If you’re spending time outside in grassy, heavily wooded areas during the warmer months (particularly in the Northeast and Midwestern regions of the United States), you could very well be coming in contact with ticks—and unfortunately, at risk for contracting tick-borne diseases like Lyme.
Lyme disease is caused by four main species of bacteria: Borrelia burgdorferi, Borrelia mayonii, Borrelia afzelii, and Borrelia garinii bacteria. Borrelia burgdorferi and Borrelia mayonii mainly cause Lyme disease in the U.S., according to the Mayo Clinic. “Lyme disease can cause chronic [health] problems if not diagnosed and treated early,” says Stephanie Sterling, MD, clinical assistant professor of infectious diseases at NYU Langone Health in New York.
The illness is transmitted via a bite from an infected black-legged tick (more commonly referred to as a deer tick), though it must be attached to you for 36 to 48 hours to transmit Lyme disease.
So what should you be looking for while you’re wandering the great outdoors? The insects are typically brown, and when they’re young, they’re actually no bigger than a poppy seed, which of course can make them difficult to detect with the naked eye. And if you’re not actively checking for a tick, then you may miss it entirely. That’s why it’s so important to think in terms of prevention.
While early signs of Lyme include rash (the “bulls-eye rash” is commonly associated with Lyme, but it only presents in nine percent of cases) and flu-like symptoms, other signs and symptoms that may crop up down the road (if left untreated) include joint paint, neurological problems, and less commonly, heart problems, eye inflammation, hepatitis, and severe fatigue. Wondering if this is you? LymeDisease.org offers a symptom checker.
If you think you may have been infected by a tick carrying the bacteria, know that it’s not always easy to get diagnosed with Lyme. In fact, according to LymeDisease.org, “False negative” test results are very common, especially in the weeks and months after infection. This is because it takes time for the antibodies—your blood protein produced in response to an antigen or infection—fighting against the Lyme bacterium to pop up and be detected. Many people carrying the disease are misdiagnosed entirely.
Related: What It’s Really Like To Suffer From Lyme Disease—And How I’ve Learned To Cope
Not everyone with Lyme will be chronically ill or debilitated, though. Some people will need a dose of antibiotics while others will need long-term care. Some people can go years without symptoms or treatment. But when symptoms get so bad that they can’t be treated easily, this is known as post-treatment Lyme disease (PTLD) or chronic Lyme disease (CLD). The Center for Disease Control & Prevention estimates that 10-20 percent of people who have Lyme have a chronic case of it.
Thankfully, there are plenty of precautions you can take to keep ticks at bay and guard yourself against Lyme disease.
- Wear long sleeves and pants when outdoors. Dr. Sterling advises wearing clothing that will guard your skin and reduce the chances of a tick actually making contact with it. She recommends wearing lightweight pants that can be tucked into socks, and a lightweight, long-sleeved shirt if you’re spending excess time in heavy brush or gardening.
- Opt for light-colored clothing, too. “Ticks are dark, and therefore, are more easily spotted on light-colored clothing,” Dr. Sterling explains.
- Consider using a repellent with DEET. In a Wilderness & Environmental Medicine study, insect repellent with DEET was found to have been “moderately effective” against tick bites. Dr. Sterling recommends using repellents that contain 20 percent DEET, specifically, or DEET alternatives picaridin and IR3535, echoing advice from the Center for Disease Control & Prevention. “Apply to clothes and exposed skin—but not your hands, eyes, or mouth,” Dr. Sterling advises.
- Reach for essential oils. A study published in the Journal of Agricultural and Food Chemistry suggested that Pelargonium roseum, also referred to as rose geranium or geranium oil, may work as well as DEET. At the very least, you’ll smell good! You can dab it all over your body for coverage—especially on your neck, wrists, and ankles. Got pups? You can help guard against ticks brought into the home by pets with peppermint oil and clove extract, which is used in Vet’s Best Natural Flea & Tick Spray.
- Do tick checks and strip down. When you return home from spending time outdoors in a heavily wooded area, you’ll do well to carefully look over your clothes and gear to make sure you aren’t bringing any unwelcome pests into your home, Dr. Sterling says. (This goes for checking pets as well.) “Consider showering after returning from prolonged hikes, gardening, or other outdoor activities,” she advises. “A shower can be a perfect opportunity to do a full-body tick check, as well as wash off any tick that may be climbing on you but not yet attached. Pay special attention to areas where tight clothing may have prevented a tick from climbing further, such as underwear lines, bra lines, belt lines. Don’t forget behind the knees, ears, armpits, and your belly button.”
Related: Shop products to protect your home and pets from ticks.
If you’re concerned that a tick may have made its way onto clothing, Dr. Sterling recommends tumbling dry clothes on high heat for 10 minutes. “Clothes should be warm and completely dry—damp clothes may require more time,” she says. “If washing clothes first, wash with hot water.” (Ticks will die in the dryer not because of the heat, but because they require dampness to survive.)
Finally, if you do happen to find a tick already attached to your skin, you can safely remove it by using tweezers to gently pull its head out, Dr. Sterling says. “Prompt removal will decrease the chance of any disease transmission, including the bacteria that causes Lyme disease,” she notes. “You can bring the tick to your doctor for it to be identified and, if appropriate, tested for bacteria.”
Call your doctor if you have a rash or fever, especially if you recently spent time outdoors.