Lyme Disease and Ticks: Separating Myth From Guidance
Lyme Disease and Ticks: what people commonly get wrong, set against what published US guidance says.
Caught early it is usually treated with a short course of antibiotics, but missed infections can spread to the joints, heart and nervous system.
Key takeaways
- Tick that spreads it: blacklegged (deer) tick
- Attachment usually needed to spread infection: 36 to 48 hours or more
- Most useful single change: Use an EPA-registered repellent with DEET, picaridin, IR3535, oil of lemon eucalyptus, PMD or 2-undecanone.
- Commonest mistake: Using nail polish, petroleum jelly or heat to make a tick detach.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
What the guidance actually says
These are the numbers the corrections below are measured against.
| Measure | Figure |
|---|---|
| Tick that spreads it | blacklegged (deer) tick |
| Attachment usually needed to spread infection | 36 to 48 hours or more |
| Typical rash | an expanding red rash in about 70 to 80% of infections, 3 to 30 days after the bite |
| Highest-risk regions | the Northeast, mid-Atlantic and upper Midwest |
| Killing ticks on dry clothes | tumble dry on high heat for 10 minutes |
Where people go wrong
Each of these is common, and each is a mistake in the sense that the guidance says otherwise.
- Using nail polish, petroleum jelly or heat to make a tick detach
- Waiting for a bull's-eye rash; many rashes are solid red
- Applying permethrin directly to skin
What to do instead
- Use an EPA-registered repellent with DEET, picaridin, IR3535, oil of lemon eucalyptus, PMD or 2-undecanone
- Treat boots, clothing and gear with 0.5% permethrin, or buy pre-treated clothing
- Shower soon after coming indoors and check your whole body, children and pets for ticks
- Remove an attached tick with fine-tipped tweezers, pulling upward with steady pressure, then clean the area
The part that is genuinely uncertain
Guidance changes, and it changes because evidence does. The figures above reflect current US guidance from the bodies named at the foot of this page; where those bodies revise their position, theirs is the account to follow rather than this one.
Related topics
- The Evidence on Antibiotics, Without the Hype (Immunity)
- What the Guidance Really Says About Malaria Prevention (Travel Health)
- What the Guidance Really Says About Athlete's Foot (Foot Health)
- Common Childhood Infections: What the Evidence Actually Says (Children's Health)
Where to go next
- Lyme Disease and Ticks: A Beginner-Friendly Start
- A Q and A on Lyme Disease and Ticks
- Lyme Disease and Ticks — the reference entry
- Infectious Diseases: The Complete Guide
- The Evidence on West Nile Virus and Mosquitoes, Without the Hype
- What the Guidance Really Says About Norovirus
When to speak to a doctor
See your doctor if you develop a rash, fever, chills, headache, fatigue or joint aches in the weeks after a tick bite, and tell them where you have been. Call 911 for chest pain, fainting, a very slow or irregular heartbeat, or sudden weakness or drooping of the face.
Where this comes from
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.
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