What is the best way to remove a tick?

Don't be so quick to reach for the tweezers.

Australia is home to around 70-75 species of ticks, ten of which are known to bite humans. They are predominantly found in the lush bushland of eastern Australia. 

When tick saliva is injected into a human host, it can transfer pathogens that cause severe allergic reactions, ranging from flu-like symptoms to anaphylaxis or the development of a mammalian meat allergy. Three known tick-borne illnesses are present in Australia and also pose a risk: Queensland tick typhus, Flinders Island spotted fever and Q fever. 

There are different schools of thought about the safest way to remove a tick, but scientific consensus is around the following steps: 

1. Initially, try not to disturb the tick

"The aim of tick removal is to minimise the injection of mouth and alimentary tract contents from the tick into the human target," said a spokesperson for the Department of Health, who was contacted by Insight to ensure the information on their website was up-to-date (last updated November 2015).

Also avoid squeezing the body of the tick, pulling it out with force or brushing it away, as this risks the release of its potentially toxic saliva into the human target.

Prior to removal, the tick may be sprayed with an aerosol insect repellent containing pyrethrin or a pyrethroid chemical, although there is currently no evidence to suggest that this is of benefit. Permethrin based creams, which are available from chemists may also be used. Apply at least twice with a one minute interval between applications.

If you have difficulty removing the tick or suffer any symptoms after removal, seek medical attention urgently.

2. Consider your implements for removal

The Department of Health says there is no difference in the method of removal associated with allergy and infection. They recommend using fine point tweezers (similar to surgical) or forceps, and to avoid household tweezers.  

"Grasp the tick as close to the skin’s surface as possible," their site reads. "Pull upwards with steady pressure and avoid jerking or twisting the tick."

This should only be attempted should you have the right implements. If you do not, leave the tick in place and immediately seek medical attention from a GP or hospital emergency department.

A growing number of experts also advocate killing the tick with an ether-containing aerosol freezing spray before removal, and allowing it to fall off on its own. The Australian Society of Clinical Immunology and Allergy (ASCIA) recommends this method, as does Insight guest Dr Sheryl Van Nunen, from the Tick Allergy Research Centre. 

However, the Department of Health "does not recommend this method until evidence-based research becomes available. When new evidence is published this document will be reviewed."

3. Prevention of future bites 

If you plan to be in a tick-endemic area, wear long pants that can be tucked into thick socks, long-sleeved shirts and hats. Apply DEET insect repellent before entering these areas.

If you have an established tick allergy, ensure you carry an EpiPen with you.

Full statement from spokesperson for the Australian Government Department of Health

The advice on the department’s webpage is current and was agreed by State and Territory Health Departments.

There is no difference between the removal technique associated with allergy and infection. The aim of tick removal is to minimise the injection of mouth and alimentary tract contents from the tick into the human target. Use only fine point tweezers and avoid squeezing the body of the tick.