Which antibiotics should be taken after a tick bite?

Understanding Tick Bites and Potential Risks

Identifying the Tick Bite

A tick bite often appears as a small, red papule or a puncture wound surrounded by a faint halo. The entry point may be difficult to see if the tick has detached, but a raised, erythematous lesion, sometimes with a central dark spot representing the tick’s mouthparts, is typical. Look for the following indicators:

Localized redness or swelling at the bite site
A raised, itchy bump or a flat rash expanding outward
Presence of a tiny black dot or a tiny, engorged tick attached to the skin
Tenderness or mild pain around the area

The duration since the bite influences the risk of infection. Record the date of exposure, the geographic region where the bite occurred, and whether the tick was identified as a known disease vector. Prompt recognition of these signs enables timely medical evaluation and selection of an appropriate antimicrobial regimen.

Diseases Transmitted by Ticks

Lyme Disease

A tick bite can transmit Borrelia burgdorferi, the bacterium that causes Lyme disease. Early infection typically manifests as erythema migrans, fever, fatigue, and arthralgia. Prompt antimicrobial therapy reduces the risk of disseminated disease and long‑term complications.

For patients with confirmed or suspected early Lyme disease, the first‑line oral regimens are:

Doxycycline 100 mg twice daily for 10–21 days (adults and children ≥8 years).
Amoxicillin 500 mg three times daily for 14–21 days (children, pregnant or lactating women, doxycycline‑intolerant patients).
Cefuroxime axetil 500 mg twice daily for 14–21 days (alternative for doxycycline intolerance).

When neurologic involvement, carditis, or severe arthritis is present, intravenous therapy is indicated:

Ceftriaxone 2 g daily for 14–28 days.

A single 200 mg dose of doxycycline administered within 72 hours of a tick bite may be used as prophylaxis if the tick was attached for ≥36 hours, the local infection rate exceeds 20 %, and there are no contraindications.

Adjustments are required for renal impairment, hepatic disease, or known drug allergies. Monitoring for adverse effects—such as gastrointestinal upset, photosensitivity, or Clostridioides difficile infection—is essential throughout treatment.

Other Tick-Borne Illnesses

Tick bites can transmit a range of bacterial infections beyond the most common Lyme disease. Recognizing these agents is essential for selecting appropriate antimicrobial therapy after exposure.

Common tick‑borne bacterial illnesses include:

Anaplasmosis – caused by Anaplasma phagocytophilum; symptoms often involve fever, headache, and muscle aches.
Ehrlichiosis – caused by Ehrlichia chaffeensis or related species; presents with fever, fatigue, and leukopenia.
Rocky Mountain spotted fever – caused by Rickettsia rickettsii; characterized by fever, rash, and possible organ dysfunction.
Tularemia – caused by Francisella tularensis; may produce ulcerative skin lesions, lymphadenopathy, or pneumonia.
Bartonellosis (cat‑scratch disease) – occasionally transmitted by ticks; leads to lymphadenitis and fever.

Antibiotic regimens for these infections are largely overlapping, allowing a single therapeutic approach in many cases. Doxycycline, administered at 100 mg twice daily for 10–14 days, is the first‑line agent for anaplasmosis, ehrlichiosis, and Rocky Mountain spotted fever. It also covers tularemia and Bartonella spp. in most clinical scenarios. In patients with contraindications to doxycycline (e.g., pregnancy, severe allergy), alternative options include:

Azithromycin for anaplasmosis and ehrlichiosis.
Ciprofloxacin for tularemia when doxycycline cannot be used.
Gentamicin for severe tularemia or when rapid bactericidal activity is required.

Choosing the appropriate antimicrobial depends on the identified or suspected pathogen, patient age, pregnancy status, and drug tolerance. Empiric doxycycline remains the most practical choice when multiple tick‑borne illnesses are possible, providing coverage for the majority of bacterial agents transmitted by ticks.

When to Consider Antibiotic Treatment

Factors Influencing Treatment Decisions

Time Since Bite

The interval between attachment and removal determines whether prophylactic therapy is indicated and which agents are appropriate. If the bite occurred within 72 hours and the tick is identified as a potential vector for Borrelia burgdorferi, a single dose of doxycycline (200 mg) is recommended. Treatment beyond 72 hours loses proven efficacy for preventing Lyme disease and should not be initiated solely for prophylaxis.

