Fresh tick bites

Treat tick bites

Erythema migrans – infection caused by tick bites

Erythema migrans – infection caused by tick bites

A tick bite – what now?

When dealing with a tick bite, it is important to remain calm and not panic. However, there are some important steps to consider. The top priority is to remove the tick without haste, but as quickly as possible. If you are unsure or find it difficult to reach the spot, it is advisable to ask a second person for assistance.

When removing the tick, various methods are possible to gently remove it. You can pull out, pry or twist the tick, both clockwise and counterclockwise. Various tools for removing ticks are available in pharmacies, drugstores or supermarkets.

Note: If the tick's body is crushed, it can release intestinal contents and pathogens into the bite site.

The main purpose of removing the tick quickly is to reduce the risk of infection with pathogens. This is particularly true for Lyme disease: The bacteria live in the tick's intestines and need time to enter the host's body via the salivary glands. This transfer can take up to 24 hours. If you notice a tick bite early and remove the tick, you can significantly reduce the risk of Lyme disease.

Remove tick bite

When do I have to see a doctor?

 

If, in the days and weeks after the tick bite, the redness at the bite site expands and becomes larger than a two-euro piece, it could be migrating erythema, also known as erythema migrans.

This redness occurs as one of the first signs in 50-90 percent of those affected by Lyme disease. In such a case, it is advisable to have a doctor take a look at the affected area and point out that a tick bite has occurred.

The same applies if a possible erythema occurs elsewhere on the body. As the name suggests, erythema migrans is not always limited to the puncture site.

A helpful tip: Mark the reddened puncture site on the skin with a ballpoint pen, for example. This way you can monitor whether the redness is spreading.

As soon as Borrelia enters the organism, the body's own defense mechanisms cause the formation of antibodies. These antibodies belong to the immunoglobulin M (IgM) and immunoglobulin G (IgG) classes. IgM antibodies appear during a recent infection and are recognized by doctors in the early stages of the disease.

If the infection goes undetected for a long time, IgG antibodies are formed. In order to diagnose Lyme disease, Lyme disease blood values ​​are of central importance.

Tests such as luminescence immunoassay (LIA) and enzyme-linked immunosorbent assay (ELISA) provide information about whether these antibodies are present in the blood. A positive test result indicates that the body has come into contact with the Borrelia pathogens.

Tick ​​bite treatment
Tick ​​bite removal

Erythema migrans – infection caused by tick bites

Which diseases can be transmitted by ticks in Germany?

Lyme disease

What is Lyme disease?

Lyme disease is a disease that is transmitted by ticks. It is also called Lyme borreliosis or Lyme disease. Lyme disease can take many forms and vary in severity and predominantly affects the skin, but the nervous system, joints and heart can also be affected. Lyme disease is caused by bacteria of the type Borrelia burgdorferi, which can be transmitted by ticks anywhere in Germany. Lyme disease occurs more frequently from June to August.

What symptoms can occur?

Most Borrelia infections go unnoticed or show a variety of symptoms at different times. A typical indication in around 90% of cases is “wandering erythema” (erythema migrans), a ring-shaped skin redness with a pale center and growing edges. Fever, swelling of the lymph nodes and pain in muscles and joints may occur as the disease progresses. Nodular swellings of the skin are less common, especially in children. Chronic skin inflammation (acrodermatitis chronica atrophicans) can occur.

Neuroborreliosis, which affects the nervous system, manifests itself in about 3% of cases with burning nerve pain, facial paralysis or numbness. About 5% of those affected experience Lyme arthritis, primarily in the knee joints. Heart problems are very rare, but can cause inflammation or arrhythmias.

