Tick Bites and Possible Lyme Disease: When to Seek Care

An independent educational resource prepared by Mark M. Simonian, MD, FAAP

Sources checked: August 9, 2026     |     Medical review completed: August 9, 2026

This page is for general education only and does not replace individualized medical advice. This resource does not establish a doctor-patient relationship. For questions about your own child, contact your child's current healthcare professional.

Magnolia Pediatrics, Valley Children's Healthcare

2497 E. Herndon Avenue, Suite 101, Clovis, CA 93611     |     559-538-3070

Most tick bites do not cause illness. Remove an attached tick promptly, then watch the child for fever, a spreading rash, or new symptoms during the following days and weeks. Tell a healthcare professional about the bite and any recent outdoor travel or activity.

Urgent Warning Signs - Check This First

A tick bite itself is usually not an emergency. Urgency depends on the child's symptoms, not on trying to identify a tick at home.

CALL 911 NOW

  • A severe allergic reaction with breathing or swallowing difficulty, collapse, or blue or gray color

  • The child is unresponsive, has a seizure, severe trouble breathing, or another life-threatening emergency

GET EMERGENCY MEDICAL CARE NOW

  • A severe headache with confusion, stiff neck, repeated vomiting, weakness, fainting, or a child who is difficult to wake

  • A rapidly worsening illness with high fever, a widespread purple or red rash, severe pain, or a child who looks very ill

  • New facial weakness, trouble walking, severe weakness, or new neurologic symptoms after a possible tick exposure

CONTACT YOUR CHILD'S HEALTHCARE PROFESSIONAL TODAY

  • Fever, chills, unusual fatigue, headache, muscle or joint aches, or a new rash in the days or weeks after a tick bite or likely tick exposure

  • A red rash that enlarges over days, with or without central clearing; it may be solid red and does not need to look like a classic bull's-eye

  • The bite site becomes increasingly red, warm, swollen, painful, drains pus, or develops red streaks

  • You cannot remove the tick completely, the tick may have been attached for a long time or is noticeably engorged, or the child was exposed in an area where Lyme disease occurs

  • A tick bite during the last 72 hours that may meet criteria for Lyme disease preventive treatment; a clinician must determine whether preventive antibiotics are appropriate

How to Remove an Attached Tick

  • Use clean, fine-tipped tweezers. Grasp the tick as close to the skin as possible.

  • Pull upward with steady, even pressure. Do not twist, jerk, crush, burn, cover the tick with petroleum jelly, or use nail polish or other home remedies.

  • After removal, clean the bite area and hands with soap and water or an appropriate skin cleanser.

  • If small mouthparts remain, do not dig into the skin. The body often pushes them out as the skin heals. Call if the area becomes infected or you are concerned.

  • Dispose of the tick by placing it in alcohol, a sealed bag or container, or wrapping it tightly in tape. Do not rely on tick testing to decide whether a child needs treatment.

What Is Normal After a Tick Bite

  • A small red, itchy, or tender bump near the bite can occur soon after removal and usually improves over a few days.

  • A local reaction that begins within 24 hours and stays small is not, by itself, evidence of Lyme disease.

  • Some infections transmitted by ticks can cause symptoms days to weeks later. Watch the whole child, not only the bite site.

Watching for Lyme Disease and Other Tick-Borne Illness

In California, and especially after travel, ticks can transmit several diseases. Lyme disease can begin 3 to 30 days after an infected tick bite with fever, chills, fatigue, headache, muscle or joint aches, and/or an enlarging red rash. Other tick-borne illnesses can also cause fever, rash, and body aches. Early evaluation is important when a child becomes ill after tick exposure.

Antibiotics After a Tick Bite

Antibiotics are not routinely needed after every tick bite. In limited high-risk situations, a clinician may recommend a single preventive dose of doxycycline within 72 hours after removal. That decision depends on the tick, the location and likely duration of attachment, the timing, and the child's individual circumstances. Do not use leftover antibiotics or delay tick removal while waiting for advice.

Prevention

  • When in grassy, brushy, wooded, or leaf-litter areas, use an EPA-registered repellent according to its label. Do not use products containing oil of lemon eucalyptus or para-menthane-diol on children younger than 3 years.

  • Wear long sleeves and long pants when practical. Clothing and gear may be treated with 0.5% permethrin; never apply permethrin directly to skin.

  • Check children carefully after outdoor activity, including the scalp and hairline, behind the ears, under the arms, in the groin, behind the knees, and around the waist.

  • Shower soon after returning indoors, check clothing and gear, and place outdoor clothing in a hot dryer as directed by the garment label.

Call Preparation

  • When and where the possible exposure occurred, including travel outside the local area

  • When the tick was noticed and removed, whether it looked flat or engorged, and a photo of the tick if available; do not delay care to obtain a photo

  • Any fever, rash, headache, body aches, joint pain, fatigue, or changes in behavior

  • Repellents, medicines, or treatments already used

Related Guides

  • Insect Bites and Stings in Children: When to Seek Care

  • Rashes and Skin: When to Seek Care

  • Fever and Illness: When to Seek Care

  • Sun Safety and Sunburn in Children: When to Seek Care

Sources and Medical Review

  • Centers for Disease Control and Prevention (CDC), What to Do After a Tick Bite https://www.cdc.gov/ticks/after-a-tick-bite/index.html

  • Centers for Disease Control and Prevention (CDC), Preventing Tick Bites https://www.cdc.gov/ticks/prevention/index.html

  • HealthyChildren.org (AAP), How to Remove a Tick https://www.healthychildren.org/English/health-issues/conditions/from-insects-animals/Pages/How-To-Remove-A-Tick.aspx

  • California Department of Public Health (CDPH), Tick-Borne Disease Prevention https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/TickBorneDiseasePrevention.aspx

  • California Department of Public Health (CDPH), Lyme Disease https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/LymeDisease.aspx