How is a subcutaneous tick treated in humans? - briefly
The tick is extracted with fine forceps, grasping the mouthparts near the skin and pulling straight upward, followed by antiseptic cleansing of the site. If local inflammation or systemic symptoms appear, a short course of antibiotics (e.g., doxycycline) is administered.
How is a subcutaneous tick treated in humans? - in detail
A tick that has penetrated the dermis and remains beneath the skin requires prompt, sterile removal to prevent infection and transmission of pathogens. The clinician first confirms the presence of the embedded arthropod by visual inspection, often aided by magnification or dermatoscopy. If the tick is not visible on the surface, gentle palpation may locate the protruding mouthparts.
Removal proceeds with the following steps:
- Disinfect the surrounding skin with an appropriate antiseptic (e.g., 70 % isopropanol or chlorhexidine).
- Use fine‑pointed tweezers or a specialized tick‑removal hook to grasp the tick as close to the skin as possible, avoiding compression of the body.
- Apply steady, upward traction without twisting; the goal is to extract the entire organism, including the hypostome, in one motion.
- Inspect the extracted tick for completeness; any retained fragments warrant further removal with a sterile needle or scalpel.
- Clean the bite site again with antiseptic and cover with a sterile dressing if needed.
After extraction, assess the patient for signs of local inflammation, secondary bacterial infection, or systemic illness. Provide written instructions to monitor for fever, rash, joint pain, or neurologic symptoms over the next 2–4 weeks. If the tick species is known to transmit Lyme disease, Rocky Mountain spotted fever, or other vector‑borne illnesses, consider prophylactic antibiotic therapy according to regional guidelines—commonly a single dose of doxycycline (200 mg) for Lyme disease when removal occurs within 72 hours of attachment and the tick is identified as Ixodes scapularis.
Document the encounter, including the date of removal, tick identification (if possible), and any prescribed medication. Schedule a follow‑up appointment or advise the patient to seek medical attention promptly if any adverse symptoms develop.