When the bite is older than 72 hours but signs of infection appear (e.g., erythema migrans, fever, arthralgia), a full therapeutic course is required. Recommended regimens include:

Doxycycline 100 mg orally twice daily for 10–21 days (first‑line for adults and children ≥8 years).
Amoxicillin 500 mg orally three times daily for 14–21 days (alternative for doxycycline‑intolerant patients or pregnant women).
Cefuroxime axetil 500 mg orally twice daily for 14–21 days (alternative for those unable to take doxycycline or amoxicillin).

For patients presenting with severe systemic involvement or late manifestations, intravenous ceftriaxone 2 g daily for 14–28 days is indicated. Choice of agent must consider age, pregnancy status, allergy history, and renal function. Prompt initiation after symptom onset improves outcomes, regardless of the elapsed time since the bite.

Tick Identification

Identifying the tick species that has bitten a patient is a prerequisite for selecting an appropriate antimicrobial regimen. Different ticks transmit distinct pathogens; the choice of prophylactic or therapeutic antibiotics depends on the vector’s known disease profile.

Key morphological traits distinguish the most common human‑biting ticks in North America:

Ixodes scapularis (black‑legged tick) – small, reddish‑brown body; long, slender mouthparts; visible scutum only on the anterior dorsal surface of unfed females; legs relatively short.
Dermacentor variabilis (American dog tick) – larger, brown‑orange body; ornate scutum covering the entire dorsal surface; legs noticeably longer than those of Ixodes.
Amblyomma americanum (lone star tick) – dark, reddish‑brown body; white, star‑shaped spot on the female’s dorsal shield; legs long and robust.

Species identification directly influences antibiotic recommendations. For bites from Ixodes ticks, a single 200 mg dose of doxycycline within 72 hours of attachment reduces the risk of Lyme disease. Bites from Dermacentor or Amblyomma ticks, which may transmit Rocky Mountain spotted fever or ehrlichiosis, require a full 5‑day doxycycline course initiated promptly after diagnosis. Alternative agents (e.g., amoxicillin) are reserved for patients with contraindications to tetracyclines.

Practical steps for accurate identification:

Remove the tick with fine‑tipped tweezers, grasping near the mouthparts.
Place the specimen in a sealed container with a damp cotton swab.
Capture a high‑resolution photograph from dorsal and ventral views before preservation.
Compare the images to validated identification keys or submit to a reference laboratory.
Document the bite date, duration of attachment, and geographic location.

Accurate species determination enables clinicians to apply evidence‑based antimicrobial protocols, minimizing unnecessary treatment while preventing severe tick‑borne infections.

Geographic Location and Endemic Areas

Geographic distribution determines the spectrum of tick‑borne pathogens and therefore the optimal prophylactic or early‑treatment antibiotic. In regions where Borrelia burgdorferi predominates, a single 200 mg dose of doxycycline administered within 72 hours of removal reduces the risk of Lyme disease. In the United States, the Northeast, Upper Midwest, and parts of the Pacific Northwest are classified as high‑incidence Lyme zones; doxycycline is the drug of choice for adults and children older than eight years. For pregnant patients and children under eight, a five‑day course of amoxicillin (500 mg three times daily) is recommended instead of doxycycline.

In Europe, especially central and northern countries such as Germany, Sweden, and the Czech Republic, Borrelia afzelii and Borrelia garinii are common. Doxycycline remains first‑line, but cefuroxime axetil (250 mg twice daily for ten days) is an accepted alternative for those who cannot tolerate tetracyclines.

Asian endemic areas, including parts of Japan, China, and Korea, present a broader pathogen mix that may include Rickettsia spp. and Anaplasma phagocytophilum. Doxycycline (100 mg twice daily for ten days) covers both Lyme‑like spirochetes and rickettsial agents, making it the preferred empiric choice.

A concise reference:

United States (Northeast, Upper Midwest, Pacific Northwest): doxycycline 200 mg single dose; amoxicillin for pregnancy/young children.
Europe (central/northern): doxycycline 100 mg twice daily 10 days; cefuroxime axetil as alternative.
Asia (Japan, China, Korea): doxycycline 100 mg twice daily 10 days; covers Borrelia, Rickettsia, Anaplasma.

Local health‑authority guidelines may adjust dosages or duration based on resistance patterns and patient‑specific factors; clinicians should consult regional protocols before prescribing.

