How to remove a tick safely

In an emergency

In an absolute emergency, with no tick remover tool, go to the DENTIST. Dentists have the appropriate fine, pointed tweezers and the equipment to sterilize them.

If you ask a dentist for help who has not removed a tick before, show them the brief instructional video (scroll down).

We regularly hear stories of people who have gone to their GP, then the nearest vet, then the out of hours surgery, then their Accident and Emergency department at hospital, and found that one or more of these places did not have the right equipment to remove the tick.

What is the best way to remove a tick?

There is much debate on the best tool to remove ticks.

Our list of sources below, which is not exhaustive, found conflicting results. Factors affecting the outcome (total removal including intact feeding parts, and transmission of disease) include not only the size of the tick, but where it is positioned on the person or animal, how long it has been feeding, and the skill of the person removing it.

The principles agreed by everyone are:

  • Remove the tick as soon as possible. The longer it is attached, the higher the probability that it will infect you with Lyme disease. The way ticks feed means that the likelihood of getting infected with disease, if the particlar tick which has bitten you is a carrier, reaches its maximum after being attached for 24 hours. However, research has found ticks can spread some strains of borellia Burgdorferi in 16 hours of attachment. We have been sent anecdotal claims of infection taking place in even shorter periods than this.
  • Remove the entire tick, without leaving any feeding parts behind in your flesh. You need a tool you can get right under the tick’s body, around the small feeding parts next to your skin. Once ticks are fully engorged they can become so deeply embeded that it is hard to access their feeding parts.
  • Ticks need to be pulled out firmly and vertically. Do not yank clumsily or twist the tick off sideways. They embed themselves deeply and don’t come off easily.
  • Tick removal needs to be a short, rapid operation. Squeezing the tick’s body can squirt the germs from its stomach directly into your blood stream.
  • Don’t put substances on the tick. People sometimes say that coating a tick in vaseline, petrol, nail varnish or something else that suffocates it will make it fall off by itself. Research has shown this is not true. If anything, this may make the tick more likely to vomit its stomach contents into your blood stream.

 

What tick remover tool should I buy?

Various very fine forceps, notched or looped tools, and fine tweezers, are sold for tick removal.

This picture shows a tick remover tool ready to pull the fully engorged adult tick upwards vertically:

You can see in this photo how the tweezers are slender enough to fit under the tick’s body, and grasp it around the feeding parts. This tick is not fully engorged:

To remove a nymph tick, which is more likely to bite humans, you will need very narrow, pointed tweezers. Ordinary, square-ended tweezers are not suitable at all, nor are pointed tweezers which are not narrow enough. As you can see in this photo, these tweezers are just going to squash this tick nymph as they are too large to fit under its body. Some notched tick remover tools would be slim enough to slide under the tick, whilst others would be too thick, and simply squash it.

Suitable forceps or tweezers are used by dentists and you can buy them from Ebay or Amazon. They are called “cotton swab tweezers”. Only buy a pair with tips which taper into sharp points.

 

How do I remove a tick using tweezers?

  • Use a pair of sharp, pointed tweezers.
  • Close the tips around the tick’s feeding parts, underneath the body of the tick.
  • Lift the tick away from the skin vertically and intact. Pull, don’t yank.
  • Clean the area with alcohol disinfectant.
  • Stick the tick onto a piece of paper with sellotape, without touching the tick. You may wish to show this to your doctor so he/she can ascertain that it was indeed a tick that bit you.

Watch this video for a demonstration of correct tick removal using tweezers:

How do I remove a tick using a tick tool?

Tick removers, sold online or from a pharmacy or vet, have various forms. They are all designed to grasp the tick so you can pull it out vertically.

Whichever tick remover toll you buy, read the instruction for that particular tool carefully to make sure you know how to use it correctly.

  • Some tools have a slot which you slide under the tick, to then prise the tool away from the skin. This includes the Tom’O’Tick twister and the Lifesystems safecard. When you see the size of the notch and the thickness of the plastic on most of these tools, it is easy to realise why these cannot be used to remove tiny tick nymphs.
  • Some tools have a tiny lassoo which you loop around the tick, and then pull it out. This include the Trix Tick lassoo.
  • Some tools have claws which can be spread out and then closed together next to the skin, around the tick’s feeding parts. This includes the Care Plus Tick Out tool.

NEVER buy a tick remover which tells you to “twist” the tick out. It must only be pulled out vertically.

 

BEWARE of misinformation about tick removal online!

DO NOT do any of the following:
burn the tick, smother the tick in Vaseline, rub around it with a cotton bud, squeeze the tick, try to twist or rotate it, stick tape over it, try to pull it out with square ended tweezers, or generally hurt or harass it in any way while attached.

This will simply make it spew the contents of its gut directly into your blood stream, which may include any of 16 different diseases.

Removal with fingernails is advocated by some people. In an emergency, where there is no alternative, this may work provided the person removing the tick has long nails, and is dextrous enough to pull the tick out vertically rather than crushing it or pushing it sideways.

Sources and Further Information

“Tick bite prevention and tick removal” British Medical Journal Clinical Review

“Evaluation of Five Popular Methods for Tick Removal” Glen R. Needham

“The application of petroleum jelly, fingernail polish, 70% isopropyl alcohol, or a hot kitchen match failed to induce detachment of adult American dog ticks”

“It is recommended that the tick be grasped as close to the skin as possible with curved forceps; if these are not available, use tweezers or protected fingers. Pull straight up with steady even pressure.”

“Effect of Tick Removal on Transmission of Borrelia burgdorferi and Ehrlichia phagocytophila by Ixodes scapularis Nymphs” Franka des Vignes et al 

“All gerbils with ticks removed >- 47 hrs post-attachment were found to be infected. After 16.7 hrs as well as after 28.9 hrs of tick feeding, approximately 50% of the gerbils had acquired a transmissible infection, thus Bb-transmission to a host may even occur in the early phases of I. ricinus feeding.”

“Evaluation of three commercial tick removal tools” Richard L. Stewart at al

“Nymphal ticks were consistently removed more successfully with commercial tools when compared with tweezers but with more difficulty than adults were removed.”

But contrast this with:

“Evaluation of methods of tick removal in human ixodidiasis” Oteo JA et al

“With regard to the type of removal method and the development of complications, only three patients who had ticks pulled with tweezers experienced complications compared with 23 patients who used other methods (p = 0.0058). With regard to specific complications (LB and/or spotted fever) and/or development of B. burgdorferi or R. conorii infection significant differences were also observed when tweezers were used for removal of ticks compared with other tick removal methods (p < 0.05). CONCLUSION: The removal of ticks with tweezers significantly protects from the development of complications and infection by tick-borne microorganisms.”