Tick bites

At a glance

  • Tick bites usually only cause minor problems, like itching.
  • But ticks can transmit diseases – in Germany mostly Lyme disease (also called Lyme borreliosis) and (in some areas) tick-borne encephalitis (TBE).
  • You can prevent tick bites by wearing suitable clothing and using sprays.
  • A TBE vaccine is recommended if you are often outdoors in high-risk areas.
  • It is important to remove the tick quickly after a tick bite and to look for signs of disease.

Introduction

Photo of two people working in the garden

Anyone who spends a lot of time outdoors will probably come across ticks sooner or later. News reports on ticks can paint an alarming picture, but they aren't actually as dangerous as many people think. Although ticks can carry and spread disease, tick bites don't usually cause health problems. In Germany, ticks are active between about March and November.

If you are bitten by a tick, any problems are usually only temporary and minor. Tick bites rarely have serious or lasting effects. And there are several things you can do to prevent tick bites and possible complications. This can make it easier to deal with these tiny creatures.

What are ticks?

Ticks are spider-like arachnids. The castor bean tick is the most commonly found tick in Europe. These ticks mostly feed on the blood of host animals like rodents and deer. The blood of the host animals may contain germs, which are then transferred to the feeding ticks and can be passed on to humans later on.

When ticks have found a host to feed on, they usually look for areas of soft skin. Once a tick has found a suitable place to feed, it uses its mouth-parts to cut through the host’s skin, inserts a feeding tube (which also serves as an anchor) into the wound and then feeds on blood until it is full.

It doesn't hurt when a tick latches on to your skin and feeds. If you don't find the tick and remove it first, it will fall off on its own once it is full. This usually happens after a few days, but it can sometimes take up to two weeks. Like when you have a mosquito bite, your skin will usually become red and itchy near the tick bite. People often only notice that they have a tick once their skin starts to itch.

You can carefully remove a tick yourself.

Which dieseases do ticks transmit?

Two main diseases can be transmitted by ticks in Germany: Lyme disease (also called Lyme borreliosis) and tick-borne encephalitis (TBE), which can cause inflammation of the brain (encephalitis) or the membranes surrounding the brain and spinal cord (meningitis). Infection is only possible if the tick that bites you is infected, and also manages to transmit the viruses or bacteria.

Lyme disease is much more common than TBE. Generally speaking, TBE is rare, and doesn't occur at all in many regions. Neither of these two diseases can be spread from one human to another. In other words: if someone is infected, they are not contagious to others.

Prevention

Your risk of a tick bite will mainly depend on where you spend your time and what you do outdoors. Wearing closed shoes on hikes through tall grass or shrubs can help keep ticks out. Clothes that cover as much of your body as possible – like full-length trousers and long-sleeved shirts – make it harder for ticks to attach. It is easier to see them on light-colored clothing. Ticks can be found both out in the wild and in gardens or parks.

Ticks may wander around your body for a few hours before biting. So you can prevent bites and substantially lower your risk of Lyme disease or TBE by checking your body for ticks right after spending time in a forest or meadow, and removing any you find. Children often won't remember to look for ticks, so they might need a reminder or some help. It also makes sense for adults to have someone help, especially to check hard-to-see places.

According to the German Robert Koch Institute, tick repellent sprays only offer temporary protection from ticks. The effect wears off after two to four hours, so you will need to re-apply the spray on longer walks.

There is a vaccine for TBE. The TBE vaccine may be a good idea if you spend a lot of time outdoors in high-risk areas.

Last but not least, it's important to look out for signs of if you have been bitten, and to seek medical attention if any symptoms develop.

Bayrisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL). Erkrankungen durch Zeckenstiche: FSME. 2022.

Deutsche Dermatologische Gesellschaft (DDG). Kutane Lyme Borreliose (S2k-Leitlinie, in Überarbeitung). AWMF-Registernr.: 013-044. 2016.

Deutsche Gesellschaft für Neurologie (DGN). Neuroborreliose (S3-Leitlinie). AWMF-Registernr.: 030-071. 2020.

Richardson M, Khouja C, Sutcliffe K. Interventions to prevent Lyme disease in humans: A systematic review. Prev Med Rep 2019; 13: 16-22.

Robert Koch-Institut (RKI). FSME: Antworten auf häufig gestellte Fragen zu Zecken, Zeckenstich, Infektion. 2020.

Robert Koch-Institut (RKI). FSME: Risikogebiete in Deutschland. (Epidemiologisches Bulletin Nr. 7). 2022.

Robert Koch-Institut (RKI). Infektionsepidemiologisches Jahrbuch meldepflichtiger Krankheiten für 2020. Berlin: RKI; 2020.

Robert Koch-Institut (RKI). RKI-Ratgeber: Frühsommer-Meningoenzephalitis (FSME). 2022.

Robert Koch-Institut (RKI). RKI-Ratgeber: Lyme-Borreliose. 2019.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on September 19, 2022

Next planned update: 2025

Publisher:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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