What are ticks and how can they be removed?

When ticks have found a host to feed on, they usually look for areas of soft skin. They don't normally bite right away, and sometimes wander around the body for several hours. The ticks then often end up around your hairline, behind your ears or in folds of 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.

If a tick has attached itself to your skin, it's important to remove it as soon as possible. Doing so will lower your risk of getting Lyme disease.

Special tools are available for removing ticks, including tick tweezers, tick-removal cards and hook-like instruments. These tools are shaped to make it easy to slide them between the tick and your skin without squeezing the tick. You can find these kinds of aids in pharmacies, for example.

Normal tweezers can also be used, as long as the tips of the tweezers bend inwards. If the tips are flat, the tick will be squeezed when you try to get hold of it. This should generally be avoided, because then germs could be squeezed out of the tick and into your body.

A tick-removal card can be used as follows:

• Slide the tick-removal card between the skin and the tick.
• Push the tick out of the skin, keeping the card close to the skin.
• Do not try to pull the tick out of the skin using the card. Otherwise it will slip through the slit in the card.

• Get hold of the tick with the tweezers as close to the bite as possible.
• Then gradually pull it out, being careful not to squeeze it too much with the tweezers.
• If the tick doesn't come out, twisting it slightly can help. It doesn't matter which direction you twist it in.

If you don't have the right tool, you could also try to remove the tick using your fingernails. It is important to get hold of the tick’s head as close to the skin as possible, and avoid squeezing it with your fingers.

Once you have removed the tick, you can disinfect the nearby skin – for instance, with alcohol – and inspect the area to see whether you managed to remove all of the tick. If the mouth-parts are still stuck in your skin you might see a small black dot, which a doctor can then remove. Mouth-parts that are left behind can sometimes lead to a small inflammation, but are usually harmless.

People used to recommend trying to suffocate the tick by putting things like nail polish, glue, toothpaste, alcohol or oil on it. But it can take a very long time for ticks to fall off that way, so it may even increase the risk of infection.

Once the tick has been removed, it's important to keep an eye on the bite in the following weeks. If a circular red skin rash appears, it may be a sign of Lyme disease. This rash may affect another part of the body, like your legs, head or neck. If you think you have Lyme disease, you need to see a doctor. The same is true if you develop flu-like symptoms such as fever or aching joints. If the flu-like symptoms occur after only one or two weeks, it could also be a TBE infection – but that is rare.