Ticks must to be killed prior to attempted removal because if not, they may increase secretion of toxin into the surrounding tissue. This may result in several outcomes:
1. There may be a much more severe local inflammatory reaction. This is often accompanied by locally enlarged and tender lymph glands, headaches, myalgia or feeling non-specifically unwell.
2. The individual is at increased risk of developing tick anaphylaxis.1
3. There is an increased risk of tick-borne diseases. The incidence of this rises the longer the tick is feeding, in addition to any increased toxin that is injected because a tick is disturbed.
4. In individuals who have an allergic diathesis, proteins found in the blood of animals the tick feeds off may be injected into a new host by the tick. This can result in cross-reaction with other proteins.1
It is also very important to remove the entire tick and not to leave the head under the skin. If this happens there is an increased risk of tick allergy, bacterial and tick-borne infection and local inflammation. The tick head may be removed using the sharp end of an 18g needle (this is the author’s preference because of the width of the end). If this fails exploration under local anaesthetic is an alternative.
The best way to kill a tick is to use an ether–containing spray (cryotherapy).1 There are ether products (designed for wart removal) that are found in pharmacies and these are the advised way to kill ticks, although such use is off-licence.
If an individual is known to be allergic to ticks they must be advised to seek urgent medical advice and not try to remove the tick themselves. If they are anaphylactic to ticks they must be referred to an immunologist, given adrenaline auto-injectors and have an up to date action plan.
1. ASCIA, ‘Tick allergy’ 2014