Tick bite

What is a tick bite?

A tick is a small (one to three millimetres), brown-black spider-like insect. Ticks crawl. They cannot jump or fly. Ticks live mainly in bushes and tall grass, in forests, heathland, dunes, parks and gardens. They prefer moist environments and are mainly active from March to October. Every year in the Netherlands, one million people are bitten by a tick. Ticks are also found abroad.

Ticks crawl or climb onto passing people and animals and bite into the skin. By sucking blood, the tick slowly swells into a brown-black or greyish ball of approximately one centimetre. After a few days, the tick releases itself.

A tick bite can occur anywhere on the body, especially in warm, moist areas such as the armpits, groin, backs of the knees and the buttock cleft; in children often also on the head, behind the hairline and behind the ears.

Some ticks are infected with bacteria. They can then transmit diseases such as Lyme disease. If you remove the tick immediately, the chance of infection is small.

What are the symptoms of a tick bite?

Tick bites are often painless, which means you do not notice them. A red spot often quickly appears at the site of the bite, as with most insect bites. The spot usually does not grow larger than one or two centimetres and disappears within two weeks.

What can I do to prevent tick bites and/or Lyme disease?

Checking and removing

Check your skin carefully after being in nature (in forests, parks, heathland, dunes or gardens, in tall grass and among bushes and fallen leaves). Remove any ticks immediately. Check your entire body, especially warm, moist areas such as the armpits, groin, backs of the knees, the buttock cleft, and especially in children, also the head, behind the hairline and behind the ears. Ticks are very small, so check with good lighting, using glasses and a mirror if necessary. Have hard-to-see areas (back and buttocks) checked by someone else.

After a day in nature, it is also wise to shake out or brush off your clothes, cap, socks and shoes outside to remove any ticks. Or wash the clothes at 60 degrees to kill any ticks.

After a tick bite, you should watch for symptoms of Lyme disease in the following months (see below).

Protection and prevention

You can reduce the chance of tick bites by avoiding tall grass and bushes and staying on walking paths in nature. Close-fitting clothing (with long sleeves and trouser legs tucked into socks) also provides some protection. Small children can wear a cap to protect their head against ticks.

If you are going out in an area where many ticks are found, you can provide extra protection by applying an insect repellent containing DEET to your skin. This is available at chemists and pharmacies. For adults, the product may contain a maximum of 50% DEET; for children, a maximum of 20%. Read the instructions on the packaging. Some people develop skin problems from DEET.

People who spend a lot of time in or work in tick-rich natural areas can provide extra protection by wearing clothing treated (impregnated) with insect repellent. Impregnated clothing can also be purchased at specialist outdoor shops. Even then, it remains important to check thoroughly for ticks daily.

How do you remove a tick?

The best method is to use pointed tweezers (or a tick remover) to grip the tick as close to your skin as possible. Pull the tick carefully out of the skin. If the tick’s mouthparts break off and remain in the skin, this is not a problem. The remaining piece will come out by itself.

You should not treat or sedate the tick with alcohol, oil, nail polish, soap or other substances. It is suspected that this increases the chance of infection.

If you are unable to remove the tick, see your GP or the GP out-of-hours post (HAP) the same day.

After removing the tick, clean the wound with alcohol (70%) or povidone-iodine solution. If you do not have these, wash it thoroughly with water and soap.

Note the date of the tick bite in your diary. Also write down where the tick attached itself (which part of your body). Also note in which region and country.

Medication after a tick bite

If you remove a tick within 24 hours, medication is not necessary. The chance of Lyme disease is so small that the disadvantages of antibiotics outweigh the benefits. If the tick has been attached for longer, you can still receive a single dose of antibiotics within 72 hours. A responsible alternative is to wait and watch carefully for symptoms that may be consistent with Lyme disease. There is then still enough time to treat with antibiotics.

When should you contact your GP?

Contact your GP:

• If you are unable to remove a tick; go to the practice or the GP out-of-hours post (HAP) the same day.
• If you have removed a tick that had probably been attached to the skin for 24 hours or longer.
• If, near the tick bite, a red or blue-red spot or ring appears within a few days to three months that grows larger within a few days (erythema migrans).

• If you start feeling flu-like symptoms with fever, headache, muscle pain and fatigue within three months of a tick bite.
• If you experience double vision or a drooping face long after a tick bite.
• If you experience pain, tingling or reduced strength in your arm or leg long after a tick bite.
• If you develop one or more swollen and painful joints, usually in your arms or legs, long after a tick bite.

The last 5 symptoms may indicate Lyme disease. Lyme disease is treated with antibiotics.

More information

More information about tick bites and Lyme disease can be found at:

• The RIVM - The RIVM developed a free Tick Bite app that allows you to look up what a tick looks like and how to remove a tick quickly: Android Tick Bite app and iPhone Tick Bite app.
• Tekenradar.nl - Check the expected tick activity before going into nature.

This text is from thuisarts.nl and is based on the NHG treatment guideline Tick Bite and Erythema Migrans. Last revised: 26-02-2025.