How to treat subcutaneous ticks and which medications to use? - briefly
Remove the embedded tick using sterile forceps or a small incision, then cleanse the site with antiseptic. Administer doxycycline 100 mg orally twice daily for 7–10 days as first‑line therapy, or amoxicillin 500 mg three times daily for patients unable to take doxycycline.
How to treat subcutaneous ticks and which medications to use? - in detail
Subcutaneous ticks embed their mouthparts beneath the skin, creating a localized pocket that can harbor pathogens and provoke inflammation. Prompt extraction and appropriate pharmacologic support reduce the risk of infection and alleviate tissue reaction.
First‑line removal involves sterile technique: disinfect the area, grasp the tick’s mouthparts with fine forceps, and apply steady traction parallel to the skin surface. Avoid twisting or crushing the body to prevent saliva release. After extraction, cleanse the site with an antiseptic solution and apply gentle pressure to stop bleeding.
Pharmacologic interventions fall into three categories:
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Topical agents
- 1% permethrin cream applied once daily for three days; effective against residual larvae and reduces secondary bacterial colonization.
- Mupirocin 2% ointment twice daily for five days; treats localized Staphylococcus aureus or Streptococcus pyogenes infections.
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Oral antibiotics
- Doxycycline 100 mg orally twice daily for ten days; first‑line for suspected tick‑borne bacterial diseases such as Lyme disease, ehrlichiosis, and anaplasmosis.
- Amoxicillin‑clavulanate 875/125 mg orally twice daily for seven days; alternative when doxycycline is contraindicated (e.g., pregnancy, children under eight).
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Systemic antiparasitics
- Ivermectin 200 µg/kg orally as a single dose; indicated for persistent dermal inflammation or when multiple embedded ticks are present.
Adjunctive care includes non‑steroidal anti‑inflammatory drugs (e.g., ibuprofen 400 mg every six hours) to control pain and swelling, and antihistamines (cetirizine 10 mg daily) for allergic reactions. Patients should monitor the site for expanding erythema, fever, or flu‑like symptoms and seek medical evaluation if these develop within two weeks.
Documentation of the tick’s species, removal date, and any adverse reactions assists clinicians in tailoring follow‑up and reporting to public health authorities.