Editor's Note: We've made updates to this Journal entry. We've given this information its own page. View all the tick details here.

May is the beginning of deer tick season in New England. Deer ticks often carry, and sometimes transmit, Lyme disease.

Lyme disease is really unpleasant, varied, and difficult to diagnose. We have friends that have gone years with misdiagnosis. the best way to avoid it and get properly diagnosed it to become an expert in tick avoidance, checking, and elimination. Here are some steps worth taking.

How to avoid getting bitten by a Deer Tick

Stay on the trail. Avoid brushing up against tall grass and overgrown brush. Don't bushwhack.
Ticks almost always come from thigh level or lower; they don't drop from trees on their prey. They can come from above but the odds are significantly higher that they'll come from below.
Cover your skin:
- Wear long socks - even in the summer. Lighter colors make it easier to do tick checking.
- Wear arm screens or arm warmers.
- Wear tight clothing - bibs, fitted cycling jersey - so that a tick can't get past the selvege.
Use insect repellent with DEET in it. the higher the concentration of DEET, the longer the protection lasts; for example, 24% DEET provides an average of 5 hours of protection. DEET at 7% provides about 2 hours of protection.
Treat your cycling clothing with permethrin.
Wear a cycling cap. While they are not likely to come from above, hair is a home for them. A chapeau reduces the chance a tick can hide on you.
Make checking for ticks part of your riding routine:
- Check yourself every 2-3 hours while riding.
- Check yourself at the end of your ride. Odds of getting Lyme disease if the tick is attached to your skin for less than 24 hours is extremely low - some well-respected documents say the odds are zero : "During the first 24 hours of tick attachment, there is no transmission."
Shave your legs: Leg hair makes it much easier for a tick to hitch a ride on you.
Don't ride on deer tracks. Not that most people would, but if you're into off-trail riding, deer tracks can be very tempting.

Spotting a Deer Tick

Deer ticks are very small; the young are typically about the size of a poppy seed. Full grown ticks are about 2-3mm, or a tenth of an inch. Pictured is an example of a deer tick an OBC scout found on body. It's less than half the size of a sesame seed! It is definitely a Nymph - probably a female. Initially we thought it was a larva because it was so small, but this tick has eight legs; larvae have six legs.

Self-Inspection: Post-Ride

Deer ticks can be very small – much smaller than you might possibly imagine.
If you’ve been on a muddy or dirty ride, wash up before self-check. A deer tick can easily look like a spec of dirt. Ideally, take a shower.
Only a close physical inspection will find ticks. We find that using hands as a second set of eyes helps find the smallest small ticks.
Pay close attention to the edges of your bibs, socks, and sleeves.
Pay extra attention to your hairline and hair, in and around ears, arm pits, back of knees.
Ticks can get on your clothes and stay there for quite a while; check your clothes, cap, gloves, and shoes.
If you feel a vague scratch or itch. Do a physical check. This can seem frustrating - because we're almost always itchy somwehere. However, you’re unlikely to feel a tick bite because they secrete a numbing agent. So, if you feel any sensation at all it's likely to be very subtle. When in doubt, do a physical check.
Have your significant other help!

What to do if you have a tick on you

Photograph the site prior to removing the tick to document location of bite. Then photograph the tick after removing it. This will enable you or your doctor to determine the species - was it actually a deer tick? - and whether it took a blood meal from you - does it look bloated or engorged? [Thanks to Leon P. for this tip!]
Remove the tick promptly. The sooner you remove it, the less chance of infection; within 24-36 hours is best.
Grasp the mouth-parts with tweezers as close as possible to the attachment (skin) site. If tweezers are not available, use fingers shielded with tissue or rubber gloves. Do not handle a tick with bare hands.
Be careful not to squeeze, crush, or puncture the body of the tick, which may contain infectious fluids.
Gently pull the tick straight out with a steady motion.
After removing the tick, thoroughly disinfect the tick site with rubbing alcohol or an antibacterial wash and then wash hands with hot water and soap.
See or call a doctor if there are concerns about incomplete tick removal.
Do not remove ticks by using petroleum jelly, lit match, kerosene, nail polish, or other home remedies because they may actually increase the chance of contracting a tick-borne disease.

If you have been bitten and believe you might have Lyme disease

Does the following combination of factors describe your situation? The bite is by a deer tick, likely to have jumped on you in an area where the incidence of Lyme is high, and the tick looks engorged. In this scenario, a single dose of Doxycycline 200mg has been shown to decrease the risk of coming down with Lyme substantially, but it must be taken in the first 72-hours after removing the tick; the sooner the better. Call your doctor right away. [Thanks to Leon P. for this information!]

Content of this post are taken and edited from multiple sources:

http://www.ct.gov/caes/lib/caes/documents/publications/fact_sheets/tickbiteprevention05.pdf
http://www.dhhs.nh.gov/DPHS/cdcs/lyme/documents/lyme.pdf
http://www.dhhs.nh.gov/DPHS/cdcs/lyme/documents/tickbites.pdf
Leon P.