Get first dibs

Lyme Disease Prevention: How Transmission Works and What Actually Lowers Your Risk

Lyme disease spreads through the bite of an infected blacklegged tick. The CDC says infected ticks generally must stay attached more than 24 hours to transmit the bacteria, so prevention is layered: avoid tick habitat, use EPA-registered repellent, treat clothing with 0.5% permethrin, then check your body and remove any attached tick promptly.

How does Lyme disease actually get into a person?

In the United States, Lyme disease is caused by the bacterium Borrelia burgdorferi and, rarely, Borrelia mayonii, spread to people through the bites of infected ticks. The blacklegged tick, also called the deer tick (Ixodes scapularis), transmits infection in the northeastern, mid-Atlantic, and north-central United States. The western blacklegged tick (Ixodes pacificus) does so along the Pacific Coast.

Not every tick carries anything. The CDC says the percentage of ticks that are infected ranges from none to over 50%, depending on the area and life stage, and that blacklegged ticks in most areas of the southeastern United States are almost never infected. Several ticks people worry about cannot transmit Lyme at all: the CDC lists the lone star tick, the American dog tick, the Rocky Mountain wood tick, and the brown dog tick as unable to transmit Lyme disease bacteria. The CDC calls Lyme disease the leading cause of tickborne disease in the United States, with an estimated 476,000 infections diagnosed and treated each year.

How long does a tick have to be attached to transmit Lyme?

This is the number that makes a daily tick check worth two minutes. The CDC states that in general, infected ticks must be attached for more than 24 hours to transmit infection, and that prompt tick removal can prevent transmission. In its own words: "If you remove a tick within 24 hours, you can greatly reduce your chances of getting Lyme disease."

The catch is that the riskiest ticks are the ones you are least likely to spot. Nymphal ticks pose a particularly high risk due to their abundance and small size, about the size of a poppy seed. In areas of the eastern United States where Lyme disease is common, the CDC says nymphs are actively questing for hosts from April through July. The CDC notes that Lyme disease patients are often not even aware of a tick bite before getting sick. Adult females can also transmit the bacteria, but at roughly the size of a sesame seed they are more likely to be noticed and removed first.

Where and when do people pick ticks up?

Ticks live in grassy, brushy, or wooded areas, or even on animals. Exposure can happen year-round, but ticks are most active during the warmer months of April through September, and the CDC notes blacklegged ticks can bite any time winter temperatures are above freezing. The CDC also says many who develop Lyme disease are exposed in their own yards or neighborhoods, not just in wooded or rural areas.

What are the prevention layers, in order?

1. Avoid the habitat where you can

The CDC recommends avoiding wooded and brushy areas with high grass and leaf litter, and walking in the center of trails.

2. Put fabric between you and the tick

The EPA recommends keeping ticks away from exposed skin by wearing long-sleeved shirts, long pants, and high boots, tucking shirts into pants and pants into socks to cover the gaps where ticks get in, and wearing light-colored clothing so ticks are easier to see.

3. Treat clothing and gear with 0.5% permethrin

The CDC recommends treating clothing and gear with products containing 0.5% permethrin. It can be used on boots, clothing, and camping gear, and remains protective through several washings. You can also buy permethrin-treated clothing and gear. One rule is not optional: do not use permethrin products directly on skin.

4. Use an EPA-registered repellent on skin

The CDC recommends EPA-registered insect repellents containing DEET, picaridin, IR3535, oil of lemon eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone, and looking for an EPA registration number (EPA Reg. No.) on the label. That number means the company provided EPA with technical information on the effectiveness of the product.

Application details matter. The EPA says to follow the label directions, apply only to exposed skin and clothing rather than under clothing, avoid applying near eyes and mouth, spray on hands first and then apply to the face, never use repellents over cuts, wounds, or irritated skin, and wash treated skin and clothes with soap and water after returning indoors. For children, apply to your own hands first rather than to the child's hands. The CDC adds that sunscreen goes on first and repellent second, and that products containing OLE or PMD should not be used on children under 3 years old.

5. Run the indoor routine every time

This is the layer people skip, and it catches what the others missed.

  • Check your clothing. Tumble dry clothes on high heat for 10 minutes to kill ticks on dry clothing. Damp clothes may need additional time. If clothes need washing first, hot water is recommended, because cold and medium temperature water will not kill ticks.
  • Examine gear and pets. Ticks ride into the home on clothing and pets and attach to a person later, so check pets, coats, and daypacks.
  • Shower soon after being outdoors. The CDC states that showering within two hours of coming indoors has been shown to reduce your risk of getting Lyme disease and may be effective in reducing the risk of other tickborne diseases.
  • Do a full body check. Use a hand-held or full-length mirror. The CDC's checklist covers under the arms, in and around the ears, inside the belly button, back of the knees, in and around the hair, between the legs, and around the waist. The CDC also suggests running a lint roller over your skin, clothing, and gear to pick up unattached ticks you cannot see.

What is the correct way to remove a tick?