Prophylactic Antibiotics

Specific Guidelines for Prophylaxis

Prophylactic antibiotic recommendations after a tick attachment focus on preventing Lyme disease in high‑risk exposures.

The following conditions justify a single‑dose regimen:

Tick attachment duration ≥ 36 hours.
Exposure in a region where ≥ 20 % of ticks are infected with Borrelia burgdorferi.
No known contraindication to the recommended drug.
Prompt presentation, within 72 hours of tick removal.

The preferred agent is doxycycline, administered as a single oral dose of 200 mg. This dose must be taken as soon as possible after the bite, but no later than 72 hours post‑removal. Doxycycline is effective against the common Lyme pathogen and has a favorable safety profile for adults and children ≥ 8 years.

For patients who cannot receive doxycycline—such as children under 8 years, pregnant or lactating women, or individuals with a doxycycline allergy—alternative options include:

Amoxicillin 2 g orally, single dose, for adults; 50 mg/kg for children.
Cefuroxime axetil 1 g orally, single dose, for adults; 30 mg/kg for children.

These alternatives should be administered within the same 72‑hour window.

Patients with known severe hypersensitivity to penicillins or cephalosporins should avoid amoxicillin and cefuroxime; consult a clinician for a tailored regimen.

After prophylaxis, monitor for erythema migrans, fever, chills, headache, arthralgia, or fatigue. If any symptoms develop, initiate a full therapeutic course of doxycycline (100 mg twice daily for 14–21 days) or an appropriate alternative, regardless of prior single‑dose prophylaxis.

Documentation of the bite, species identification when possible, and the administered prophylactic dose are essential for ongoing clinical assessment.

Risks and Benefits of Prophylaxis

Prophylactic antibiotics are administered after a tick attachment to prevent infection with tick‑borne pathogens, primarily Borrelia burgdorferi, the cause of Lyme disease. The recommendation applies when the tick has been attached for ≥36 hours, the bite occurred in a region with high incidence of Lyme disease, and the patient is not allergic to the drug.

Benefits

Reduces the probability of developing early Lyme disease by approximately 80 % when a single dose of doxycycline is given within 72 hours of removal.
Decreases the need for subsequent diagnostic testing and longer treatment courses.
Provides immediate protection for individuals with limited access to medical care in endemic areas.

Risks

Gastrointestinal upset, including nausea and vomiting, occurs in up to 10 % of recipients.
Photosensitivity reactions may develop, requiring avoidance of prolonged sunlight exposure.
Rare but serious adverse events such as esophageal ulceration, severe allergic reactions, and, in pregnant women, potential fetal effects necessitate alternative agents.
Overuse contributes to antimicrobial resistance, diminishing the effectiveness of doxycycline for future infections.

The decision to initiate prophylaxis balances these advantages against the likelihood of adverse effects and the epidemiological risk of infection. Clinical judgment should incorporate the duration of attachment, local disease prevalence, patient age, pregnancy status, and known drug hypersensitivities.

Recommended Antibiotics for Tick Bites

Doxycycline

Dosage and Duration

After a tick exposure, clinicians usually prescribe doxycycline for prophylaxis or early treatment of Lyme disease. The standard adult dose is 100 mg taken orally twice daily. Therapy lasts 10 days when used solely as preventive medication; if early infection is confirmed, a 21‑day course is recommended.

When doxycycline is contraindicated, amoxicillin or cefuroxime serve as alternatives. Adult amoxicillin is administered at 500 mg three times daily, while cefuroxime axetil is given at 250 mg twice daily. Both regimens are continued for 21 days in confirmed infection; a 10‑day course may be used for prophylaxis, though evidence favors doxycycline.

Pediatric dosing requires weight‑based calculation. Doxycycline: 4.4 mg/kg twice daily (maximum 100 mg per dose) for 10 days (prophylaxis) or 21 days (treatment). Amoxicillin: 50 mg/kg/day divided into three doses for 21 days. Cefuroxime: 30 mg/kg/day divided into two doses for 21 days.

Key points for all regimens:

Initiate therapy within 72 hours of bite for prophylactic effect.
Ensure adherence to the full prescribed duration to prevent relapse or resistance.
Adjust dose for renal impairment or hepatic dysfunction as per prescribing information.

Contraindications and Side Effects

After a tick bite, prophylactic antibiotics such as doxycycline, amoxicillin, or cefuroxime are commonly prescribed. Their use must be evaluated against patient‑specific contraindications and potential adverse reactions.

