Ticks carrying blood-borne pathogens that can infect humans with serious diseases including Lyme Disease or Rocky Mountain Spotted Fever are present in all 48 contiguous United States. April through September is prime season for tick bites.

It’s critical to prevent tick bites on yourself and loved ones, including children and pets. Here are some best practices:

Prevention is Best

If you enjoy outdoor adventures including gardening, hiking, camping or fishing, be aware that you are heading into prime tick territory. Ticks frequent grassy, brushy or wooded areas and are even in your backyard, thanks to the birds, rodents and deer that bring them. And our beloved pets may even bring ticks inside to you. Ticks are creatures of opportunity with many pathways to making a warm-blooded human like you their next host! Don’t let them.

How to Avoid Ticks and Prevent Tick Bites

1. Avoid grassy, wooded or brush-filled areas where ticks are found, especially tall grass and areas covered in leaves.
2. When hiking, stay toward the center of trails to avoid contact with trees and brush.
3. It’s true that wearing long pants and sleeves are better than shorts or tank tops, but ticks will crawl as far as necessary to find and attach to a fold of skin. Long pants and sleeves deter but don’t prevent ticks. Tucking pants into socks is helpful, but it’s more effective to treat clothing with tick preventive products.
4. Treat clothing, boots and gear with a product that contains 0.5% permethrin, a compound produced from chrysanthemum flowers that repels ticks and kills them on contact. Permethrin-treated clothing will continue to protect through several washings. You can also buy pre-treated clothing and gear.
5. Use insect repellents registered with the EPA that contain DEET, picaridin, Oil of Lemon Eucalyptus (OLE), IR3535, 2-undecanone or para-menthane-diol (PMD). The EPA offers a search tool to find the ideal product for your needs. Never use insect repellent on babies younger than 2 months of age and never use OLE or PMD on children under 3 years old.
6. Consider EPA-approved natural repellents: 2-undecanone, garlic oil, nootkatone and mixed essential oils including rosemary, lemongrass, peppermint, thyme and geraniol.

Perform Mandatory Tick Checks When You Come Indoors

Ticks position themselves on grass and brush, standing on their back legs with front legs in the air, ready to grab potential hosts as you walk by. A thorough tick check upon coming inside is the only way to be sure you’re not their next meal. Here’s how:

1. Check your clothes. Remove clothing and check it for ticks. If you find any, flush them down the toilet. Put dry clothes in the dryer on high heat for 10 minutes to kill ticks. If clothes are damp, dry them even longer to ensure any ticks are killed. If you need to wash your clothes, use hot water, as cold or warm water won’t kill ticks.
2. Check gear and pets. Ticks will hitch a ride on anything they come in contact with, including backpacks, tents and pets.
3. Shower ASAP. Showering soon after coming indoors may reduce your risk of contracting Lyme or other tick-borne illness. The water helps wash ticks off and provides a good opportunity for a thorough tick check.
4. Do a full-body tick check. Use a hand mirror to view all areas of your body. Remember: ticks bite with an anesthetic and can’t be felt, enabling them to nestle in for a long blood meal. Seeing or feeling for them topically is the only way to know they’re there. Check your and your children’s bodies, especially in these areas:
   1. In or around ears, hair or hairline
   2. Under your arms
   3. Inside your belly button
   4. Behind the knees
   5. Between legs and in pubic region
   6. Around your waist

How to Remove an Attached Tick (Hint: Carefully)

Even with preventive measures, you still may find an attached tick. Ticks have evolved to feed on mammals stealthily, without us knowing. It happens. Here’s how to minimize potential disease implications:

1. Remove the tick immediately, but do so strategically. Never scratch, burn or pull a tick off with your fingers. Don’t douse it in alcohol or Vaseline. Those are urban myths that will likely cause more harm than good.
2. To properly remove an attached tick, use a pair of fine-tipped tweezers and apply gentle pressure as close to the tick’s head and your skin as possible. Don’t pull. The goal is for the tick to loosen its grip on its own, closing the channel between its gut—where bacteria that may carry Lyme Disease or Rocky Mountain Spotted Fever reside—and your body. Slowly pull the tick up and away as it disengages and put it in a tightly sealed plastic bag or jar with a moist towelette, keeping the tick alive so it can be identified and tested for parasites or bacteria if necessary.
3. If you’re unsure whether you removed the entire tick, see your health care provider. If a tick’s mouthparts remain in the body, or you squeezed too hard and the tick regurgitated, there is a higher risk for disease.
4. Closely watch the tick bite area for at least 30 days. Take photos and document any rash. An Erythema Migrans (EM) rash—also called a bulls-eye rash—is diagnostic of Lyme Disease. If you develop a rash, it may grow in size over time. Take daily photos as it progresses. See your health care provider—having a bulls-eye rash after a tick bite is diagnostic for Lyme Disease. That means the bacteria that causes Lyme Disease is present and you will require medical treatment.

The Role of Prophylactic Antibiotics After a Confirmed Tick Bite

If a tick was attached to you, document the exposure timeline and note any changes to your health. Symptoms of tick-borne infection may take from days to weeks to appear. Common symptoms include stiff neck, headache, night sweats, migrating joint pain, fever, new onset fatigue or flu-like symptoms. If any of these develop, see your health care provider.

Discuss the possibility of a prophylactic long course of antibiotics with your clinician. The International Lyme and Associated Diseases Society recommends a course of four to six weeks of the antibiotic doxycycline for cases where a confirmed tick bite caused an EM rash.