Tick bite itches - is that normal?
Ticks are parasites that occur worldwide. They feed on the blood of vertebrates, including the blood of humans (= host). They prefer it warm and humid and are especially active from February to October. The tick season can shift depending on the temperature. They are mainly found at the edges of forests or in gardens in tall grass and bushes.
There are many different types of ticks. Many of them are responsible for the transmission of pathogens. The pathogens are released into the wound via the tick's saliva during the sucking process. Lyme disease and early summer meningoencephalitis (TBE) are among the most common tick-borne diseases. Both diseases are mainly transmitted by the common wood tick (Ixodes ricinus).
Causes of an itchy tick bite
When a tick bites, various saliva proteins are introduced into the wound by the tick, which prevent an inflammatory reaction at the puncture site and are intended to numb the wound. As a result, a tick bite is often noticed late or not at all.
An itchy tick bite is a warning sign and can have various causes. On the one hand, an infection of the wound with bacteria can lead to itching; on the other hand, an allergic reaction to the tick's salivary proteins can be the cause. In any case, an itchy tick bite should be viewed and assessed by a doctor.
These symptoms tell me that my tick bite is dangerous
With every tick bite there is a risk of transmitting pathogens. In any case, the tick should be removed from the skin as quickly as possible. It is important that the tick is completely removed and not squeezed.
A tick bite becomes dangerous if the borreliosis or TBE pathogens are transmitted. However, there is generally no need to panic when a tick bite, as only about 4% of all ticks transmit one of the two diseases.
General signs of infection
In general, if the wound is painful, reddened or swollen, a doctor should clarify it. These symptoms are generally associated with inflammatory reactions and can be an indication of an infection or an allergic reaction.
Read more on the subject at: Inflamed tick bite - what should you do?
Indications of infection with borreliosis pathogens
Lyme disease is the most common tick-borne disease. Ticks with borreliosis pathogens (Borrelia burgdorferi bacterium) can be found all over Germany. After a few days to weeks, around half of the infected people develop a rash that spreads in a circle with central pallor (wandering redness, erythema migrans). In some cases itching also occurs. Pain is rather rare. Other symptoms can include:
- Fever after a tick bite
- a headache
- Joint and muscle pain
- Swelling of the lymph nodes
If an infection with borreliosis pathogens is not recognized and treated, the nervous system can be infested with paralysis of the facial muscles (facial paralysis) or the extremities.
More on this topic can be found here: How can you recognize Lyme disease?
Indications of an infection with the TBE virus
The TBE pathogen transmitted by the tick is the TBE virus. Ticks with TBE pathogens are found mainly in southern Germany.
In most cases, an infection with the TBE virus runs without symptoms. Flu-like symptoms occur at the onset of the infection in only 10% of cases. In the further course neurological deficits, fever and signs of meningoencephalitis can occur.
You can find more about the clinical picture of early summer meningoencephalitis here: TBE
Course of disease
There are 3 different stages in the course of Lyme disease:
Stage 1 (local early manifestation with an incubation period of 5-29 days)
- Erythema migrans
- a headache
- Joint and muscle pain
- Swelling of the lymph nodes
Stage 2 (early disseminated infection with an incubation period of weeks to months)
- Acute neuroborreliosis (involvement of the nervous system with paresis of various muscles, e.g. facial nerve palsy and signs of meningitis)
Stage 3 (late disseminated infection with an incubation period of months to years)
- Joint inflammation with joint swelling
- Skin changes, especially on the extensor sides of the extremities (acrodermatitis chronica atrophicans)
- Chronic neuroborreliosis with progressive brain inflammation (encephalitis / encephalomyelitis)
Erythema migrans occurs at the beginning only in 50% of those affected (clear indication of Lyme disease). Not every stage has to be run through, stages can also be skipped.
Read more about the symptoms of Lyme disease on the following page: Symptoms of borreliosis
Borreliosis is a bacterial infection and can therefore be treated well with the help of an antibiotic. The antibiotic of choice is doxycycline, which must be taken for two weeks. The earlier the therapy, the better the prognosis. Often there is a complete regression of the symptoms. If there are already neurological deficits, paresis can persist despite therapy.
More information here: Treatment of borreliosis
Erythema migrans can either disappear on its own or as part of antibacterial therapy. The disappearance of the rash does not have to be a sign of healing. The infection can still have spread in the body (disseminated form of Lyme disease), but this is only very rarely the case.
Therapy at the beginning of an infection often leads to the healing of the borreliosis. The prognosis is therefore good.
If the borreliosis has already spread to the nervous system unnoticed, the therapy can be more difficult and a complete cure cannot always be achieved.
Course of disease
When infected with the TBE virus, 90% of people have no symptoms.
In only 10% of cases, flu-like symptoms occur after an incubation period of approx. 7-14 days. After a subsequent fever-free interval, the fever usually rises again with signs of inflammation of the brain and meninges (meningoencephalitis).
You can find more about the course of the disease here: TBE
An infection with the TBE virus can only be treated symptomatically with pain relievers and antipyretic drugs (ibuprofen or paracetamol).In contrast to Lyme borreliosis, however, you can protect yourself against illness with the help of a TBE vaccination.
Read more about the TBE vaccination here: Vaccination against TBE
In most cases the disease proceeds without complications and heals without consequences.
Depending on the severity of the symptoms and especially when all brain structures (meninges, brain matter and possibly the spinal cord) are involved, symptoms such as headaches, paralysis, etc. may last longer or persist permanently. In very rare cases, TBE can be fatal (in about 1% of cases).
More information here: TBE
Prevent tick infection with pathogens
If you spend a lot of time in areas with ticks during the tick season, you should try to protect yourself against tick bites with the following measures:
- Bug sprays
- Covering the skin
- Avoiding walks in the woods
If a tick has already bitten, it should be removed immediately. This reduces the risk of transmission of pathogens (the longer the tick sucks, the higher the probability of pathogen transmission). Care should be taken to ensure that the tick is completely removed and not squeezed.
Read more on the topic: Tick bite
What to do with itching
If the puncture site is itchy, it is best not to scratch. This can inflame the puncture site further and further germs can get into the wound. Cooling creams or ointments and cooling packs can temporarily relieve the itching.
An itchy tick bite is always a warning sign and should be clarified by a doctor.
In general, cooling and anti-inflammatory ointments can relieve itching. However, the itching should be clarified by the doctor at an early stage, since in the case of Lyme disease, therapy with doxycycline should be started as soon as possible. If the body has a defense reaction, anti-inflammatory ointments can stop the itching.
- Cool packs
- Ice cubes
- Ribwort plantain (crushing and applying the leaves to the affected area of skin can relieve itching)
- Apply onion to itchy skin (has an antibacterial and antiseptic effect)
- Vinegar (can prevent further germs from entering, apply only after removing the tick)
Tick bite itches again after a long time - can that be an indication of Lyme disease?
Borreliosis has a relatively long incubation period. That said, it can take a long time for the first symptoms of the disease to appear. One of the most common initial symptoms is erythema migrans (wandering redness), which can be accompanied by itching, but does not have to be. It is therefore possible that a tick bite or the skin only begins to itch after several weeks. A ring-shaped reddening around the puncture site is characteristic of erythema migrans. If you notice such skin changes, you should see a doctor as soon as possible.
More on the subject: Rash after a tick bite