Medical Examiner

How Much Should I Worry About Ticks?

There are more ticks than ever … depending on where you live.

A deer tick on a blade of grass near a shoe.
Ladislav Kubeš/iStock/Getty Images Plus

If you spent a lot of time playing in the grass as a kid, there’s a good chance your parents told you to check yourself for ticks. The minute arachnids are always common, but in many places, this year is predicted to be a particularly bad one for them.* Across the United States, the tiny pests could turn up in record numbers, experts predict, burrowing into the skin around ankles and hitching rides on pets.

But how worried should you be about these blood-sucking parasites? We asked experts to tell us everything you need to know about this year’s tick season.

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Ticks seem to be everywhere now! Is the tick situation really getting worse?

It depends on where you live. In many places, tick numbers are going up—but they might be more stable in others. “It’s such a locally dependent question,” says Sam Telford, a professor of infectious disease and global health at the Cummings School of Veterinary Medicine at Tufts University. Telford, who has collected samples of ticks from some of the same sites in Massachusetts and Rhode Island for 35 years, says that he has seen more ticks in some areas. For instance, he says the island of Nantucket off the coast of Massachusetts is the worst he’s seen it in about 10 years, in terms of an index of abundance (the number of ticks he finds per minute he spends at each site). But for other sites, he says, the numbers are more normal, such as in some parts of Martha’s Vineyard.

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In general, will ticks just be worse and worse every year?

Some experts think so. “I think there’s a good chance of that,” says Howard Russell, an entomologist at Michigan State University. He says that at least in Southern Michigan, as in other areas, ticks have gotten more prevalent every year, and there’s no reason to think the trend will reverse itself any time soon.

But not everyone agrees. “I see no real evidence that ticks are increasing in abundance,” Telford says. That doesn’t mean you’re imagining things if you’re spending more time removing ticks from your body than you did before. He says that people finding an increased number of ticks on themselves could have more to do with being closer to ticks’ natural habitats than increasing numbers of ticks. New housing developments, for instance, put people into contact with tick populations living in areas that were previously wooded or undeveloped.

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Are tick populations connected to climate change?

To some extent. One reason that might be is the trend toward milder winters, says Danilo Del Campo, a dermatologist at the Chicago Skin Clinic in Illinois. (Though all doctors can recognize and treat patients with tick bites and tick-transmitted diseases, it’s a specialty of dermatologists.) Del Campo says that warmer weather may increase the populations of small rodents, like mice and rats, that ticks use as breeding grounds. Studies have suggested that because some ticks, particularly deer ticks, which carry Lyme disease, thrive in warmer temperatures, warmer weather due to climate change could increase their numbers.

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But again, it can be hard to say. Michigan’s Western Upper Peninsula has very cold winters, but Russell says the area has had a significant tick population for far longer than the Lower Peninsula, which has milder winters but didn’t have a significant tick population until about 10 years ago. “We really don’t understand fully what determines tick abundance,” says Telford. So, climate change may have some influence on tick populations, but there are a lot of factors at play.

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OK, but there are still lots of ticks where I live … should I be worried?

You should always be aware of the hazard of diseases transmitted by ticks. Most ticks are capable of transmitting disease, says Telford, though that doesn’t mean any given tick is necessarily infected, or even if they are, that they will transmit that infection. Though most species of ticks have extremely broad ranges, different tick-transmitted diseases are more common in certain states. The most common in the U.S. overall is Lyme disease; though it’s a concern anywhere deer ticks live (which is most of the eastern half of the U.S.), most cases are found in states in the Northeast and Mid-Atlantic, as well a couple Northern states. Lyme disease is transmitted by blacklegged ticks, also called deer ticks, which can also transmit other rarer diseases. Lyme disease can cause a headache and flulike symptoms. That can progress to joint aches and, in rare cases, can cause more serious and even chronic health problems if not treated properly, though most people fully recover, says Telford. The American dog tick can transmit a disease called Rocky Mountain spotted fever, though it is not common. “Always see a health care provider for any unexplained fever,” says Telford. Another tick, called the lone star tick, can cause some people to develop an allergy to red meat.

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Yikes.

Like other illnesses spread by ticks, it’s not thought to be common (although it’s hard to say for sure, since the association between tick bites and the allergy is a fairly new discovery and could be underreported). And some people eventually recover from it, says Russell. Though lone star ticks have a broad range across much of the Eastern half of the U.S., they are most common in Southeastern states, and many who develop this allergy also live in these areas.

Well, what should I do to protect myself?

