Q: My son recently pulled off and killed a tiny tick off his lower abdomen. We think it is a tick and are not sure. The tick was hard to get off according to him, but was not under his skin. After pulling it off, the area was a tiny bit red. Tiny. Gone in complete the next day. It may have been a result of him pinching the bug off of him. Now I hear so many Lyme Disease cases, I am so frightened. What do you think? Would you worry? We kept the bug in case we need to investigate. Does the tick need to be in the skin for a while before contracting disease? Would you worry?
A: Your concern is a valid one, since we do live in a high risk area for Lyme Disease. Humans can get this illness through the bite of a deer tick. These ticks are smaller than dog ticks and can be hard to spot. Here is a website with some good photos of what they look like: http://www.oes.org/html/how_2_identify_different_ticks.html. The tick needs to be attached for 2-3 days to be able to actually transmit the disease to people.
Most people associate Lyme Disease with a "bull’s eye" rash, but more than half of those infected never show this symptom. Instead, they might get conjunctivitis, fatigue, headaches, muscle pain, fever, chills, swollen glands, neck stiffness, facial nerve paralysis or motor tics. Symptoms can appear as early as three days after the bite or as long as months afterwards. Sometimes, there is no known history of a tick bite. It can take as little as 3-4 days or months to years for any symptoms to show.
It’s not uncommon for tick and insect bites to get infected or irritated. A little Neosporin and/or hydrocortisone will help reduce the local redness and swelling. If the mouthparts are still embedded, it’s best to try to remove them to reduce the risk of infection. If you do have a tick attached to your skin, the best way to remove it is to grab it with a tweezer or fingers and gently but firmly pull straight out. Don’t pull fast or jerk it as this will leave a part of the tick behind. Home remedies like dowsing the tick in alcohol or acetone don’t work very well since the tick takes a breath only about once an hour.
I usually advise my parents/patients to watch for the above mentioned symptoms. If they develop them, then I will order a Lyme test. If a patient tests positive, he/she can be treated with antibiotics. Once you get Lyme Disease and are treated, you can still get it again, much like Strep Throat.
The best defense against getting Lyme Disease is to do your best to avoid getting bitten by the Deer tick and doing thorough tick checks after going outdoors. Many patients that I diagnose with Lyme Disease don’t even know that they’ve been bitten by a tick.

I hope this helps.