What should be applied to the skin for subcutaneous ticks? - briefly
«Apply a topical acaricide such as permethrin 5 % cream to the affected area, then extract the tick with fine forceps.» «For deeply embedded specimens, a local anesthetic cream can be used prior to removal.»
What should be applied to the skin for subcutaneous ticks? - in detail
For ticks embedded beneath the epidermis, the recommended skin regimen includes three sequential actions.
First, immobilize the parasite with a fine‑pointed, non‑slipping forceps. Grasp the tick as close to the skin as possible, pull upward with steady pressure, and avoid crushing the body.
Second, cleanse the puncture site immediately after removal. Apply an antiseptic solution such as 70 % isopropyl alcohol or povidone‑iodine, allowing it to remain for at least 30 seconds before drying.
Third, protect the area with a topical agent that deters re‑infestation and prevents secondary infection. Effective options are:
- Permethrin 5 % cream or lotion, applied thinly and left for 8–12 hours before washing off.
- Picaridin gel (20 % concentration), spread over the surrounding skin and left to evaporate.
- A broad‑spectrum antibiotic ointment (e.g., bacitracin or mupirocin) applied after the antiseptic has dried, especially if the wound shows signs of irritation.
If the tick bite occurred in a region where Lyme disease or other tick‑borne illnesses are prevalent, a single oral dose of doxycycline (200 mg) may be prescribed within 72 hours of removal; however, this is a systemic measure, not a topical one.
Regular application of a repellent containing DEET (20–30 %) or permethrin‑treated clothing reduces the likelihood of subsequent subcutaneous attachment. Maintenance of skin hygiene and prompt inspection after outdoor exposure are essential components of an effective preventive strategy.