Concord Pediatrics, P.A.
248 Pleasant St. Suite 1700
Concord, NH 03301

Phone: (603) 224-1929

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Choosing a pediatrician is an important and personal decision and we want you to feel at ease with the care you and your child will receive.

My child has a tick attached to their skin! What should I do?

If you find a tick attached to you or your child's skin, there's no need to panic.  Read through the information below. If you have additional concerns or questions, please call our office.

1. Remove the tick.

There are several tick removal devices on the market, but a plain set of fine-tipped tweezers will remove a tick quite effectively.

  1. Use fine-tipped tweezers to grasp the tick as close to the skin's surface as possible.

  2. Pull upward with steady, even pressure. (See image here.)  Don't twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin.

    • If pieces of the tick remain in the skin, gently try to remove them with clean tweezers. If you are unable to easily remove the pieces easily with tweezers then leave them.  Do not worry; this does not increase the risk of Lyme Disease. Wash the site, and apply Bacitracin or Polysporin antibiotic ointment (over-the-counter) for 1 to 3 days- the body will naturally push the remaining pieces out as the skin heals. Monitor the site and call our office if you are concerned your child might have a local skin infection (if the bite area becomes red, swollen, or painful).

  3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol or soap and water.

  4. Dispose of a live tick by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet. Never crush a tick with your fingers.

Avoid folklore remedies such as "painting" the tick with nail polish or petroleum jelly, or using heat to make the tick detach from the skin. Your goal is to remove the tick as quickly as possible–not to wait for it to detach.

2. After you remove the tick:

  1. Wash the bite area gently and apply Bacitracin or Polysporin antibiotic ointment (over-the-counter) to the bite area daily for a few days while it heals. Monitor the site and call our office if you are concerned your child might have a local skin infection (if the bite area becomes red, swollen, or painful).

  2. Please note: A small (1 to 2 inch) red or purple area at the tick site in the first 24 hours is a typical local reaction and does not mean a person has Lyme Disease. If that reddish area continues to expand or becomes painful after the first 48-72 hours, please make an appointment for you child so we can evaluate the rash.

  3. In some cases a single prophylactic or prevention dose of doxycycline (an antibiotic) may be appropriate after a tick bite. Our office follows guidance from the CDC, AAP, and NH DHHS, based upon the evidence based guidelines from the Infectious Disease Society of America.  Prophylaxis with Doxycycline may be appropriate if your child if they had an engorged  (very swollen/full of blood) deer tick attached to their skin. This medication is only effective for "prevention of Lyme" if given within 72 hours of removal of the tick.  Please call our office at (603) 224-1929 to make an appointment or with any concerns or questions.  Currently there is limited safety data on the use of Doxycline for children under 8 years of age.  Based on 2018 guidelines Doxyclycline may be considered for both prophylaxis and treatment in patients of any age, including those under 8.  Your provider can discuss the best clinical course for your child.  There are several effective antibiotic treatment regimens (options for children with antibiotic allergies) for children in all age groups if Lyme Disease is diagnosed.

  4. Monitor your child (winter, spring, summer, and fall!) for signs and symptoms of Lyme Disease.  If your child develops a rash (anywhere on the body- not just at a bite site), a painful,, red, or swollen joint, a prolonged fever, or a headache that persists, see your doctor.

3. Should I get the tick tested?

People who have removed a tick often wonder if they should have it tested.  

You can read more about tick testing at the NH Department of Health and Human ServicesThe New Hampshire Department of Agriculture, Markets and Food offers free tick identification to New Hampshire residents. The intent is to monitor the distribution of tick species in NH. Ticks submitted will not be tested for disease-causing pathogens.

In general, testing of individual ticks is not useful because:

  • If the test shows that the tick contained disease-causing organisms (and chances are, a deer tick in NH will!), that does not necessarily mean that you have been infected.

  • If you have been infected, you will probably develop symptoms before results of the tick test are available. You should not wait for tick testing results before beginning appropriate treatment.

  • Negative results can lead to false assurance. For example, you may have been unknowingly bitten by a different tick that was infected.

However, you may want to learn to identify various ticks. Different ticks live in different parts of the country and transmit different diseases.

4. Learn about tick bite prevention and go back outside and enjoy nature in New Hampshire!

Read more about ticks and Lyme Disease online at the CDC and Check out this Tick Bite Fact Sheet from the NH DHHS.

Some tips for avoiding tick bites:

  • Stay on trails outdoors; avoid areas of overgrown brush and tall grasses.

  • Wear light-colored clothing so ticks can be easily seen.

  • Wear long pants, a long-sleeved shirt, closed toe shoes with socks, and a hat. Tuck your pants into your socks and your shirt into your pants.

  • Check yourself, your children, and your pets often for ticks (at bedtime and in the morning!), shower after returning indoors.

  • Use insect repellent containing DEET or permethrin (always follow directions).

  • After returning indoors, run clothes in the dryer on high heat to kill any ticks that may be on the clothing.

Create a Tick-safe Zone to Reduce Ticks in the Yard

The Connecticut Agricultural Experiment Station has developed a comprehensive Tick Management Handbook[PDF – 8.53 MB] for preventing tick bites. Here are some simple landscaping techniques that can help reduce tick populations:

  • Remove leaf litter.

  • Clear tall grasses and brush around homes and at the edge of lawns.

  • Place a 3-ft wide barrier of wood chips or gravel between lawns and wooded areas to restrict tick migration into recreational areas.

  • Mow the lawn frequently.

  • Stack wood neatly and in a dry area (discourages rodents).

  • Keep playground equipment, decks, and patios away from yard edges and trees.

  • Discourage unwelcome animals (such as deer, raccoons, and stray dogs) from entering your yard by constructing fences.

  • Remove old furniture, mattresses, or trash from the yard that may give ticks a place to hide.

Questions or Comments?
We encourage you to contact us whenever you have an interest about our services.

Call (603) 224-1929

248 Pleasant St. Suite 1700
Concord, NH 03301