How is Lyme disease treated?
  • Early treatment with antibiotics usually results in a speedy and full recovery. It can prevent serious illnesses.
  • A preventive administration of antibiotics after a tick bite without symptoms is not recommended.
  • If the redness mentioned above occurs, you should see your doctor immediately, even if you don't remember a tick bite. You should also contact your doctor if symptoms such as fever, muscle aches and headaches occur after a tick bite.
  • If there is erythema, Lyme disease can be diagnosed by a doctor through a physical examination. In the case of other symptoms that indicate Lyme disease, a laboratory blood test can be carried out for clarification.
  • Surviving Lyme disease does not protect against renewed infection.
How can you protect yourself?
  • Wear closed-toe shoes, long-sleeved shirts and long pants when in the woods or meadows. Pull the stockings over the pant legs.
  • It is best to choose light-colored clothing, then the tiny dark ticks can be seen and removed more easily.
  • If you apply tick repellents to your skin before going into forests or meadows, follow the manufacturer's instructions carefully. Important: The effect of the funds is limited in time and does not offer complete protection.
  • Despite preventive measures, thoroughly check your body for ticks after spending time in nature. Ticks like warm, soft patches of skin. Therefore look especially in the hollows of the knees, in the groins, under the armpits, behind the ears as well as on the head and hairline.

Tick-borne encephalitis (TBE)

What is TBE?

Tick-borne encephalitis (TBE) is a viral infection that can cause inflammation of the meninges, brain or spinal cord. TBE viruses are mainly transmitted to humans through ticks. Vaccinations are an important protection against this disease. Severe disease often occurs more frequently in older adolescents and adults than in children. The growing number of TBE risk areas, which now cover more than 40 percent of urban and rural districts in Germany, underlines the importance of precautionary measures.

What symptoms can occur?

The majority (70 to 95%) of people bitten by a tick infected with TBE viruses show no symptoms. Some develop flu-like symptoms such as fever, headache, vomiting or dizziness within one to two weeks of being bitten, which resolve after a few days. However, another peak of disease may occur in some of those affected, about a week later, and affects the central nervous system. Inflammation of the brain, meninges or spinal cord can occur, accompanied by fever, headaches, nausea, vomiting and nervous system disorders. Severe cases can result in paralysis, difficulty swallowing and speaking, breathing problems and severe sleepiness. A later healing without consequences is possible, but in severe cases, permanent damage can occur. About 1 in 100 people with central nervous system involvement dies from the infection, and severe cases mainly occur in adults.

What are the risk areas?

In Germany, TBE cases are registered primarily in Bavaria and Baden-Württemberg, as well as in southern Hesse, southeastern Thuringia, Saxony and, since 2022, in southeastern Brandenburg. There are also isolated risk areas in Central Hesse (Marburg-Biedenkopf district), in Saarland (Saar-Palatinate district), Rhineland-Palatinate (Birkenfeld), Lower Saxony (Emsland) and North Rhine-Westphalia (Solingen urban district). In 2023, three new risk areas were identified that border on already known TBE areas: the Anhalt-Bitterfeld district in Saxony-Anhalt and the Fürstenfeldbruck and Munich urban districts in Bavaria. This means that a total of 178 districts are designated as TBE risk areas. Every spring the Robert Koch Institute (RKI) publishes one updated map of TBE risk areas in Germany.

A TBE vaccination?

The Standing Vaccination Commission (STIKO) recommends the TBE vaccination to all people who live or are in TBE areas and are exposed to tick bites. This includes nature lovers such as walkers, campers, cyclists, joggers as well as forestry workers and farmers. Even city parks and gardens can be tick habitats. The basic immunization requires three doses of vaccine. According to the vaccination schedule, the interval between the first and second vaccination varies depending on the vaccine, followed by a third vaccination after 5 to 12 or 9 to 12 months.

Exciting study

Tick ​​saliva inhibits the skin's natural defense function

The University Clinic for Dermatology at MedUni Vienna, under the direction of Johanna Strobl and Georg Stary, launched one last year Study in the Journal of Clinical Investigation published that tick saliva inhibits the skin's natural defense function. This discovery shows that this may increase the risk of diseases such as tick-borne encephalitis (TBE) or Lyme disease.

Conventional approach

Conventional approach

Remove tick

When they bite, ticks anchor themselves in the skin with the help of small barbs on their biting proboscis and leave behind a cement-like adhesive that holds them in place. You will have to overcome some resistance when removing it. The most important thing is to remove the tick in the first place; there is no “wrong” method. The easiest way is to use pointed tweezers, a special tick card, tick tweezers or tick snare. These aids are available in pharmacies. Grab the tick as close to the skin as possible and pull it out vertically with controlled force, being careful but firm. Using tweezers, you can gently move the tick back and forth and gently shake it before pulling to make it easier. It is not necessary to turn the tick. If you are using a tick card, slide it under the tick with the slit close to the skin and remove it in a pushing motion.

