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Tick bites: What are ticks and how can they be removed?

Created: ; Last Update: April 25, 2019; Next update: 2022.

Contrary to popular belief, ticks are not insects – they are spider-like arachnids. Adult ticks have eight legs, a round body, and are just a few millimeters in diameter. When ticks feed on blood, their bodies can swell up quite a bit.

The castor bean tick is the most commonly found tick in Europe. These ticks mostly feed on the blood of host animals like rodents and deer. The blood of the host animals may contain germs, which are then transferred to the feeding ticks and can be passed on to humans later on.

Ticks survive the winter by living underground. As soon as it gets warmer than 8 degrees Celsius (about 46 degrees Fahrenheit), they become more active again and start looking for hosts to feed on – both animals and humans. Ticks are usually active from March to November – mostly in forests, meadows, parks and gardens. They prefer warm and moist places, and often seek out bushes and grass or spots near the edge of paths or in undergrowth.

It is widely believed that ticks drop down on you from trees, but that's not true. Instead, they usually attach to you when you brush against them, often while walking through tall grass or shrubs. Dogs and outdoor cats commonly pick up ticks because they often walk through undergrowth and shrubs.

How do ticks bite?

When ticks have found a host to feed on, they usually look for areas of soft skin. They don't normally bite right away, and sometimes wander around the body for several hours. The ticks then often end up around your hairline, behind your ears or in folds of skin. Once a tick has found a suitable place to feed, it uses its mouth-parts to cut through the host’s skin, inserts a feeding tube (which also serves as an anchor) into the wound and then feeds on blood until it is full.

It doesn't hurt when a tick latches on to your skin and feeds. If you don't find the tick and remove it first, it will fall off on its own once it is full. This usually happens after a few days, but it can sometimes take up to two weeks. Like when you have a mosquito bite, your skin will usually become red and itchy near the tick bite. People often only notice that they have a tick once their skin starts to itch.

Removing ticks

If a tick has attached itself to your skin, it's important to remove it as soon as possible. Doing so will lower your risk of getting Lyme disease.

Special tools are available for removing ticks, including tick tweezers, tick-removal cards and hook-like instruments. These tools are shaped to make it easy to slide them between the tick and your skin without squeezing the tick. You can find these kinds of aids in pharmacies, for example.

Normal tweezers can also be used, as long as the tips of the tweezers bend inwards. If the tips are flat, the tick will be squeezed when you try to get hold of it. This should generally be avoided, because then germs could be squeezed out of the tick and into your body.

Illustration: Removal of a tick using a tick removal card – as described in the article

A tick-removal card can be used as follows:

  • Slide the tick-removal card between the skin and the tick.
  • Push the tick out of the skin, keeping the card close to the skin.
  • Do not try to pull the tick out of the skin using the card. Otherwise it will slip through the slit in the card.

Illustration: Removal of a tick using tick tweezers – as described in the article

Removal of a tick using tick tweezers

(Tick) tweezers can be used as follows:

  • Get hold of the tick with the tweezers as close to the bite as possible.
  • Then gradually pull it out, being careful not to squeeze it too much with the tweezers.
  • If the tick doesn't come out, twisting it slightly can help. It doesn't matter which direction you twist it in.

If you don't have the right tool, you could also try to remove the tick using your fingernails. It is important to get hold of the tick’s head as close to the skin as possible, and avoid squeezing it with your fingers.

Once you have removed the tick, you can disinfect the nearby skin – for instance, with alcohol – and inspect the area to see whether you managed to remove all of the tick. If the mouth-parts are still stuck in your skin you might see a small black dot, which a doctor can then remove. Mouth-parts that are left behind can sometimes lead to a small inflammation, but are usually harmless.

People used to recommend trying to suffocate the tick by putting things like nail polish, glue, toothpaste, alcohol or oil on it. But it can take a very long time for ticks to fall off that way, so it may even increase the risk of infection.

Should you watch the bite afterwards?

Even once the tick has been successfully removed, it's important to keep an eye on the bite in the following weeks. If a circular red skin rash appears, it may be a sign of Lyme disease. Then you need to see a doctor. The same is true if you develop flu-like symptoms such as fever or aching joints. If the flu-like symptoms occur after only one or two weeks, it could also be a TBE infection – but that is rare.

Sources

  • Bayrisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL). Erkrankungen durch Zeckenstiche: FSME. February 14, 2019.
  • Robert-Koch-Institut (RKI). RKI-Ratgeber: Lyme-Borreliose. March 01, 2013.
  • IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

    Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. We do not offer individual consultations.

    Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

© IQWiG (Institute for Quality and Efficiency in Health Care)
Bookshelf ID: NBK279240

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