User login
Liquid soap to remove that tick?
The prevalence of Lyme disease in the United States has steadily increased over the past several years. In 2013, the disease was reported in all but 8 states.1 Prevention, as we know, is key.
Common preventive steps include using DEET insect repellent, wearing long pants and sleeves outdoors, tucking pants into socks, wearing light-colored clothing to make ticks more visible, and checking one’s body daily for ticks.2,3 The next best way to prevent Lyme disease is timely tick removal, as it is believed that in most cases the Lyme disease bacterium can be transmitted after 36 to 48 hours of tick attachment.2,3
The safest and most effective method of removal remains controversial. The Centers for Disease Control and Prevention (CDC) recommends using forceps or tweezers to grab the tick as close to the skin as possible, and without twisting, pulling it straight up with steady, even pressure.4
We have used an alternate method of removing ticks that can be done at home or in a clinic without the use of special tools. It has been 100% effective in the 9 patients who presented to our clinic with attached deer ticks. With a cotton swab, apply liquid soap in circles over the tick for about 30 to 60 seconds. Then, use a dry cotton swab to wipe away the soap. The tick will be found on the swab with its head intact. We found this “home remedy” to be fast, easy, and painless; it also doesn’t appear to rely on suffocation.
Because there is no squeezing or twisting, the risk of regurgitation is minimized, and thus, the process is much less frightening for children—and maybe even for some adults.
Dionna Rookey, PA-C
Lebanon, NH
Louis A. Kazal, Jr, MD, FAAFP
Hanover, NH
1. The Centers for Disease Control and Prevention. Reported cases of Lyme disease by state or locality, 2004-2013. The Centers for Disease Control and Prevention Web site. Available at: http://www.cdc.gov/lyme/stats/chartstables/reportedcases_statelocality.html. Accessed April 14, 2015.
2. The Centers for Disease Control and Prevention. Preventing tick bites on people. The Centers for Disease Control and Prevention Web site. Available at: http://www.cdc.gov/lyme/prev/on_people.html. Accessed April 14, 2015.
3. National Institutes of Health Medline Plus. Tick removal. Medline Plus Web site. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/007211.htm. Accessed April 8, 2015.
4. The Centers for Disease Control and Prevention. Tick removal. The Centers for Disease Control and Prevention Web site. Available at: http://www.cdc.gov/lyme/removal/index.html. Accessed April 8, 2015.
The prevalence of Lyme disease in the United States has steadily increased over the past several years. In 2013, the disease was reported in all but 8 states.1 Prevention, as we know, is key.
Common preventive steps include using DEET insect repellent, wearing long pants and sleeves outdoors, tucking pants into socks, wearing light-colored clothing to make ticks more visible, and checking one’s body daily for ticks.2,3 The next best way to prevent Lyme disease is timely tick removal, as it is believed that in most cases the Lyme disease bacterium can be transmitted after 36 to 48 hours of tick attachment.2,3
The safest and most effective method of removal remains controversial. The Centers for Disease Control and Prevention (CDC) recommends using forceps or tweezers to grab the tick as close to the skin as possible, and without twisting, pulling it straight up with steady, even pressure.4
We have used an alternate method of removing ticks that can be done at home or in a clinic without the use of special tools. It has been 100% effective in the 9 patients who presented to our clinic with attached deer ticks. With a cotton swab, apply liquid soap in circles over the tick for about 30 to 60 seconds. Then, use a dry cotton swab to wipe away the soap. The tick will be found on the swab with its head intact. We found this “home remedy” to be fast, easy, and painless; it also doesn’t appear to rely on suffocation.
Because there is no squeezing or twisting, the risk of regurgitation is minimized, and thus, the process is much less frightening for children—and maybe even for some adults.
Dionna Rookey, PA-C
Lebanon, NH
Louis A. Kazal, Jr, MD, FAAFP
Hanover, NH
The prevalence of Lyme disease in the United States has steadily increased over the past several years. In 2013, the disease was reported in all but 8 states.1 Prevention, as we know, is key.
Common preventive steps include using DEET insect repellent, wearing long pants and sleeves outdoors, tucking pants into socks, wearing light-colored clothing to make ticks more visible, and checking one’s body daily for ticks.2,3 The next best way to prevent Lyme disease is timely tick removal, as it is believed that in most cases the Lyme disease bacterium can be transmitted after 36 to 48 hours of tick attachment.2,3
The safest and most effective method of removal remains controversial. The Centers for Disease Control and Prevention (CDC) recommends using forceps or tweezers to grab the tick as close to the skin as possible, and without twisting, pulling it straight up with steady, even pressure.4
We have used an alternate method of removing ticks that can be done at home or in a clinic without the use of special tools. It has been 100% effective in the 9 patients who presented to our clinic with attached deer ticks. With a cotton swab, apply liquid soap in circles over the tick for about 30 to 60 seconds. Then, use a dry cotton swab to wipe away the soap. The tick will be found on the swab with its head intact. We found this “home remedy” to be fast, easy, and painless; it also doesn’t appear to rely on suffocation.
Because there is no squeezing or twisting, the risk of regurgitation is minimized, and thus, the process is much less frightening for children—and maybe even for some adults.