Treat tick bites
Remove tick bite

After removal

After the tick has been completely removed, the bite site should be disinfected with a wound disinfectant. After a tick bite, it is important to keep an eye on the skin area for about six weeks. Immediate redness of the area after the bite is normal, but this redness should subside within a few days. It may happen that parts of the tick have not been completely removed, but in most cases this is only remnants of the biting apparatus, not the head of the tick. The body often rejects these foreign bodies on its own, but it is advisable to have any stuck parts removed by a doctor. If the area becomes inflamed, a doctor should be consulted, especially if children are affected. Tetanus protection should also be checked for every wound. If the skin becomes red again days to weeks after the bite, a doctor should be consulted as this could be a sign of erythema migrans, an early sign of Lyme disease. It is important to see a doctor if flu-like symptoms such as fever, headache and body aches occur one to two weeks after the bite, as these could be signs of TBE.

Remove tick

When they bite, ticks anchor themselves in the skin with the help of small barbs on their biting proboscis and leave behind a cement-like adhesive that holds them in place. You will have to overcome some resistance when removing it. The most important thing is to remove the tick in the first place; there is no “wrong” method. The easiest way is to use pointed tweezers, a special tick card, tick tweezers or tick snare. These aids are available in pharmacies. Grab the tick as close to the skin as possible and pull it out vertically with controlled force, being careful but firm. Using tweezers, you can gently move the tick back and forth and gently shake it before pulling to make it easier. It is not necessary to turn the tick. If you are using a tick card, slide it under the tick with the slit close to the skin and remove it in a pushing motion.

After removal

After the tick has been completely removed, the bite site should be disinfected with a wound disinfectant. After a tick bite, it is important to keep an eye on the skin area for about six weeks. Immediate redness of the area after the bite is normal, but this redness should subside within a few days. It may happen that parts of the tick have not been completely removed, but in most cases this is only remnants of the biting apparatus, not the head of the tick. The body often rejects these foreign bodies on its own, but it is advisable to have any stuck parts removed by a doctor. If the area becomes inflamed, a doctor should be consulted, especially if children are affected. Tetanus protection should also be checked for every wound. If the skin becomes red again days to weeks after the bite, a doctor should be consulted as this could be a sign of erythema migrans, an early sign of Lyme disease. It is important to see a doctor if flu-like symptoms such as fever, headache and body aches occur one to two weeks after the bite, as these could be signs of TBE.

Treatment with phlebolysis

In the past, various traditional treatments were used, but today the technology of phlebolysis is becoming increasingly important. This innovative method combines electrolysis and radiofrequency to specifically treat fresh tick bites and interrupt their blood supply.

This procedure results in the affected tissue being denatured, minimizing the risk of infection. In combination with a local, antibacterial treatment such as iodine plasters, it is believed that the risk of a Borrelia infection becomes extremely low.

Phlebolysis is applied using a fine needle that does not heat up and therefore does not cause burns. This needle is used to close the blood vessels in the affected skin area.

For those affected, this provides a gentle method for removing fresh tick bites, which can significantly reduce the risk of infection with Lyme disease or TBE. The use of phlebolysis opens up new possibilities for many people who are bitten by ticks.

However, it is of the utmost importance that this treatment is always carried out by an experienced doctor. An experienced doctor can provide individual advice and determine the optimal course of action for each individual patient.

Benefits of Phlebolysis Treatment:

 

  • No anesthesia necessary

  • No scarring known

  • Gentle and painless method

  • Immediately visible reaction

  • Applicable on any skin

  • No risk of burns as the tool is cold

  • no bleeding

  • No risk of infection

  • The patient is not restricted after the treatment

A fitting one Video by Dr. med. Dirk Wiechert, which deals with topics such as tick bites, Lyme disease infections, TBE diseases, vaccinations and much more.

A fascinating one Video by Dr. med. Dirk Wiechert, which deals with topics such as tick bites, Lyme disease infections, TBE diseases, vaccinations and much more.

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