Contraindications

Doxycycline: pregnancy, lactation, children younger than eight years, known hypersensitivity to tetracyclines, severe hepatic impairment.
Amoxicillin: documented penicillin allergy, previous anaphylactic reaction to β‑lactams, severe renal dysfunction without dose adjustment.
Cefuroxime: allergy to cephalosporins or cross‑reactive penicillin allergy, severe hepatic disease, concomitant use of drugs that prolong the QT interval.

Side Effects

Doxycycline: photosensitivity, gastrointestinal upset, esophageal irritation, rare intracranial hypertension, reversible tooth discoloration in children.
Amoxicillin: diarrhea, nausea, rash, Stevens‑Johnson syndrome, Clostridioides difficile infection.
Cefuroxime: injection‑site pain (intravenous), elevated liver enzymes, hypersensitivity rash, hemolytic anemia in patients with glucose‑6‑phosphate dehydrogenase deficiency.

Clinicians should verify medical history, assess liver and kidney function, and monitor for early signs of adverse reactions before initiating therapy.

Amoxicillin

When Amoxicillin is Preferred

Amoxicillin is the first‑line oral agent for preventing early Lyme disease when the tick is identified as a carrier of Borrelia burgdorferi and the bite occurred within the previous 72 hours. The drug is preferred in patients who can tolerate penicillins and have no contraindications such as severe allergy.

Typical scenarios for choosing amoxicillin include:

Adult or pediatric patients (≥ 5 years) with a confirmed or highly suspected Ixodes tick bite and no signs of disseminated infection.
Cases where doxycycline is unsuitable, for example in pregnant or breastfeeding women, children under eight, or individuals with photosensitivity.
Situations where rapid oral dosing is required and intravenous therapy is unnecessary.

If the patient presents with a macular rash, neurological symptoms, or cardiac involvement, a broader spectrum antibiotic or intravenous regimen may be indicated instead of amoxicillin.

Dosage and Duration Considerations

After a tick bite, antibiotic therapy must be calibrated to the agent, patient age, weight, and clinical indication. Dosage and treatment length directly affect efficacy and resistance risk.

For adults, doxycycline is the preferred choice. The standard regimen is 100 mg taken twice daily for 10–14 days. In children weighing at least 15 kg, the same dose applies; for those under 15 kg, 2.2 mg per kilogram of body weight, administered twice daily, is recommended for the same duration.

Alternative agents are used when doxycycline is contraindicated. Typical schedules include:

Amoxicillin: 500 mg three times daily for 10 days (children: 50 mg/kg/day divided into three doses).
Cefuroxime axetil: 500 mg twice daily for 10 days (children: 30 mg/kg/day divided into two doses).

When prophylaxis is indicated—e.g., a bite by a nymphal Ixodes species in an endemic area, attachment time exceeding 36 hours, and no contraindication to doxycycline—a single 200 mg dose of doxycycline should be administered within 72 hours of removal.

Duration may be extended beyond the standard 10 days if:

Early localized or disseminated infection develops.
Neurological or cardiac manifestations appear.
Renal impairment requires dose adjustment and monitoring.

Weight‑based calculations, renal function, and the presence of rash or gastrointestinal intolerance dictate modifications to the base regimens, ensuring therapeutic levels are maintained throughout the prescribed course.

Cefuroxime Axetil

Alternative Options

After a tick bite, prophylactic doxycycline is the standard choice for preventing Lyme disease when the tick is engorged, attached for more than 36 hours, and the bite occurs in a high‑incidence region. When these criteria are not met or doxycycline cannot be used, alternative approaches are appropriate.

A low‑risk exposure can be managed by:

Immediate removal of the tick with fine‑tipped tweezers, grasping close to the skin and pulling steadily upward.
Thorough cleaning of the bite site with antiseptic solution.
Daily inspection of the area for rash, fever, or joint pain for up to 30 days.
Use of over‑the‑counter analgesics or antipyretics to control discomfort.
Documentation of the bite date, location, and tick characteristics for future reference.

When antibiotic therapy is contraindicated (allergy, pregnancy, pediatric age < 8 years), options include:

Azithromycin 500 mg on day 1, followed by 250 mg daily for four additional days, as an alternative for Lyme prophylaxis.
Amoxicillin 500 mg three times daily for 10 days, suitable for children and pregnant patients.
Close clinical follow‑up with prompt initiation of therapy if early Lyme symptoms appear.

