Skip to main content

Summer time advice

You are toweling off after a shower and notice a tick. What should you do? First remove it. The best way is with a removal tool that looks like an ice cream scoop with a v notch-works very well and easily found. If not available, simple traction with tweezers. If not completely removed, an allergic reaction may recur, which may result in the parts having to be surgically removed. Do you have to worry? Depends.

The most common infection caused by ticks (deer ticks) is Lyme’s disease. For infection to occur, the tick must be attached for 36-72 hours. Less time almost precludes infection. Blood tests for Lyme’s disease can be inaccurate for recent infections, but become very accurate for infections over 2 months old. How do you know if infected ?-the vast majority of people do not have any symptoms-for example, the Lyme rash (bullseye) is not unique to Lyme’s disease and is only seen in 20% of patients infected. Any rash is suspicious, as are any constitutional symptoms (i.e. flu-like).

Early treatment ranges from 1-3 days up to 3 weeks, depending upon when the bite occurs and treatment begins (earlier is easier to treat). Chronic Lyme disease can be difficult to treat. Doxycycline is the treatment of choice, but can cause severe sun hypersensitivity reactions (sunburn). Amoxicillin is used in children and pregnant women. Unfortunately, there are many other conditions caused by different ticks in different regions. Relapsing fever is seen in the Western US. Rocky Mountain Spotted Fever (wood tick) is seen in the East/Southwest US.

Erlichiosis and Alpha Gal allergy(not an infection but an allergy to ANY meats consumed, causing severe itching/hives) from lone star tick, seen in Southern Atlantic/South Central US. Tularemia is seen in the Southeast, South Central and Western US. Viral infections include Powassan virus (deer tick virus) and febrile illness (lone star tick fever) - the latter seen in Missouri/Tennessee. Colorado tick fever is seen in Western US, and a hemorrhagic fever is seen in Europe and Africa. Protozoan infections include Babesiosis (Northeast and Western US) and Cytauxzoonosis from the dog tick, seen in South/Southeast US. Finally, there is “tick paralysis” caused by a toxin.

Due to the warm winter, 2017 has been a banner year for tick bites. So, what do you do? Removing the tick as soon as you can is critical, but does not prevent all diseases. Any symptoms should by promptly reported to your physician as soon as possible. A Lyme blood test is needed if there is a history of >/= 36 hours of exposure or multiple bites. There are usually 2 tests needed, one to check for exposure up to 2 months prior to the test, and repeated 2 months later. Perhaps an annual test thereafter. Treatment depends upon length of time after bite, the sooner after the bite the easier the treatment. Any rash or symptoms usually require initiation of therapy.

Prevention is the best policy. Avoid high grassy areas/wooded areas. Long pants to cover tops of shoes/socks and bloused. Apply 100% DEET to clothes (NOT SKIN) and regular DEET to exposed areas, and check your skin as soon as you can after coming home from such areas. Report bites and symptoms to your physician.

Posted on

You Might Also Enjoy...

I have these Brown Spots

We get a lot of questions about brown spots. Dr. Berger discusses what causes them and what can be done about them.


So, you have a tattoo. Now that you have “grown up” you want it gone, or are just tired of it. What to do? Tattoos are injection of ink into the upper level of the skin(dermis).


There has been a lot of news recently regarding sunscreens, demonstrating a lot of confusion about what they are and how they work.

Skin Cancer Awareness Month

Each year the summer season is kicked off each May by way of the skin cancer awareness month. The first Monday of May is designated Melanoma Monday.

Hair Loss

You have noticed that your hair is getting thinner- is it because Uncle Joe or Aunt Jane had thin hair, or some other reason? What can you do about it? The most common cause of hair loss, by far and away, is the “inherited” type, or androgenic alopecia.

Dry Skin/Eczema

Now that the summer is fading, time to review the changes the fall will bring to your skin. Sometime about mid-October, the humidity will drop from it’s oppressive high to more comfortable levels.