Written by Dr Lyndsey Boreham, Private GP at Dr Helen Medical
Living and working close to the New Forest means we are incredibly fortunate to have beautiful woodland, heathland and open countryside on our doorstep. Witnessing the New Forest ponies and their foals basking in the sunshine, especially during the summer months, is just glorious!
As a mum, a GP and keen runner, I would never want concerns about ticks to stop anyone enjoying the outdoors. However, it is sensible to know how to avoid tick bites, check your family afterwards and recognise when a bite may need medical attention.
Ticks are common in woodland and grassy areas, particularly where deer and other animals are present. Most tick bites do not cause illness, but some ticks can carry the bacteria responsible for Lyme disease. The most important things are to find and remove ticks promptly and to keep an eye out for symptoms afterwards.
What is a tick?
Ticks are tiny, spider-like creatures that feed on the blood of animals and humans. Unlike insects that fly or jump, ticks wait on grass and vegetation before attaching themselves to a person or animal brushing past.
Some can be extremely small, particularly young ticks known as nymphs, so they are not always easy to spot. A tick bite is not usually painful, which means you may only notice it when checking your skin later.
Ticks can be active throughout the year, although activity tends to be greater during the warmer months. Woodlands, grasslands and areas of scrub are typical tick habitats, making awareness particularly important when enjoying the New Forest.
How can I avoid tick bites in the New Forest?
There is no need to avoid family walks, picnics or days outdoors, but a few simple precautions can help reduce the chance of being bitten:
- Keep to clearly defined paths where possible.
- Avoid brushing against long grass and dense vegetation.
- Wear long trousers and long-sleeved tops in overgrown areas.
- Tuck trousers into socks if walking through long grass.
- Choose light-coloured clothing, which makes ticks easier to spot.
- Use an insect repellent containing DEET, following the instructions carefully.
- Check exposed skin and clothing during and after your walk.
In my house, the post-walk tick check has simply become part of the routine, much like checking for muddy shoes before coming indoors.
Where should I check for ticks?
After spending time in the New Forest, check your clothing and carefully look and feel across the skin. Ticks often attach themselves in warm or less visible areas, including:
- Behind the knees
- Around the waistband
- In the groin
- Under the arms
- Around the wrists
- Behind the ears
- At the back of the neck
- Along the hairline and through the scalp
Children are more likely than adults to have ticks attached around the head and neck, so check these areas particularly carefully. Remember to check pets too, as ticks can attach themselves to dogs after a walk.
What should I do if I find a tick?
If you find an attached tick, remove it as soon as possible.
Use a fine-tipped pair of tweezers or a specially designed tick-removal tool. These are inexpensive and useful to keep in a family first-aid kit.
To remove a tick safely:
- Grasp it as close to the skin as possible.
- Pull slowly and firmly upwards.
- Try not to squeeze or crush the tick.
- Clean the bite area with antiseptic or soap and water.
Avoid covering the tick with substances such as petroleum jelly or essential oils, and do not try to burn it off. These methods may irritate the tick and are not recommended.
It can also be helpful to take a photograph of the bite and make a note of the date. This gives you a useful point of comparison if the skin changes or symptoms develop.
Does every tick bite cause Lyme disease?
No. Most tick bites do not lead to Lyme disease and not every tick carries the bacteria that cause it.
If you have removed a tick and feel completely well, you will not usually need treatment. Preventative antibiotics are not routinely prescribed following a tick bite in the UK.
However, it is important to remain aware of possible symptoms in the weeks that follow. Lyme disease is generally easier to treat when it is recognised early.
What does a Lyme disease rash look like?
One of the best-known signs of Lyme disease is a circular or oval rash known as erythema migrans.
The rash may:
- Gradually spread outwards
- Look like a bullseye or target
- Have a darker or lighter area in the centre
- Appear pink, red or purple
- Look more like a bruise on brown or black skin
Unlike many insect-bite reactions, a Lyme disease rash is not usually hot, painful or itchy.
It does not always appear immediately. According to the NHS guidance on Lyme disease, it most often develops within one to four weeks but can appear up to three months after a bite.
A small area of redness or itching immediately around a bite is often a local skin reaction and does not necessarily mean Lyme disease. If the redness begins to expand, however, it should be assessed by a clinician.
It is also important to know that not everyone with Lyme disease develops or notices a rash.
What other Lyme disease symptoms should I look out for?
Some people experience flu-like symptoms in the days or weeks after being bitten, including:
- A high temperature or feeling hot, cold or shivery
- Headaches
- Muscle or joint pain
- Unusual tiredness or loss of energy
- Swollen glands
These symptoms can have many different causes, but you should speak to a doctor if they develop after a known tick bite or after spending time in woodland or long grass.
When seeking medical advice, mention your recent visit to the New Forest even if you do not remember being bitten. Ticks are small and their bites can easily go unnoticed.
When should I make a GP appointment?
Arrange an urgent GP appointment or contact NHS 111 if, within three months of a tick bite or visiting a tick habitat, you:
- Develop a spreading circular or oval rash
- Experience unexplained flu-like symptoms
- Feel unusually tired or unwell
- Develop muscle or joint pain
- Are concerned that a tick has not been removed properly
- Notice that the bite area is becoming increasingly painful, hot, swollen or producing discharge
Seek urgent medical help for serious symptoms such as facial weakness, confusion, a severe headache with neck stiffness, breathing difficulties or a significant change in your child’s responsiveness.
How is Lyme disease diagnosed and treated?
A GP will ask about your symptoms, any rash you have noticed and recent time spent in wooded or grassy areas.
Lyme disease is not always diagnosed through a blood test. Tests can be less reliable during the early stages and a characteristic spreading rash may be enough for a clinician to recommend treatment.
If Lyme disease is suspected, it is usually treated with antibiotics. The type and duration will depend on factors including your symptoms and age. Most people recover well, particularly when treatment begins promptly.
Enjoy the Forest, but make tick checks part of the routine
The New Forest is a wonderful place for children and adults to walk, play and spend time together. Tick awareness should help us enjoy it more safely, not make us frightened of being outdoors.
Wear suitable clothing, check everyone carefully when you return home and remove any ticks promptly. Most bites will cause no further problems, but if a spreading rash appears or you begin to feel unwell, please do not ignore it.
Concerned about a tick bite?
If you or your child has been bitten by a tick, has developed an unusual rash or feels unwell after spending time in the New Forest, our GPs at Dr Helen Medical can provide a thorough assessment and advise on any treatment or further testing required.
Book a private GP appointment at Dr Helen Medical in Ringwood by calling 01202 022956 or click here.