Tick removal — Using proper technique for tick removal is important. Several methods of tick removal have been advocated. A study that evaluated the use of forceps or protected fingers, or the application of petroleum jelly, fingernail polish, isopropyl alcohol, or a hot match, found that only the use of forceps or protected fingers resulted in the satisfactory removal of 29 adult American dog ticks without leaving the mouthparts in the host skin [11].

In most countries, the proper technique for removal of the attached tick involves the use of a clean fine-tipped tweezer (or similar devise) [12] and includes the following steps (figure 4):

●If available, use tweezers (or small forceps) to grasp the tick as close to the skin surface as possible. In the absence of tweezers, use paper or cloth to protect the fingers during tick extraction.
●Pull straight up gently but firmly, using steady pressure. Do not jerk or twist.
●Do not squeeze, crush, or puncture the body of the tick, since its fluids may contain infectious agents.
●Disinfect the skin thoroughly after removing the tick and clean your hands with alcohol or soap and water.
●If sections of the mouthparts of the tick remain in the skin, they should be left alone as they will normally be expelled spontaneously.
●After the tick removal and the skin cleansing, the person bitten (or the parents) should observe the area for the development of EM for up to 30 days following exposure. Components of tick saliva can cause transient erythema that should not be confused with erythema migrans (EM).
●Since the tick usually needs to be attached for two to three days before transmission of the Lyme disease agent occurs, removal of the tick within this time frame often prevents the infection [5-8].

— UpToDate

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