What should be done after a tick bite if a red spot and itching appear, and which treatment should be chosen? - briefly
Remove the tick promptly, clean the bite area with antiseptic, then apply a topical corticosteroid or take an oral antihistamine to control itching; if fever, expanding rash, or exposure to Lyme‑risk areas is noted, seek medical care for possible antibiotic therapy such as doxycycline.
What should be done after a tick bite if a red spot and itching appear, and which treatment should be chosen? - in detail
After a tick attachment, first extract the arthropod with fine‑point tweezers, grasping as close to the skin as possible and pulling straight upward. Disinfect the bite site with an antiseptic solution such as povidone‑iodine or alcohol. Observe the area for at least 24 hours.
If a localized erythema develops together with pruritus, take the following actions:
-
Symptomatic relief
- Apply a low‑potency corticosteroid cream (e.g., 1 % hydrocortisone) to reduce inflammation and itching.
- Administer an oral antihistamine (diphenhydramine 25 mg or cetirizine 10 mg) if itching is severe.
-
Infection control
- Inspect the lesion for signs of secondary bacterial infection: increasing warmth, purulent discharge, or expanding erythema.
- If infection is suspected, begin a short course of oral antibiotics targeting Staphylococcus aureus and Streptococcus pyogenes (e.g., cephalexin 500 mg three times daily for 7 days).
-
Lyme disease prophylaxis
- Determine the tick’s attachment duration; risk rises after ≥ 36 hours.
- When the tick is identified as Ixodes scapularis or Ixodes ricinus in a region with documented Lyme incidence ≥ 20 cases per 100 000, prescribe a single dose of doxycycline 200 mg within 72 hours of removal, provided the patient is not pregnant or allergic to tetracyclines.
-
Follow‑up
Prompt removal, proper wound care, and targeted therapy based on clinical signs minimize complications and ensure appropriate management of tick‑borne reactions.