A tick is a small brown or dark colored insect, often found attached to the skin (although you may see it crawling on clothing or skin if caught early). Dog ticks can be the size of an apple seed while deer ticks can be as small as a poppy seed. They frequent areas with many plants, like tall grassy spaces or heavily wooded environments. There are multiple ways to decrease the risk for a tick bite: wearing an insect repellent with Deet (20-30%) or wearing clothes pre-treated with permethrin can be deterrents to ticks. Also, it is recommended to wear clothes that cover the skin such as hats, long sleeve shirts, pants, and closed shoes. If clothing can be tucked in, this also makes it more difficult for ticks to get to the skin; tuck pants legs into socks and shirts into waistbands.
Ticks may appear very small and the bites are not often painful or itchy, making them easy to miss. For this reason, if you or your child are spending time outdoors near many plants, it is recommended to conduct routine body tick checks afterward. Although a tick bite can occur anywhere on the body (including the scalp), ticks are most commonly found on warm areas, such as the armpits, waistband, and behind the ears. If you find a tick on your child, follow these steps to remove the insect:
Using tweezers, grasp the insect by the head, as close to the child’s skin as possible. Steadily pull straight up without twisting or crushing the tick.
If you cannot grab the tick due to its small size, you may attempt removal by scraping it off of the skin with the edge of a credit card.
After the tick has been removed, wash the affected skin with soap and water, then apply an antibacterial ointment (such as Neosporin).
Lyme disease is one of the possible diseases that may be transmitted by ticks in Virginia. The risk for transmission is relatively low: about a 2% risk of developing lyme disease after a bite. Depending on the circumstances surrounding the tick bite and removal, prophylactic antibiotics may be considered for your child on a case-by-case basis. If you suspect the tick was attached to the skin for >36 hours or became engorged (three times its expected size), and was removed within the past 72 hours, call us to make an appointment for further evaluation. If your child has had a tick bite, monitor them for fever and/or a rash at the site of the bite, which can occur up to 4 weeks later. If your child has any concerning symptoms after a tick bite, they should be evaluated by a health care provider.
If you have concerns about a tick bite, but are not sure what to do next, check out the CDC Tick Bite Bot tool!
Healthy Children. (June 3, 2024). How to Remove a Tick. https://www.healthychildren.org/English/health-issues/conditions/from-insects-animals/Pages/how-to-remove-a-tick.aspx
American Academy of Pediatrics. (2023). Managing Infectious Diseases in Child Care and Schools: a Quick reference guide, 6th edition.