Dionna Rookey, PA-C
Lebanon, NH
Louis A. Kazal, Jr, MD, FAAFP
Hanover, NH
1. The Centers for Disease Control and Prevention. Reported cases of Lyme disease by state or locality, 2004-2013. The Centers for Disease Control and Prevention Web site. Available at: http://www.cdc.gov/lyme/stats/chartstables/reportedcases_statelocality.html. Accessed April 14, 2015.
2. The Centers for Disease Control and Prevention. Preventing tick bites on people. The Centers for Disease Control and Prevention Web site. Available at: http://www.cdc.gov/lyme/prev/on_people.html. Accessed April 14, 2015.
3. National Institutes of Health Medline Plus. Tick removal. Medline Plus Web site. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/007211.htm. Accessed April 8, 2015.
4. The Centers for Disease Control and Prevention. Tick removal. The Centers for Disease Control and Prevention Web site. Available at: http://www.cdc.gov/lyme/removal/index.html. Accessed April 8, 2015.
1. The Centers for Disease Control and Prevention. Reported cases of Lyme disease by state or locality, 2004-2013. The Centers for Disease Control and Prevention Web site. Available at: http://www.cdc.gov/lyme/stats/chartstables/reportedcases_statelocality.html. Accessed April 14, 2015.
2. The Centers for Disease Control and Prevention. Preventing tick bites on people. The Centers for Disease Control and Prevention Web site. Available at: http://www.cdc.gov/lyme/prev/on_people.html. Accessed April 14, 2015.
3. National Institutes of Health Medline Plus. Tick removal. Medline Plus Web site. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/007211.htm. Accessed April 8, 2015.
4. The Centers for Disease Control and Prevention. Tick removal. The Centers for Disease Control and Prevention Web site. Available at: http://www.cdc.gov/lyme/removal/index.html. Accessed April 8, 2015.
Another treatment option for keloids
I did not see the use of plain lidocaine (without epinephrine) included in “Keloids: Which treatment is best for your patient?” (J Fam Pract. 2013;62: 227-233) as one option to manage keloids. Treating keloids with intralesional 2% lidocaine plain has been very rewarding for my patients and for me.
This approach has a distinct advantage over injections containing steroids because it can be repeated more frequently (every 2-4 weeks) without fear of subcutaneous atrophy, telangiectasias, or pigment change. I no longer see sections of excessive scar atrophy with uneven, patchy, “skipped” areas from the nconsistent effect that steroids can have on lesions. Lidocaine is infiltrated superficially and forced into the mid and deep sections of the keloid; the underlying and immediate neighboring subcutaneous tissue is treated as well. With repeated injections, there typically is more uniform shrinkage and color change that closely matches that of the surrounding skin.
The mechanism of action of lidocaine in the scar is a matter of conjecture. Clinicians with experience in treating keloids in such a manner believe that the lidocaine has a weak antiinflammatory effect and may serve as an irritant to stimulate the healing process.
Louis A. Kazal Jr, MD, FAAFP
Hanover, NH
I did not see the use of plain lidocaine (without epinephrine) included in “Keloids: Which treatment is best for your patient?” (J Fam Pract. 2013;62: 227-233) as one option to manage keloids. Treating keloids with intralesional 2% lidocaine plain has been very rewarding for my patients and for me.
This approach has a distinct advantage over injections containing steroids because it can be repeated more frequently (every 2-4 weeks) without fear of subcutaneous atrophy, telangiectasias, or pigment change. I no longer see sections of excessive scar atrophy with uneven, patchy, “skipped” areas from the nconsistent effect that steroids can have on lesions. Lidocaine is infiltrated superficially and forced into the mid and deep sections of the keloid; the underlying and immediate neighboring subcutaneous tissue is treated as well. With repeated injections, there typically is more uniform shrinkage and color change that closely matches that of the surrounding skin.
The mechanism of action of lidocaine in the scar is a matter of conjecture. Clinicians with experience in treating keloids in such a manner believe that the lidocaine has a weak antiinflammatory effect and may serve as an irritant to stimulate the healing process.
Louis A. Kazal Jr, MD, FAAFP
Hanover, NH
I did not see the use of plain lidocaine (without epinephrine) included in “Keloids: Which treatment is best for your patient?” (J Fam Pract. 2013;62: 227-233) as one option to manage keloids. Treating keloids with intralesional 2% lidocaine plain has been very rewarding for my patients and for me.
This approach has a distinct advantage over injections containing steroids because it can be repeated more frequently (every 2-4 weeks) without fear of subcutaneous atrophy, telangiectasias, or pigment change. I no longer see sections of excessive scar atrophy with uneven, patchy, “skipped” areas from the nconsistent effect that steroids can have on lesions. Lidocaine is infiltrated superficially and forced into the mid and deep sections of the keloid; the underlying and immediate neighboring subcutaneous tissue is treated as well. With repeated injections, there typically is more uniform shrinkage and color change that closely matches that of the surrounding skin.
The mechanism of action of lidocaine in the scar is a matter of conjecture. Clinicians with experience in treating keloids in such a manner believe that the lidocaine has a weak antiinflammatory effect and may serve as an irritant to stimulate the healing process.
Louis A. Kazal Jr, MD, FAAFP
Hanover, NH