick habitats including the woods and brushy areas cannot be avoided. After spending time in the woods or thick-brushy areas, you should always check for ticks. Dr. Salber explains exactly how:

Take off all your clothes and look over every part of your body from head to toe. That means standing in front of a mirror to check your backside as well. Be sure to carefully run your fingers through your hair as well, looking in the mirror as you do. Having a partner’s eyes on you as well, can be helpful. If your dog went with you on the hike, he deserves a thorough tick check as well. Ticks come in all sizes, some can be quite small and some can be large if they have are engorged from just having finished a blood meal.

If you see a tick, “remain calm,” advises Jorge Parada, MD, medical advisor for the National Pest Management Association, but you’ll also want to remove it immediately and completely. As for how to remove a tick, Dr. Parada offers the following method:

Gently pull back any hair from around the tick, exposing the skin near the tick/bite. Locate the head of the tick, grasp it as close to the skin as possible using fine-tipped tweezers and gently squeeze. Do not grab the tick’s body, as this can increase the chance of injecting the tick’s blood into the skin. Pull outward in a straight motion until the pressure pulls out the head of the tick. Do not twist or wiggle the tick, as that may tear the head off, leaving it lodged in the skin.

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“If the mouth parts break off, leave them alone because your body will expel them on their own,” advises Dr. Salber, and whatever you do, don’t try to dig them out because that’s a recipe for a bacterial skin infection. Removing ticks should always be followed by hand-washing and cleansing the bite area with soap and water, rubbing alcohol or an iodine solution (to avoid bacterial infection). What you should not do is try to burn the tick off of your skin with a match or paint it with nail polish, according to Jeremy Allen, MD, a physician with American Family Care. They don’t work for removing ticks and are merely old wive’s tales.

There is some disagreement among experts about whether it is useful to save the tick for testing for specific tick-borne illness, but it is widely accepted that it can be helpful to take photos or be prepared to describe the tick in order to identify the species in order to narrow down which illnesses you may be at risk for. For example, Lyme disease is transmitted only by deer ticks.

You don’t necessarily need to see your doctor after removing a tick, but if you believe that the tick was a deer tick and was attached to you for a period of 24 hours or thereabouts, your doctor may be willing to prescribe a prophylactic antibiotic (200 mg of doxycycline within 72 hours after the bite) according to Joshua Zeichner, MD, a dermatologist in New York. Even if you don’t see your doctor immediately, you should continue to observe the site of the bite for the expanding redness, which would suggest the characteristic rash associated with Lyme disease, says Dr. Salber. “The salmon-colored rash expands over a few days to weeks and can get as big as eight inches in diameter. It may eventually become clear in the center, creating what is known as a “bulls-eye” lesion.” Nearly 80 percent of people with Lyme disease develop this rash, so if you see it, you need to see a doctor quickly because Lyme disease can be treated effectively when caught early. If not, Lyme disease can develop into a chronic illness.

These are the states where you should be most concerned about Lyme disease.



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