In regions where Lyme disease incidence is low, or when the tick is removed within 24 hours, observation without antimicrobial agents remains a validated strategy, provided that the patient receives clear instructions for symptom monitoring and seeks medical evaluation at the first sign of illness.

Specific Situations for Use

Antibiotic therapy after a tick bite is reserved for defined clinical scenarios; routine treatment is unnecessary when the bite is recent and the patient shows no signs of infection.

Bite from a tick species known to transmit Lyme disease in a region with documented incidence, and the tick remained attached for ≥ 36 hours.
Removal of an engorged tick that has fed for ≥ 24 hours, regardless of species, when the patient is immunocompromised or pregnant.
Development of erythema migrans or other characteristic skin lesions within ≤ 30 days of the bite.
Evidence of co‑infection risk (e.g., Anaplasma, Babesia) in areas where these pathogens are prevalent.
Onset of cellulitis, severe local inflammation, or systemic symptoms such as fever, chills, or arthralgia shortly after the bite.
History of prior inadequate prophylaxis or treatment failure for Lyme disease.

For prophylaxis in the first three situations, a single 200 mg dose of doxycycline administered within 72 hours of tick removal is recommended. When doxycycline is contraindicated—children younger than 8 years, pregnant or lactating women—amoxicillin 500 mg three times daily for 10 days or cefuroxime 500 mg twice daily for the same duration are appropriate alternatives. Established infection with erythema migrans or systemic involvement requires a full 10‑day course of doxycycline (100 mg twice daily) or the amoxicillin/cefuroxime regimens described above. Timing of the initial dose is critical; delayed initiation reduces prophylactic efficacy.

Important Considerations and Next Steps

Monitoring for Symptoms

Early Signs of Infection

Recognizing the initial manifestations of infection after a tick bite is essential for selecting an effective antimicrobial regimen. Early clinical clues appear within days to weeks and guide the decision to initiate therapy promptly, reducing the risk of complications.

Typical early indicators include:

Expanding red rash, often oval and gradually enlarging (erythema migrans)
Localized swelling or tenderness at the bite site
Fever, chills, or sweats
Headache, fatigue, or general malaise
Muscle or joint aches, especially in the lower back or knees
Swollen regional lymph nodes
Occasionally, a small ulcer or vesicle at the attachment point

When these signs emerge, empirical treatment should target the most likely pathogens transmitted by the tick, primarily Borrelia species, with doxycycline as the first‑line option for adults and children over eight years. For patients unable to receive doxycycline, alternatives such as amoxicillin or cefuroxime axetil are appropriate. Prompt initiation based on the presence of the listed early symptoms improves outcomes and minimizes progression to disseminated disease.

Delayed Symptoms

After a tick bite, some infections do not manifest immediately. Delayed symptoms usually appear days to weeks later and may signal the need for antimicrobial treatment.

Typical delayed manifestations include:

Erythema migrans: expanding red rash, often with central clearing, appearing 3‑30 days post‑bite.
Fever, chills, headache, and muscle aches developing 1‑2 weeks after exposure.
Joint pain, particularly in large joints, emerging weeks to months later.
Neurological signs such as facial palsy, meningitis‑like headache, or peripheral neuropathy, occurring weeks after the bite.
Cardiac involvement, including heart block or myocarditis, presenting within a month.

These clinical patterns correspond to infections such as Lyme disease, anaplasmosis, ehrlichiosis, and, less frequently, spotted fever rickettsioses. Early recognition of delayed symptoms guides the selection of antibiotics.

First‑line oral therapy for most tick‑borne bacterial infections is doxycycline, administered for 10‑21 days depending on the disease. For patients unable to tolerate doxycycline, amoxicillin (for Lyme disease) or a macrolide (for certain rickettsial infections) may be used. Intravenous ceftriaxone is reserved for severe neurological or cardiac complications.

Prompt initiation of the appropriate antibiotic after the appearance of delayed symptoms reduces the risk of chronic manifestations and improves outcomes. Monitoring for symptom progression during treatment remains essential.

Consulting a Healthcare Professional

Importance of Medical Evaluation

A prompt medical assessment after a tick bite determines whether prophylactic therapy is warranted and identifies early manifestations of infection. Clinicians examine the bite site, record the tick’s species and attachment time, and evaluate for erythema migrans or systemic symptoms. Laboratory testing, such as serology, may be ordered when the presentation is ambiguous.

