So, you found a tick attached to your little one’s skin during bath time. Or maybe there’s a bullseye-shaped rash blossoming on their skin, and you’ve heard it’s a telltale sign of Lyme disease. Now what?

First, you’re well within your rights to feel creeped out! But don’t panic. Not every tick bite transmits Lyme disease.

For instance, the chances that the tick was carrying Borrelia burgdorferi—the microbe most commonly associated with Lyme disease—range from 0% to 50%, depending on the type of tick and how long it was attached. What’s more, an acute case of Lyme is highly treatable with a short round of antibiotics.

That said, there are some things you should know and steps you should take, especially if the tick is still attached, or if your kiddo is showing signs of illness or has a weakened immune system. Let’s start with getting rid of the little offender, and work our way through to treatment if it becomes necessary.

How to remove a tick from a child’s skin—the right way

You’ll find many suggestions online for removing a tick, including burning the tick or slathering it with Vaseline to suffocate it. The reality is that most of these methods don’t work, and can agitate the tick and cause it to regurgitate its contents into your bloodstream, increasing the risk of infection with Lyme or another tick-borne illness. (Not to mention, putting a flame anywhere near an anxious child’s skin is practically guaranteed to result in a burn.)

To properly remove a tick once it has latched on, follow these three simple steps:

  1. Use a pair of fine-pointed tweezers. Place them as close to your skin as possible and grasp the tick’s mouth.
  2. Firmly pull the tick straight out of the skin.
  3. Wash the bite with soap and water.

The sooner you remove a tick, the lower the risk for infection. Though it’s not known exactly how long it takes for a tick to transmit Lyme, some experts suggest it could be as little as six hours.

For further guidance on how to remove a tick, check out this video from the University of Manitoba.

Consider the type of tick

There are hundreds of different species of ticks in the world. The good news is, they don’t all carry Borrelia burgdorferi, the bacteria associated with Lyme disease. The not so good news: All ticks carry microbes, some of which can cause Lyme or other concerning illnesses.

Here are six ticks to be on the lookout for in the states., plus the microbes and illnesses to be most aware of:

  • Black-Legged Deer Tick: Found throughout the Eastern United States, it’s most common in the Northeastern, Mid-Atlantic, and North-Central U.S. These ticks carry Borrelia (Lyme), as well as Ehrlichia—a bacteria that can cause Ehrlichiosis, an infection characterized by fever, chills, headache, and muscle aches that requires antibiotics.
  • The Western Black-Legged Tick: These ticks reside on the Pacific U.S. coast, particularly in northern California. They transmit Lyme and Anaplasmosis, which has similar symptoms to Lyme and calls for antibiotics.
  • The Lone Star Tick: Most common in the Southern U.S., it extends out to Oklahoma and Texas, and in the Mid-Atlantic extending up into the Northeastern U.S. The Centers for Disease Control (CDC) calls this a “very aggressive tick” toward humans, and it’s distinguishable by the “lone star” or white dot on its back. Lone Star ticks transmit Ehrlichiosis and STARI (Southern Tick-Associated Rash Illness), a Lyme disease-like syndrome, as well as alpha-gal syndrome, a recently identified condition characterized by a potentially life-threatening allergy to red meat. See your doctor immediately if you are concerned about a severe allergic reaction.
  • The American Dog Tick: It has the most common distribution in the mid-states east of the Rockies, and it can transmit Rocky Mountain Spotted Fever (RMSF), a potentially deadly illness characterized by fever, headache, and rash. RMSF requires early treatment with an antibiotic, so see a doctor immediately if you suspect it.
  • Rocky Mountain Wood Tick: Another carrier of RMSF, as well as tularemia — a potentially life-threatening infection that can usually be successfully treated with antibiotics. This tick is found in the Rocky Mountain states.
  • Brown Dog Tick: This tick transmits RMSF and can be found worldwide, but is most commonly found in the Southwestern U.S. and along the U.S.-Mexico border.

Ticks can be tough to identify, especially when they’re nymphs—tiny immature ticks that are less than 2mm big and very difficult to see at all. Not to mention, the majority of people who get bit by a tick don’t ever see the tick or know they were bitten unless symptoms arise.

If you do find the tick and want to have it tested for pathogens, talk with your child’s pediatrician about their thoughts. You may be able to mail it to labs like IGeneX to see if it carries harmful microbes.

Watch for signs + symptoms of Lyme disease

The telltale sign of Lyme disease is the classic bullseye or EM (Erythema Migrans) rash, with the tick bite in the center and a red ring surrounding the bite. But while the EM rash is only associated with a Borrelia infection, it’s important to note that it occurs in only two-thirds of cases, and sometimes you don’t see it because it’s hidden under your child’s hair.

Early symptoms of Lyme disease mimic a mild viral syndrome, making it ever-so-important to identify the connection with a tick bite, especially in young children.

Common symptoms of an acute Lyme infection include:

  • Low-grade fever
  • Occasional chills
  • Fatigue
  • Stiff neck
  • Rash around the tick bite
  • Transient muscle aches

The very best defense against developing illness from a tick bite is a healthy immune system. If your child’s immune system is doing its job, post-bite symptoms are mild or even non-existent. In the absence of any symptoms, the official guidelines offered by the CDC do not recommend testing or treatment for a tick bite.

What to do if you suspect Lyme disease

When symptoms do occur, the CDC recommends two-tiered testing, which includes an initial screening test (ELISA), followed by a Western blot test for confirmation. If the test is positive, the CDC recommends starting antibiotic treatment, although the formal criteria for initiating antibiotic treatment are not made clear.

Unfortunately, by the time symptoms are present, and tests are positive, the microbes are well dispersed and deeply buried in tissues, making antibiotics less effective. What’s more, the CDC guidelines don’t account for the possibility of other tick-borne microbes in general. I’ve seen this frequently in my medical practice, where patients were treated with antibiotics and developed symptoms months or even years later.

If you’re shaking your head in frustration, you’re not alone. No one seems to have the perfect answer to the problem, and I know this can leave parents in a real quandary about how to best protect their child. The solution I’ve come up with over many years of seeing Lyme disease patients provides redundant layers of protection.

Your best bet is to consult with your pediatrician as well as a Lyme disease specialist in your area. They can provide you with the best options for your specific scenario.

Here’s what I have chosen to do:

For a symptomatic tick bite, I generally recommend a course of antibiotics, as per CDC guidelines. I usually don’t recommend antibiotics for a tick bite without symptoms—not because I don’t think microbes have been transmitted, but because it indicates that your child’s immune system is working properly and will keep the microbes in check on its own.

Symptoms or no, herbs are also at the top of my recommendation list. Though no formal clinical studies have been done, herbs known to have antimicrobial properties are quietly gaining popularity as the most effective and reliable solution for chronic Lyme disease. The antimicrobial properties found in herbs such as cat’s claw, andrographis, garlic, and Japanese knotweed are a perfect match for suppressing the types of microbes transmitted by ticks. These herbs are very safe, can be taken by children, and can be used for prolonged periods without concern for harm. I recommend herbs for several weeks to months for any and every tick bite, starting at the time of the bite. If you are interested in trying these, speak with your pediatrician.

They help support immune system functions, and again, a healthy immune system is the best protection against chronic infection. Add to that a healthful diet, a clean environment with minimal exposure to toxins, low stress, and an active lifestyle, and you’ll go a long way toward reducing the incidence of Lyme and other tick-borne illnesses, as well as all chronic illnesses, in your little ones.

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