There’s lots you can do, starting with being aware if you’re in an area where there are likely ticks. “If something can touch your ankle, like brush, grass, bushes, that’s something to just be careful with,” says Del Campo. He recommends covering up by wearing long pants and long sleeves, especially if you’re gardening. Wearing light-colored clothing can also allow you to better see any ticks. “If you’re alone and you don’t care, you can tuck to your pants in your socks,” he says. “It’s cool to be uncool.”

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OK, I care less about being cool than not getting ticks on me. Should I get a TickSuit?

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Del Campo says wearing a TickSuit, which covers almost your entire body, is likely effective—but  probably overkill.

Other than long clothes, what is the right level of protection? And what do I do if I really don’t want to wear long sleeves?

One of the simplest things you can do is use insect repellant. Del Campo recommends one with 20 to 30 percent DEET, the active ingredient in many bug sprays. Telford says that clothing treated with an insect repellant called permethrin will give you “the biggest bang for your buck.” You can buy the repellant, but he says it’s also easy to buy clothing that has been pretreated, like socks.

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Del Campo also recommends that his patients find a “buddy” who is willing to check them for ticks, whether that be a partner, a sibling, or a friend you’ve been outside with. He says it can be useful to quickly check each other after, for instance, a hike, even before getting in the car and parting ways. After you get home, a shower can help remove any ticks that haven’t yet attached themselves to you and also just help you check yourself more carefully. Telford recommends showering as soon as you can after being in an area with ticks so that they are less likely to have attached themselves to you.

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OK, what about pets? Do I really have to check my dog for ticks? My dog takes tick medication, isn’t that enough?

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Yes, if your dog is on tick medication, the tick may well die and fall off—but only if the tick actually bites your dog. Ticks can also wind up in their fur for a bit without biting, remain alive, and make their way into your home. Which means it could eventually come out of the fur and attach itself to you. “My wife and I refer to our dogs as tick collection and relocation experts,” says Russell.

Even if the tick does bite your dog, there’s no guarantee that the medication will work in every case. “Every dog is an individual, just like every human is an individual, and the efficacy may differ,” says Telford. So for both you and your dog’s sake, you should keep checking them.

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I found a tick on myself. What should I do? 

Don’t panic. If it hasn’t attached its mouthparts to the skin, you can just brush it off (outside) and not worry about it. A tick has to bite you to infect you.

If it has attached itself, you can use tweezers to remove it. “Grab it right as close to the skin as you can and firmly pull it off,” says Russell. Emphasis on firm—you want to avoid leaving part of the tick buried in the skin. You can dispose of it by putting it in a sealed bag, wrapping it in tape, putting it in alcohol, or flushing it down the toilet. Just don’t crush it with your fingers. You can also put it in a Ziploc bag or in alcohol and bring it to your doctor if you want help identifying it. Although there are companies you can send ticks to that will test them for diseases, Telford says this isn’t necessary or even generally recommended, since even a tick carrying a disease might not have transmitted the infection.

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If you live in an area where Lyme disease is common and the tick was attached for three days or more, check with your doctor. You can usually tell it’s been a while if the blood-engorged tick is quite large, or it’s been that long since you’ve been in a high-risk area. Your doctor might prescribe you a single tablet of an antibiotic called doxycycline—particularly if the tick is a deer tick—which reduces the risk of developing Lyme disease by 85 percent. But even so, some doctors will just wait to see if you develop symptoms, especially if you don’t live in a high-risk area. People bitten by a tick carrying Lyme disease will often develop a characteristic rash around the bite that looks like a bull’s-eye. If this happens, or if someone has any unexplained fever or other symptoms soon after being bitten, a doctor can prescribe antibiotics, which are extremely effective at treating Lyme disease.

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I have another concern … I heard that some ticks are so small you can’t even see them.

Almost any tick in its nymph or larval stage is about the size of a poppyseed, so it’s true that they can be very easy to miss (the Centers for Disease Control and Prevention demonstrated this by superimposing tiny images of ticks among the poppyseeds on a lemon poppyseed muffin in a 2018 tweet, much to the chagrin of muffin lovers). Nymph ticks may also be more likely to transmit Lyme disease. Many deer ticks are in this stage during the month of June, which is why Lyme disease incidence tends to be the highest during June and July, Telford says. That said, they definitely aren’t impossible to see. “You just need to know what to look for,” says Telford.

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This all sounds very scary.

It’s good to be aware, but don’t stress out about it. “Do everything that you can do when you’re in certain areas, and take care of your skin and any significant others you’re with,” says Del Campo. “But outside of that, live your life.” As long as you wear insect repellant, take precautions, and are reasonably careful, you shouldn’t need to worry. He adds that if you have any concerns, you can talk to your primary care doctor or dermatologist.

Telford agrees: “People should not be afraid of ticks, and they should go out and enjoy nature.”

Correction, June 30, 2021: This article originally misstated that ticks are insects. They are arachnids.

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