Speed beats technique. The CDC says to remove the tick as soon as possible and not to wait for a healthcare provider, because delaying removal could increase your risk.

  1. Grasp the tick as close to the skin's surface as possible with clean fine-tipped tweezers. If you do not have them, the CDC says regular tweezers or your fingers will work, grasping close to the skin to avoid squeezing the tick's body.
  2. Pull away from the skin with steady, even pressure. Do not twist or jerk, which can break off the mouthparts and leave them in the skin. If that happens, your body will push them out over time, and if you cannot remove them easily with tweezers, leave them alone.
  3. Dispose of the live tick in a sealed container, wrapped tightly in tape, flushed down the toilet, or in alcohol. Do not crush it with your fingers.
  4. Clean the bite area and your hands with soap and water, rubbing alcohol, or hand sanitizer, then check for other ticks. The CDC notes that finding one means there may be others.

The CDC warns against petroleum jelly, heat, nail polish, or other substances meant to make the tick detach, because this may agitate the tick and force infected fluid into the skin. It also advises against sending the tick for testing, and says that if you do become ill, you should not wait for tick testing results before beginning appropriate treatment.

What early symptoms mean it is time to call a doctor?

Early signs appear 3 to 30 days after a tick bite. The CDC lists fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes, which may occur in the absence of rash.

The erythema migrans (EM) rash occurs in approximately 70 to 80 percent of infected people. It begins at the bite site after a delay of 3 to 30 days, averaging about 7 days, and expands gradually over several days, reaching up to 12 inches (30 cm) or more across. It may feel warm to the touch but is rarely itchy or painful, and it sometimes clears as it enlarges, producing the target or "bull's-eye" look. The CDC is clear that it does not always appear as a classic bull's-eye and may show up anywhere on the body. Do not confuse it with the ordinary bite reaction: a small bump or redness that appears immediately and resembles a mosquito bite is common, generally goes away in 1 to 2 days, and is not a sign of Lyme disease.

Later signs, days to months after a bite, include severe headaches and neck stiffness, additional EM rashes elsewhere on the body, facial palsy, arthritis with severe joint pain and swelling particularly in the knees, heart palpitations or an irregular heartbeat, dizziness or shortness of breath, nerve pain, and shooting pains, numbness, or tingling in the hands or feet.

The CDC's rule of thumb: if you develop a rash or fever within several weeks of removing a tick, see your doctor, and tell them about the bite, when it occurred, and where you most likely acquired the tick. The outlook with care is good. The CDC states that most cases of Lyme disease can be treated successfully with a few weeks of antibiotics. In certain circumstances a single dose of doxycycline after a tick bite in an area where Lyme disease is common may lower risk, and the CDC advises asking your healthcare provider whether that is appropriate for you.

Common questions

If I pulled the tick off the same day, am I in the clear?

The CDC states that in most cases a tick must be attached more than 24 hours before the Lyme disease bacterium can be transmitted, and that removing it within 24 hours greatly reduces your chances. Still watch for a rash or fever in the weeks afterward and see your doctor if either appears.

Does Lyme always start with a bull's-eye rash?

No. The EM rash occurs in approximately 70 to 80 percent of infected people, and the CDC notes it does not always appear as a classic bull's-eye. Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes may occur in the absence of rash.

Do ticks shut down in winter?

Not entirely. Tick exposure can occur year-round, and the CDC notes blacklegged ticks can be active and bite people any time winter temperatures are above freezing.

About Longsleeve

Longsleeve is an EPA-registered picaridin lotion (EPA Reg. No. 101457-1). It repels mosquitoes and ticks for up to 14 hours. It is fragrance-free, with nine disclosed ingredients.

Nothing on this page is medical advice. If you have been bitten by a tick, or you have symptoms you are worried about, talk to a clinician.

Sources

  1. CDC, How Lyme Disease Spreads. https://www.cdc.gov/lyme/causes/index.html
  2. CDC, Preventing Lyme Disease. https://www.cdc.gov/lyme/prevention/index.html
  3. CDC, Preventing Tick Bites. https://www.cdc.gov/ticks/prevention/index.html
  4. CDC, Signs and Symptoms of Untreated Lyme Disease. https://www.cdc.gov/lyme/signs-symptoms/index.html
  5. CDC, What to Do After a Tick Bite. https://www.cdc.gov/ticks/after-a-tick-bite/index.html
  6. CDC, About Lyme Disease. https://www.cdc.gov/lyme/about/index.html
  7. CDC, About Permethrin-Treated Clothing and Gear. https://www.cdc.gov/mosquitoes/prevention/about-permethrin-treated-clothing-and-gear.html
  8. EPA, Using Insect Repellents Safely and Effectively. https://www.epa.gov/insect-repellents/using-insect-repellents-safely-and-effectively
  9. EPA, Tips to Prevent Tick Bites. https://www.epa.gov/insect-repellents/tips-prevent-tick-bites

Last reviewed 2026-08-05 · every claim on this page is sourced above