Based on the evaluation, the provider selects an appropriate antibiotic regimen, dosage, and duration. For most adult patients with confirmed exposure, a single dose of doxycycline is recommended; alternatives such as amoxicillin or cefuroxime are prescribed for children, pregnant women, or those with contraindications.

Factors influencing antibiotic choice

Tick species known to transmit Borrelia burgdorferi
Attachment duration exceeding 36 hours
Presence of rash, fever, or joint pain
Patient age, pregnancy status, and allergy history

Accurate assessment prevents unnecessary medication, reduces the risk of resistance, and ensures timely treatment of emerging infection.

Diagnostic Testing

After a tick attachment, diagnostic testing determines whether antimicrobial therapy is required and which agent will be most effective. The decision hinges on detection of pathogen exposure, disease stage, and risk of complications.

Key laboratory methods include:

Serologic assay for Borrelia antibodies – enzyme‑linked immunosorbent assay (ELISA) followed by Western blot confirmation; identifies early‑localized and disseminated Lyme disease.
Polymerase chain reaction (PCR) – detects bacterial DNA in blood, cerebrospinal fluid, or tissue; useful for early infection when antibodies are not yet present.
Culture – rarely performed for Borrelia due to low sensitivity; occasionally employed for other tick‑borne agents such as Ehrlichia or Rickettsia.
Complete blood count and inflammatory markers – reveal leukocytosis or elevated C‑reactive protein, supporting systemic infection.

Interpretation of results guides antibiotic selection. A positive Borrelia serology in the early stage typically warrants doxycycline for 10–21 days; a confirmed disseminated infection may require a longer course or alternative agents such as amoxicillin for patients unable to tolerate doxycycline. Positive PCR for Anaplasma or Ehrlichia directs therapy toward doxycycline, while a confirmed Rickettsial infection also calls for doxycycline. Negative test results, coupled with low clinical suspicion, usually lead to observation without antimicrobial treatment.

Preventing Future Tick Bites

Protective Measures

Ticks can transmit bacterial infections that may require antibiotic treatment. Reducing exposure to ticks lowers the likelihood of needing medication after a bite.

Wear long sleeves and long trousers; tuck shirts into pants and pant legs into socks.
Apply EPA‑registered repellents containing DEET, picaridin, or IR3535 to skin and clothing.
Perform systematic tick inspections after outdoor activities; examine scalp, behind ears, underarms, and groin.
Remove attached ticks promptly with fine‑pointed tweezers; grasp close to the skin, pull upward with steady pressure, and disinfect the bite site.
Maintain yard by clearing tall grass, leaf litter, and brush; create a barrier of wood chips or mulch between lawn and wooded areas.
Keep pets on veterinary‑approved tick preventatives; check animals for ticks before they enter the home.

These actions constitute the primary preventive strategy, minimizing the need for antibiotic intervention following a tick encounter.

Tick Repellents

Tick repellents reduce the likelihood of tick attachment, thereby lowering the probability of bacterial transmission and the subsequent need for antimicrobial treatment after a bite. Effective repellents create a chemical barrier that deters questing ticks from climbing onto skin or clothing.

Commonly recommended repellents include:

DEET (N,N‑diethyl‑meta‑toluamide) at concentrations of 20–30 % for skin application; provides up to 8 hours of protection.
Picaridin (KBR 3023) at 20 % concentration; comparable efficacy to DEET with less odor.
IR3535 (ethyl butylacetylaminopropionate) at 20 % for skin; effective against several tick species.
Oil of lemon eucalyptus (OLE) containing 30 % p‑menthane‑3‑ol; effective for up to 6 hours.
Permethrin 0.5 % for clothing and gear; long‑lasting after multiple washes, unsuitable for direct skin contact.

Application guidelines:

Apply skin repellents evenly, covering all exposed areas, avoiding eyes and mouth.
Treat outdoor clothing, socks, and hats with permethrin; allow treated items to dry before wearing.
Reapply skin repellents according to label instructions, especially after swimming or heavy sweating.
Use repellents on children according to age‑specific recommendations; avoid products not approved for pediatric use.

While repellents do not replace medical evaluation after a tick bite, consistent use markedly diminishes the risk of infections such as Lyme disease, reducing the necessity for prophylactic antibiotics.