It's warming up in the Pioneer Valley, which means it's high tick season!

How to prevent tick bites before you go out
Following these simple steps can prevent ticks from attaching:

Avoid Direct Contact with Ticks

  • If possible, avoid tick-infested areas or areas you believe may be infested with ticks.
  • If unavoidable, plan activities involving tick habitat for the hottest, driest part of the day.
  • Avoid walking through wooded and brushy areas with tall grass and leaf litter.
  • Walk in the center of mowed or cleared trails to avoid brushing up against vegetation.

Dress Appropriately

  • Wear light-colored clothing to make ticks easier to detect.
  • Wear long pants tucked into socks or boots and tuck your shirt into your pants to keep ticks on the outside of your clothes.
  • Do not wear open-toed shoes or sandals when in potential tick habitat.

Use Tick Repellents

  • Use products that contain 20% picaridin to treat clothing. It can also be safely applied to skin (just avoid the hands and face). It works great against mosquitos as well.
  • Use 0.5% permethrin to treat clothing and gear. Do not apply permethrin directly to your skin.
  • The use of repellents that contain 20-30% DEET on exposed skin and clothing can effectively repel ticks (and mosquitos) for several hours.
  • Other tick repellents recommended by the Centers for Disease Control and Prevention (CDC) include oil of lemon, eucalyptus (not for use on children under 3 years of age), and IR3535.
  • When using repellents, always follow label directions.

How to check for ticks when you return home

  • Check your clothing for ticks. Ticks may be carried into the house on clothing. Any ticks that are found should be removed. Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors. If the clothes are damp, additional time may be needed. If the clothes require washing first, hot water is recommended. Cold and medium temperature water will not kill ticks.
  • Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and daypacks.
  • Shower soon after being outdoors. Showering within two hours of coming indoors has been shown to reduce your risk of getting Lyme disease and may be effective in reducing the risk of other tickborne diseases. Showering may help wash off unattached ticks and it is a good opportunity to do a tick check.
  • Check your body for ticks after being outdoors . Conduct a full body check upon return from potentially tick-infested areas, including your own backyard. Use a hand-held or full-length mirror to view all parts of your body. Check these parts of your body and your child’s body for ticks.

Clipart image of a woman illustrating where on the body to look for ticks: in and around the hair, in and around ears, under the arms, inside belly button, between the legs, back of the knees

Make sure to do tick checks daily. But if you do find a tick attached to your skin, there's no need to panic!

How to remove a tick once it has attached
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. Don't twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove everything easily with clean tweezers, leave it alone and let the skin heal.
  3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, 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.

Clipart image showing how to remove an embedded tick with a pair of tweezers.

Ticks enlarge as they get engorged. The longer a tick is attached the larger it will get, until it is full and drops off. A tick can only transmit disease when it has been attached long enough to be engorged (typically 36-72 hours).

How do I know what kind of tick it is?
Scutums and Festoons!
Deer ticks (the species that can transmit Lyme disease) have a black scutum and no festoon. Dog ticks (which cannot treansmit Lyme disease, but can transmit other diseases) have a mottled scutum that resembles a watermellon seed, and a festoon. See the photos below, and get aquianted with these critters (and these great crossword puzzle terms!).

Now what?
The likelihood of developing an illness from a tick bite is low if the tick was attached for less than 36 hours and is not engorged. While you do not need to see us for every tick bite, please call if you develop a rash or fever between 3 and 30 days of removing a tick, and then make sure to tell us about the recent tick bite. We'll want to know:

  1. When the bite occurred
  2. When the tick was removed
  3. What kind of tick it is (keep the tick in a zip-locked plastic bag or take a clear photo for us)
  4. Whether the tick is engorged

Should I or my child be treated after a tick bite?
While most tick bites have a very low likelihood of transmitting Lyme diease, under certain cicrumstances the risk is considerably higher, approaching 25-30%. Under the following tick bite circumnstances, it may be beneficial to receive a single dose of an antibiotic called doxycycline to prevent Lyme disease (note that all of these conditions must be met in order for this antibiotic to be prescribed):

  1. Lyme disease is common in the area in which the tick bite occured ( i.e., CT, DE, MA, MD, ME, MN, NH, NJ, NY, PA, RI, VA, VT, WI)
  2. The attached tick can be identidied as an adult or nymphal deer tick ( i. scapularis )
  3. The estimated time of attachment is ≥ 36 hours based on the degree of tick engorgement with blood or likely duration of tick attachment
  4. The antibiotic can be started within 72 hours of tick removal
  5. The antibiotic doxycycline is not contraindicated (ie. no allergy or other reason the antibiotic cannot be given. Note: no other antibiotic is approved for Lyme prevention following a tick bite)

If all of the above criteria are met, you will need to be seen by an Amherst Pediatrics provider before doxycycline will be prescribed.

How do I know if my child has Lyme disease?
First of all, don't panic! Most tick bites do not result in Lyme disease or other tick-bourne illnesses. And only adult or nymphal deer ticks can transmit Lyme. Also, Lyme disease is typically easy to diagnose and treat. Let us know if you have any of the following signs or symptoms, particularly within 3-30 days of a known tick bite:

  • Fever
  • Chills
  • Headache
  • Fatigue
  • Joint and/or muscle aches
  • Swollen lymph nodes
  • Lyme rash (erythema migrans) - this is a ring-like or linear rash that appears at the site of a tick bite between 3-30 days of the bite. The rash enlarges for several days and can become quite large. It is NOT present at the time of the bite. This is important to remember, because all insect bites can cause an initial reaction which is often confused with a Lyme rash. These reactions tend to fade within a few days, whereas the Lyme rash continues to enlarge.
    >> Click here to see photos of the Lyme rash

Later signs of Lyme disease include:

  • Severe headache or neck stiffness
  • Lyme rash appearing elsewhere on the body
  • Joint pain and swelling
  • Facial palsey (drooping of one side of the face)
  • Heart palpitations
  • Dizziness
  • Shortness of breath
  • Pain, numbness, or tingling of hands and feet
  • Unexplained behavioral or memory changes

If you have any concerns or additional questions about tick bites or Lyme disease, you can check out the following web sites or give us call.

CDC - Lyme Disease Website

Ticks - KidsHealth Website

TIcks and Lyme Disease - HealthyChildren website

Contact Us

Our Address
31 Hall Dr.
Amherst, MA 01002
Tel: (413) 253-3773
Fax: (413) 256-0215
Email: [email protected]

Please note temporary office hours
during the COVID-19 pandemic

Patient Care Hours:
8:00 AM - 4:45 PM: In-office and MyChart Telehealth visits
4:45 PM - 6:00 PM: MyChart Telehealth visits only

8:00 AM - 12:00 PM: MyChart Telehealth visits only

The COVID-19 situation is ever unfolding. We are dedicated to the safety of our patients and staff. Please refer to our website for updates on this changing situation.

* Please note: It is our policy that we do not approve referral requests for visits to outside urgent care centers during times that our office is open.

We are open for urgent visits only on most Holidays. However, our office is closed on the following holidays:

- New Year's Day
- Easter Sunday
- Memorial Day
- July 4th
- Labor Day
- Thanksgiving Day
- Christmas Day

For urgent concerns, you can always reach an on-call provider, even when our office is closed.