Summer on the Cape should be about tea dances, dune hikes, and late-night lobster rolls, not Googling “tiny spider thing on my thigh at 2 a.m.” Here’s the Tom of P-Town Health playbook for turning a tick-bite scare into a non-event—complete with why you should save the tick, when post-exposure doxycycline (PEP) makes sense, and how to reach us if you need help fast.
1. Chill, Then Flick It Off—Correctly
Grab fine-tipped tweezers and grasp the tick as close to the skin as possible.
Pull straight up with steady pressure—no twisting, nail-polish, Vaseline, or peppermint tricks.
Wash the bite (soap + water or alcohol). CDC
Pro tip: Snap a photo of the tick in situ before removal; it can help with species ID later.
2. Give the Tick a Tiny Airbnb
Saving the critter lets labs confirm the species, life-stage, feeding status, and even test for pathogens—and that can guide treatment later.
| How to store | Why |
|---|---|
| Slide the tick into a zip-lock bag (one per tick). If it’s alive, add a barely damp paper towel so it doesn’t desiccate. | Keeps DNA intact for testing. |
| Label the bag with date, body site, and where you were hiking/playing. | Critical epidemiologic info. |
| Pop the bag in the refrigerator (or a cool pocket of your cooler) until you decide what to do. | Slows decay; no alcohol needed. |
These handling steps match the submission instructions from the UMass Amherst TickReport™ lab, the go-to tick testing service for Cape Cod. tickreport.com
Want a report card on your hitchhiker? Order a mail-in test kit at TickReport.com or drop the bag at their Amherst lab—results land in your inbox in ≤ 3 business days. tickreport.com
3. Log the Details
Time attached? A flat, “seed-like” tick = likely < 24 h; a plump, gray one may have fed ≥ 36 h.
Life stage? Nymphs (poppy-seed size) cause most Lyme in New England.
Your meds & allergies? Will matter for doxycycline decisions.
4. Decide on Doxy PEP
A single 200 mg dose of doxycycline (4.4 mg/kg up to 200 mg in kids ≥ 8 y) within 72 h of removing a high-risk Ixodes scapularis bite lowers the chance of Lyme by about 87 %. IDSA HomeCDC
PEP is recommended when all of these boxes are ticked (pun intended):
| ✔︎ Criterion | Why it matters |
|---|---|
| Tick is likely Ixodes (deer tick) | They carry Lyme in MA. |
| Attachment ≥ 36 h or tick engorged | Transmission risk rises sharply after 36 h. |
| You can swallow doxy ≤ 72 h post-removal | Beyond that, benefit drops. |
| No doxy contraindication (pregnancy, severe allergy, kids < 8 y, etc.) | Safety first. |
If any box is unchecked, skip prophylaxis and move to watchful waiting (see § 5). Remember: doxy PEP doesn’t prevent babesiosis or anaplasmosis, so symptom vigilance is still key. Mass.gov
5. Monitor Like a Boss
Check the bite site daily for 30 days. Call us (or any clinician) ASAP for:
Expanding red rash ≥ 2″ (classic erythema migrans)
Fever, chills, sweats, body aches, Bell’s palsy, weird bruising, or crushing fatigue
No screening blood test is needed right after the bite; antibody tests won’t turn positive that early.
6. Prevent the Encore
Permethrin-treated clothing, 20–30 % DEET or picaridin on exposed skin, and a nude tick check after every dune romp keep the rest of your vacation itch-free. MA DPH has a handy prevention toolkit if you’re nerdy like us. Mass.gov
7. Need Backup?
Tom of P-Town Health often has same-day slots for tick-bite assessments:
go to tomofptown.com and register then you can request an appointment
What about “herbal prophylaxis”?
No botanical has been proven to prevent Lyme after a bite. Save your money for another lobster roll.
I’m pregnant—can I still get treated?
PEP decisions are individualized; amoxicillin is used for early Lyme in pregnancy. Call us for obstetric-friendly guidance.
References
CDC. What to Do After a Tick Bite (updated 2025). CDC
IDSA–AAN–ACR. 2020 Lyme Disease Guidelines, Section IV: Chemoprophylaxis. IDSA Home
CDC. Lyme Disease Treatment & PEP Overview (Aug 2024). CDC
TickReport™. Sending & Receiving Tick Specimen FAQ (accessed Apr 2025). tickreport.com
MA Dept. of Public Health. Tick-Borne Disease Prevention portal (2024). Mass.gov
Stay safe, save that tick, and enjoy every glorious, glitter-covered moment of your P-Town summer!
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