DEAR DOCTOR K:

I live in a heavily wooded area, so I'd like to know the best way to remove a tick if you spot one on your skin.

DEAR READER:

Knowing how to remove a tick is a useful skill for anyone who spends time outdoors, or who cares for someone who does. The sooner a tick is removed -- correctly -- the less likely the critter can deliver bacteria that cause Lyme disease or other tick-borne diseases.

Very young deer ticks feed on mice and other small mammals. Those animals have the bacteria that cause Lyme disease in their blood. Once the tick feeds, the bacteria enter the ticks.

The next late spring or summer these ticks are "older children." This is typically the time that they will get on our skin and start to feed. Because they're so small, it's easy not to notice them. They are brown and about the size of a poppy seed. If they have two days to feed on our skin, they will transmit the Lyme disease bacteria to us. (Occasionally, adult female deer ticks feed on us, but they are much bigger and harder to miss.)

Deer ticks are designed to feed successfully on us. They have a two-pronged mouthpart that sticks to our skin because each part has tiny backward-pointing barbs. Just to be sure that their mouthparts stick to our skin, their saliva forms a sticky glue. It's a fiendishly clever anatomy.

We also have been clever, however: We invented tweezers. To remove a tick, use a pair of fine-tipped tweezers to grasp the tick as close to your skin as possible. Then pull it upward, slowly and steadily. (I've put an illustration of how to remove a tick on my website, AskDoctorK.com.)

If the mouthpart remains in the skin, try to remove it. If you can't, check with your doctor. Try not to crush or squeeze an attached tick.

Once the tick has been removed, clean your skin and wash your hands with soap and warm water. Dispose of the tick by placing it in alcohol or flushing it down the toilet.

The first sign of Lyme disease is often a rash that looks like a red bull's-eye. Keep an eye out for this rash at the site of your tick bite for about one month after you've been bitten. If you notice a rash, contact your doctor right away. Antibiotics can usually cure the illness.

Follow these tips to prevent tick bites in the first place:

(1) Avoid woods, high brush and grasses, where ticks hide.
(2) Wear light-colored clothing, which makes ticks easier to spot.
(3) Tuck your pants inside your socks to create a physical barrier.
(4) Use insect repellent, especially those containing DEET or permethrin.
(5) Stay in the sun. Ticks don't like dry, open areas.
(6) Thoroughly inspect yourself, your children and your pets, especially the legs and groin, after you've been out in the woods.

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

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