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Tick and Mite Bites

by Robert A. Barish, MD, MBA, Thomas Arnold, MD

Ticks carry many diseases. For example, deer ticks may carry the bacteria that cause Lyme disease (see Lyme Disease) or the protozoa that cause babesiosis (see Babesiosis). Other types of ticks may carry the bacteria that cause rickettsial or ehrlichial infections (see Overview of Rickettsial Infections). The bites of pajaroello ticks, which are present in Mexico and the southwestern United States, produce pus-filled blisters that break, leaving open sores that develop scabs.

Mite infestations are common and are responsible for chiggers (an intensely itchy rash caused by mite larvae under the skin), scabies (see Scabies), other itchy rashes, and a number of other disorders. The effects on the tissues around the bite vary in severity.

Treatment

Tick bites can sometimes be prevented by taking precautions in areas where ticks are common (see Preventing Tick Bites).

Ticks should be removed as soon as possible. Removal is best accomplished by grasping the tick with curved tweezers as close to the skin as possible and pulling it directly out. The tick’s head, which may not come out with the body, should be removed, because it can cause prolonged inflammation. Most of the folk methods of removing a tick, such as applying alcohol, fingernail polish, or petroleum jelly or using a hot match, are ineffective and may cause skin damage or cause the tick to expel infected saliva into the bite site. After the tick is removed, an antiseptic should be applied. If swelling and discoloration are present, an oral antihistamine may be helpful. If the tick appears to have been attached for an extended period (the tick is very swollen) or Lyme disease is prevalent in the area, doctors may give an antibiotic to help prevent Lyme disease.

Some mite infestations are treated by applying a cream containing permethrin or a solution of lindane. A cream containing a corticosteroid is sometimes used for a few days to reduce itching caused by mite infestations. If permethrin or lindane is used, it is given before the corticosteroid.

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