Everyone should avoid specific tick-infested areas, including tall grass, woods, and bushes where ticks tend to congregate. If this is not possible, people should take additional preventive measures. The U.S. Centers for Disease Control (CDC) also recommends:
- Use of tick repellent. Insect repellants that contain DEET are the most effective.
- Routine checks for ticks. Removal of infected ticks within 48 hours of attachment substantially reduces the likelihood of Lyme disease transmission.
- Prompt antibiotic prevention for high-risk tick bites. Although this method is controversial, the CDC concludes that it is probably beneficial.
- Removing brush and leaves. Such landscaping measures can reduce transmission rates by 50 - 90%.
- Applying pesticides to yards once or twice per year. This can decrease the number of ticks by 68 - 100%.
Protecting Property from Tick Infestation
Mowing the grass regularly, clearing away leaves, and placing wood chips as a barrier around a lawn can help greatly reduce the tick population.
Permethrin for the Lawn. Insecticides can significantly reduce tick infestation. Insecticides should be applied in late spring or early fall in a strip a few feet wide along the perimeter of the lawn where small animals are likely to enter or live.
The most commonly used insecticides are pyrethrins, which are compounds derived from the Chrysanthemum family. They are available as natural products or in synthetic forms (permethrin). They are poisons that affect the nerve system of insects. However, they are safe, particularly the natural products, and for humans and pets. All pyrethrins are highly toxic for certain fish and slightly toxic for birds, such as mallard ducks. Some people do experience an allergic reaction to them. As with all insecticides, there is some concern about the possible consequences of long-term exposure. But to date there is no evidence of any harm.
Cardboard tubes stuffed with permethrin-treated cotton are available in hardware stores. The tubes are placed where mice can find them (dense, dark brush) and collect the cotton for lining their nests. The pesticide on the cotton kills any immature ticks that are feeding on the mice. Best results are obtained with regular applications early in the spring and again in late summer.
Other Pesticides. Other tick-killing spray pesticides that have been used include those containing diazinon, chlorpyrifos, and carbaryl. Animal studies have reported severe toxic effects associated with these chemicals. Some of these chemicals are being phased out for home use. Parents should balance the effects of a very negligible risk for a highly treatable infection against excessive use of possibly harmful chemicals.
Protective Clothing in the Woods
Anyone who walks or camps in the woods during tick season should wear protective clothing, including:
- Light-colored clothing that makes it easier to spot ticks
- Long-sleeved shirts and long pants with cuffs tucked into shoes or socks (ticks can’t jump or fly but they do crawl upward)
- High boots, preferably rubber
Simply washing clothes will not kill ticks. After being outdoors, people should run their clothes through a dryer at high temperature for a half hour. Spraying clothes with solutions containing permethrin (Permanone, Duranon, and Permakill) provides additional protection. Keep in mind that these sprays should not be applied to the skin. Clothes should not be retreated with permethrin for 48 hours unless they have been washed after the first application.
DEET. Most insect repellents contain the chemical DEET (N,N-diethyl-meta-toluamide), which remains the gold standard of currently available mosquito and tick repellents. DEET has been used for more than 40 years and is safe for most children when used as directed. Comparison studies suggest that DEET preparations are the most effective insect repellents now available.
Concentrations range from 4 to almost 100%. The concentration determines the duration of protection. Most adults and children over 12 years old can use preparations containing a DEET concentration of 20 - 35% (such as Ultrathon), which provides complete protection for an average of 5 hours. Higher DEET concentrations may be necessary for adults who are in high-risk regions for prolonged periods.
DEET products should never be used on infants younger than 2 months. According to the Environmental Protection Agency, DEET products can safely be used on all children age 2 months and older. The EPA recommends that parents check insect repellent product labels for age restrictions.
If there is no age restriction listed, the product is safe for any age. The American Academy of Pediatrics recommends that children use concentrations of 10% or less; 30% DEET is the maximum concentration that should be used for children. In deciding what concentration is most appropriate, parents should consider the amount of time that children will be spending outside and the risk of insect bites and insect-borne disease.
When applying DEET, take the following precautions.
- Do not use on the face, and apply only enough to cover exposed skin on other areas.
- Do not over apply and do not use under clothing.
- Do not apply over any cuts, wounds, or irritated skin.
- Parents or an adult should apply repellent to a child and not let the child apply it. They should first put DEET on their own hands and then apply it to the child. Avoid putting DEET near the child's eyes, mouth, and hands (since children frequently touch their faces).
- Wash any treated skin after going back inside.
- If using a spray, apply DEET outdoors -- never indoors. Spray repellents should not be applied inside or directly on anyone's face.
Picaridin. Picaridin, also known as KBR 3023 or Bayrepel, is an ingredient that has been used for many years in repellents sold in Europe, Latin America, and Asia. A product containing 7% picaridin is now available in the United States. Picaridin can safely be applied to young children and is also safe for women who are pregnant or breastfeeding. Insect repellents containing DEET or picaridin work better than other products for protection against ticks.
Tick Check and Tick Removal
Tick Check. Studies indicate that ticks begin transmitting the Lyme disease spirochete within 36 – 48 hours after attachment. Removing a tick within 48 hours can reduce your chance of contracting Lyme disease. The following tips are important for self-inspection:
- Ticks responsible for Lyme disease are very small and may resemble freckles or scabs.
- People spending time in tick-infested locations should inspect themselves several times a day, including at bedtime.
- Check non-exposed areas, such as the back of the knee, as well as exposed areas. Someone else should check the scalp, back of the neck, and other difficult to reach areas.
- Check clothing as well as skin. A tick on can be hidden in folds or creases.
Tick Removal. If an attached tick is discovered, there is no reason to panic. Not all ticks are infected, and not everyone who is bitten by a tick will get Lyme disease. Do not put a hot match to the tick or try to smother it with petroleum jelly, nail polish, or other substances. This only prolongs exposure time and may cause the tick to eject the Lyme spirochete into the body.
The following is the safest and most effective way to remove an attached tick:
- Grasp the tick's mouth area with clean, fine-tipped tweezers as close to the skin as possible. (Take care not to handle it with bare fingers as this can also spread infection.)
- Next, pull upward with a steady even pressure. Do not twist, crush, or squeeze the body area of the tick, because this region contains the infectious organism. In fact, do not be alarmed if some of the mouth parts remain in the skin. They are not infectious.
- Put the tick in a jar or container of alcohol, which will kill it. You can place a piece of adhesive tape on the top of the tick and fold it over, without touching the insect. Then simply throw it away. Tape is also effective for trapping a tick that has not yet attached to the skin.
- Once the tick is removed, wash the bite area with soap and water or with an antiseptic to destroy any contaminating microorganisms. Wash hands as well.
Since dogs, cats, and even horses can get Lyme disease, inspect pets for ticks regularly. Discuss with your veterinarian the best tick prevention product for your pet. Lyme disease vaccines are available for dogs, but they do not offer total protection. Veterinarians vary in their use of the vaccines. There is no Lyme disease vaccine for humans.