Treatment and Prevention
Treatment:
Antibiotics: Experts used to believe that even in areas with many cases of Lyme disease, the majority of deer ticks were not infected with the bacteria so the risk of infection after such a bite was relatively low. Infection rates are now estimated to be as low as 2% or as high as 90% depending on the tick species and region. In general, however, routine use of antibiotics to prevent Lyme disease is not recommended.
For people who require treatment for a mild infection associated with Lyme disease, the doctor usually prescribes an antibiotic to be taken by mouth for 14 to 21 days. Such antibiotics include doxycycline* (for adults, children over 8 years of age, and non-pregnant women), amoxicillin (for children and pregnant women who are not allergic), and cefuroxime or erythromycin (for people who are allergic or cannot tolerate the first 2 antibiotics).
For people who require treatment for more severe infections associated with Lyme disease, the doctor usually prescribes an intravenous (given through the vein) antibiotic (e.g., ceftriaxone, cefotaxime, penicillin) for 2 to 4 weeks. For persistent infections, 3 months of intravenous antibiotics may be necessary. On occasion, treatment with an oral (by mouth) antibiotic may be prescribed following treatment with an intravenous antibiotic.
If the tick is identified and removed within 72 hours of the bite, and assuming that no skin rash is present, the doctor may consider prescribing only a single 200 mg dose of doxycycline to be taken by mouth. This treatment has been shown to help prevent the rash from developing.
Inflammation of the brain and neurologic symptoms will usually clear up once the antibiotics have killed the bacteria.
Anti-inflammatory and pain medications: Aspirin* or nonsteroidal anti-inflammatory drugs (NSAIDs) can usually control swelling and pain in the joints. In cases where aspirin or an NSAID cannot be tolerated or the person is allergic, the doctor may prescribe acetaminophen.
Heart medications: For people with heart problems due to Lyme disease, medications for regulating heart rate may be recommended. In more severe cases, surgery may be required to install a pacemaker device.
Prevention:
You can help prevent Lyme disease if you know what to look for. The tick digs its mouth into the skin and feeds for 2 or 3 days before dropping off. Evidence suggests that the bacteria are transmitted towards the end of this process. If you spend days in the woods, you should wear long pants, socks, a hat, and a long-sleeved shirt to reduce the chances of tick bites. As an extra precaution, put tape around the area where your pants and socks meet.
If you spend several days outdoors in areas that might contain ticks, inspect yourself daily, once you're indoors. Check your skin carefully for ticks, and ask someone to check your scalp for ticks. If a tick has already latched on to you, don't panic. Even if the tick is infected, it isn't likely to transmit the bacteria causing Lyme disease before 36 hours of tick attachment.
Other things you can do include:
- If possible, stay away from tick-infested areas, especially in May, June, and July.
- Stay in the middle of hiking trails and try not to brush against grasses or leaves.
- Wear light-colored clothes to make it easy to spot ticks "hitching a ride" on you.
- Spray your clothes and exposed skin (except your face) with an insect repellent that contains DEET, or treat clothes with the insect repellant permethrin, which kills ticks on contact.
Tick removal:
The best way to remove a tick is with a drinking straw and a piece of thread. Tie a single knot in the thread and wrap it loosely around the straw. Put the straw at a 45-degree angle over the tick on the skin. Slide the thread down to the skin and tighten the knot around the tick's mouthparts. Remove the straw, and gently pull upwards with the thread. Pull the tick straight out firmly and steadily. Be patient, as proper tick removal will take time.
Some experts do not recommend using fine-point tweezers to remove the tick because they will usually crush the tick's mouthparts. Crushed ticks do not survive for very long after removal, so the bacteria that cause Lyme disease will also die quickly. Even if a person has already been infected with Lyme disease, the tests on the tick will be falsely negative.
Do not squeeze the tick's body, apply petroleum jelly or alcohol, or use a hot match, nail polish, or other products while the tick is attached. These actions could transmit the Lyme disease-causing bacteria to you.
After you've carefully removed the tick, cleanse the area with an antiseptic (e.g., alcohol) or mild soap and water. Wash your hands thoroughly with soap and water. You should also have tick bites examined by a doctor, especially if you develop a rash or flu-like symptoms.
If the tick has been removed alive, you should then place it in a container (e.g., a small jar) with a piece of moist gauze or paper towel on top so it will stay alive until you can get it to your doctor to have it tested for carrying Lyme disease. If the tick dies, the bacteria will die and the test will be falsely negative.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.