Monday, June 8, 2009

Tick Talk - What's the best way to remove ticks?

A Journey of Discovery About Tick Removal

Quick update 2013: I've now removed ticks with the soap method.  Brilliant!  Even with one firmly embedded, the tick came off whole.  I'm sold on Whole Child Pediatric's method I questioned in  2009.   Here is more on their method and my journey...

June 8th, 2009: I took my 3-year-old to be tested for Lyme disease today.  Last year Whole Child Pediatrics in Ashburn, VA, gave me a sheet on a wonderful, "100% successful", easy way to remove ticks:

Soak a cotton ball in liquid soap. Place the cotton ball on the tick. Rotate counter-clockwise. The tick comes off whole. This is much better than the usual tweezers way because there is no chance of leaving some of the tick behind. "Everyone should know this," I thought. I considered putting it on my blog, but although it came from my children's pediatrician's office, I hadn't tried it myself, so I felt I needed to do further research.
Snopes has a compelling argument that this method is an old wives tale. See:
Moreover, both the center for disease control and the US Food and Drug Administration say the best way to remove a tick is with tweezers.

With all this information, I knew exactly what do to when I realized that the miniscule scab on my daughter's thigh had legs: panic. Now I can tell you from personal experience: searching madly through the house while yelling at your husband for not having long nose and ear hair so you'd have a decent pair of tweezers, is not an effective way of removing ticks.

After doing the best I could at pulling the tick out with our lousy set of tweezers, it still looked like some remained. I called Whole Child Pediatrics to speak with the nurse. She told me, "next time use liquid soap on a cotton ball twisting counter clockwise."
"That doesn't work," I told her, "I looked it up online."
"Well, it has worked for me on all my patients - even recently for a tiny embedded tick that I thought for sure we wouldn't get out. Plus I use it all the time on my dogs."

So now I don't know who to believe. I wrote to Snopes to ask if they've actually had experience with this rotating liquid soap method not working. I suppose it is possible that experts ruled out this method without testing scientifically because there are so many wives tales that do not work. I'll let you know if I hear back. In the mean time please let me know if anyone else has success or failure removing ticks with liquid soap on a cotton ball rotating counter clockwise.

June 11, 2009 - conversation with doctor and Snopes follow-up
Today we took my daughter to her pediatrician, Dr. Chamberlain at Whole Child Pediatrics[1]. As opposed to Snopes and others, she DOES recommend using liquid soap on a cotton ball, rotating counter clockwise (CCW) on the tick. I asked her about her personal experience using this method. Dr. Chamberlain said that so far this year, she has removed 6 ticks off of her patients. Five she removed successfully with CCW motion of a soapy cotton ball. One time it did not work but, Dr. Chamberlain noted, the soap had no ill effect and it may have worked if she had more time. (She had to move on to the next appointment so the parent chose to have her remove that tick with tweezers. ) Dr. Chamberlain also told me that parents are continually thanking her for teaching them this soap method.
"Has anyone complained to you that it hasn't worked for them?" I asked. They have not.
Dr. Chamberlain informed me that she learned this method from Dr. Laura Pasternak, the wonderful doctor who founded Whole Child Pediatrics. Dr. Pasternak was the one who prepared the sheet that I had been given describing the method - not some evil prankster as I had feared on reading Snoops!
Although Dr. Chamberlain has heard the warning that stressing the tick may produce more saliva or regurgitation, she questions whether soap creates more stress than tweezers. Although tweezers are usually quicker, pinching is intense, moreover, the tick sometimes breaks. Having had the experience of picking out parts with a needle, she is sticking with the tear-free soap method for her patients, at least until she sees a scientific study proving otherwise.
To that end, I've been trying to track down scientific studies. I can not find any that deal with the CCW soap method. Of course, Snopes does specifically address the soap method, calling it "false" but from following through to their sources, it appears that they reach their conclusion by extrapolating. There are many experts, including government sources, that claim the best way to remove a tick is with tweezers and that "old wives tales" do not work. Therefore any other method must be false. However, it does not appear that these experts have tried the CCW soap method. They specifically rule out smothering with petroleum jelly and burning with a match. However, soap is very good at disengaging germs, so I find it possible that soap has attributes that petroleum jelly does not and that the mechanism at play is not smothering.
I queried Snopes directly asking if they had any experience or knowledge of scientific studies that specifically showed that the CCW rotating soapy cotton ball didn't work. They wrote back, "It may work just fine; it's just not a good idea, for all of the reasons enumerated in our article."
My daughter tested negative for lyme, thank goodness. Next time I think I will try the counter clockwise rotating cotton ball/ soap method recommended by her doctor. (And no, it isn't clockwise in Australia.) I'm also getting a pair of tick tweezers as back up.

June 12, 2009
I went to the Leesburg, Pharmacy[2] to pick up my tweezers. While there I decided to get the pharmacist's opinion. Cheri Garvin, R.Ph weighed in for trying the rotating soap method first and only using tweezers if unsuccessful. "I've just seen the body break off from the head too often with tweezers," she explained. "Soap acts as a surfactant so the tick comes out whole."

[1] Whole Child Pediatrics, 20925 Professional Plaza, Ashburn, VA 20147. Phone: (703) 723-8900
[2] Leesburg Pharmacy, 36-C Catoctin Circle, SE, Leesburg, VA 20175. Phone: 703-777-5333

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