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Injury Prevention and Safety

Tick bite - head still inside

06/19/2006

Question:

A tick was removed from me, BUT my husband was not able to get the tick`s head out. The area has slightly swollen and has not gone down or gone away after two weeks. It is not discolored or have any pus, but rather itches. Will the tick head go away on its own or will it get into my blood stream and cause me problems? Can you please tell me what to do...I really don`t want to make an unnecessary office visit if this will resolve on it`s own. THANKS!

Answer:

The tick head has reverse harpoon-like barbs that attach the tick firmly and the mouth has secreted a cement-like substance to hold the mouth parts in place. This accounts for why it is so difficult to remove completely. The head parts really will not get into your body, thankfully. Also, the red bump and itching at the attachment site is just a local reaction to a foreign protein in the skin and not a sign of systemic illness. Another happy fact is that if your husband removed the tick within 7-10 hours of its attachment to you, there is very little chance of the tick transmitting Lyme Disease or any other illness to you.

This is a tough question because there is no standard strategy. You have already waited two weeks. So you can keep waiting, disinfecting the site with alcohol or betadine 2-3 times per day and applying diphenhydramine 2% cream to relieve the itch until the head parts fall out on their own. The other alternative is your husband could attempt removal by first applying detergent to a cotton ball and rubbing it in a circular motion over the mouth parts to loosen the tick cement holding the head in place; then taking a clean needle, wiping it with alcohol, and attempting to lift out the tick head parts.

Most importantly, you should write down the date the tick was discovered and partially removed and then monitor yourself for symptoms of tick-borne illness. These include the flu-like symptoms of fever, malaise, headache, neck stiffness, and rash other than at the site of tick attachment. If you have these symptoms, you should contact your doctor and tell him the date you were bitten by the tick. Prompt treatment limits the disease. Also, preventive treatment in the absence of symptoms has not proven helpful.

I hope this information is helpful. I know waiting and seeing what happens is not easy.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University