What kills a subcutaneous tick? - briefly
Topical acaricides—permethrin, ivermectin cream, or benzyl benzoate—effectively eradicate ticks embedded beneath the skin, and surgical removal with sterile forceps under local anesthesia provides immediate elimination. Prompt treatment prevents further tissue damage and infection.
What kills a subcutaneous tick? - in detail
A tick that has migrated beneath the epidermis cannot be removed with standard tweezers; it must be exterminated in situ. Effective strategies include:
- Topical acaricides – permethrin 5 % cream or spray applied directly over the lesion penetrates the skin and kills the parasite within hours. Ivermectin 1 % lotion is another option, acting systemically after transdermal absorption.
- Systemic therapy – oral ivermectin (200 µg/kg single dose) reaches the tick through the bloodstream, leading to paralysis and death within 24–48 h. Doxycycline is not acaricidal but prevents bacterial transmission while the tick is dying.
- Cryotherapy – a brief application of liquid nitrogen or a cryoprobe freezes the surrounding tissue, destroying the tick’s body and mouthparts. The procedure must be performed by a clinician to avoid excessive skin loss.
- Surgical excision – under local anesthesia, a dermatologist incises the skin, extracts the entire tick, and sutures the wound. Complete removal eliminates the parasite and reduces the risk of secondary infection.
- Laser ablation – pulsed-dye or CO₂ lasers vaporize the tick’s cuticle and internal structures. The method requires specialized equipment and experienced personnel.
Adjunct measures:
- Clean the area with antiseptic before and after treatment.
- Monitor for signs of local inflammation, necrosis, or systemic illness.
- Administer a prophylactic antibiotic (e.g., doxycycline 100 mg twice daily for 10 days) if the tick species is known to carry Lyme‑borrelia or other pathogens.
Choosing the appropriate approach depends on the tick’s location, depth, patient age, and available medical resources. In most cases, a clinician‑prescribed topical acaricide or a single oral dose of ivermectin provides rapid eradication with minimal tissue damage. Surgical removal remains the definitive option when pharmacologic methods fail or when precise histopathologic assessment is required.