6 Expert-Approved Tips To Prevent Lyme Disease This Summer
Summer is fast approaching, and there are so many reasons to be pumped about it—barbecues, outdoor yoga, long meditative hikes, and naturally higher vitamin D levels, to name a few. But warm weather also brings with it something far more anxiety-inducing: Lyme disease, an infection caused by the bacteria Borrelia burgdorferi that's transmitted to humans through a bite from an infected black-legged or deer tick.
Currently, the Centers for Disease Control and Prevention (CDC) estimates that 300,000 people contract Lyme disease in the U.S. every year—but many experts believe the true number of cases is much higher and that many people go undiagnosed (due, in part, to ineffective diagnostic tests), which can lead to debilitating late-stage symptoms that are often misdiagnosed as other chronic conditions such as fibromyalgia and multiple sclerosis.
Yes, all of this sounds pretty terrifying, but we're not here to freak you out. The good news: You can drastically lower your odds of contracting Lyme disease in the first place if you take appropriate preventive measures, and you can get it treated early (when it's most responsive to antibiotics) if you know how to spot its earliest signs and symptoms.
Here, six doctor-approved ways to protect yourself from Lyme disease this year.
1. Take steps to bolster your immune system all year long.
Nourishing your body with nutrient-rich whole foods, healing your gut if it's compromised, getting enough deep sleep and exercise, and minimizing stress may be your best first line of defense in protecting yourself from Lyme. Why? Many respected integrative practitioners who treat Lyme patients believe that a strong immune system can make all the difference in your body's ability to fight off Lyme on its own if you are bitten and infected or at least minimize your Lyme symptoms and make you more responsive to treatment.
"I've encountered a lot of people who have evidence that they've been exposed to Lyme, yet they've never had a single symptom," says Darin Ingels, N.D., naturopathic doctor and author of The Lyme Solution: A 5-Part Plan To Fight the Inflammatory Autoimmune Response and Beat Lyme Disease. "So theoretically, if you get bitten by a tick that carries Lyme or the common co-infections and your immune system does what it's supposed to, you could get rid of it before it becomes problematic."
Other doctors agree: "Is it possible to have Lyme and not get sick or to have an acute infection and get over it by yourself? Absolutely. There are some people who encounter Lyme and their immune system just handles it—knocks it back and just walls it away," says Kristin Reihman, M.D., family medicine doctor and author of Life After Lyme. "That's why the focus of my Lyme interventions really center on the immune system."
2. Know where ticks are lurking (it's not just the woods!).
While it's true that most Lyme-carrying ticks are found in the Northeast and Midwest, Lyme disease has been found in all 50 states. "Pretty much the entire East Coast and West Coast are covered with these deer ticks, and they're starting to push inland," says Ingels. "They've migrated due to birds, so we're seeing them move out of their typical geographic area."
You might also assume that Lyme-carrying deer ticks (and ticks in general, which can carry other pathogens) are confined to wooded areas, but no such luck. Ticks can be found anywhere that the animals they feed on (mice, rats, squirrels, deer, and others) live. And yes, this often means damp, shrubby, wooded, brushy, leafy areas deep in the countryside, but it can also mean the grass or leaf piles in your yard, beach grass by the ocean, or places like Central Park. "I used to see patients in Manhattan and they would get Lyme disease," says Ingels.
So, while it’s extra important to be vigilant about avoiding ticks in high-risk parts of the country and in rural areas with lots of vegetation, you may still need to take some of the precautions below no matter where you live.
3. Dress appropriately and use the right repellent.
If you’re out doing yard work, out hiking in the woods, gardening, or spending any significant time in areas you think ticks are likely lurking, you may need to rethink your wardrobe.
"I recommend people use protective clothing, so that means long pants, long-sleeved shirts, and a hat if you’re going to be hiking in a wooded area," says Ingels. "These ticks are very tiny, and it doesn’t take much time for them to attach, so putting as much of a barrier between ticks and your skin as you can is a good idea." Not into the idea of covering up your whole body on a hot summer hike? At the very least, wear some nice tall, light-colored socks with your hiking boots so you can better spot ticks before they have a chance to crawl up onto your bare legs.
Spritzing on a good repellent is also key. The CDC recommends using a repellent containing DEET, picaridin, IR3535, oil of lemon eucalyptus (para-menthane-diol), or 2-undecanone to all exposed skin, and treating your shoes, socks, and pants with a product containing 0.5 percent permethrin. Some of these repellents (like DEET) are considered more toxic than others, so be sure to check out the Environmental Working Group’s guide to bug repellent chemicals to assess which one might be right for you and your family.
Some experts don’t use any of these repellents, however, opting instead for blends of naturally bug-repelling essential oils. "Some of the conventional stuff, like repellents containing DEET or permethrin, both of which are very toxic chemicals, is that there may be a cumulative effect if you keep applying these chemicals to your clothing and skin on a regular basis," says Ingels. "This could cause an adverse reaction over time."
Ingels personally uses Tick Tock Naturals Organic Insect Repellent, which contains a blend of lemongrass essential oil, thyme essential oil, rosemary essential oil, and eugenol (a compound extracted from essential oils like clove and cinnamon).
Bill Rawls, M.D., integrative physician and author of Unlocking Lyme also uses natural repellents containing ingredients like clove, tea tree, and eucalyptus essential oils. But, he says, it’s important to pick the right repellent for your particular situation—if you’re going to be hiking on a well-groomed path or walking in your yard, natural is probably fine; if you’re going to be wading through knee-high brush or walking through some untamed woods, then you might need to use "the big guns," he says.
4. Scan yourself for ticks, especially in these hard-to-see places.
After any significant time outdoors in areas where Lyme is known to be present, you’ll want to do a full tick scan. Showering is great, too, but that alone won’t cut it if ticks are already attached. Where to look? "Ticks like the dark moist areas of the body, so they’ll go to the places you typically don’t look—behind the knees, the groin area, armpits, your hairline, under the breasts," says Ingels. "You have to look at the cracks and crevices of the body, which are often hard to see, so it can be helpful to have someone else check you."
Also important to note: Nymphal deer ticks are responsible for causing the most cases of Lyme disease, but they are incredibly tiny—as small as a poppy seed! So be sure to take an extra careful look. The good news: If you find a tick, but it hasn’t attached, you’re likely just fine. "Ticks transmit Lyme and other co-infections once they have a blood meal," says Ingels. "So if you see a tick on you that’s moving and hasn’t attached yet, it likely hasn’t bitten you yet."
5. Remove ticks properly (and save them).
But what if you do find an attached tick after you’ve been outside? First, it’s important to know that you need to get that sucker off fast. "A lot of people think it takes two to three days for an attached tick to transmit Lyme and other bacteria or infections to you, but that’s not actually true," says Reihman. "It can happen instantaneously."
So, what’s the best way to remove a tick to minimize the chances of contracting Lyme? The CDC recommends using a pair of fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible (Ingels recommends a pair with a small attached magnifying glass) and pulling upward with a steady, even pressure. Then, thoroughly clean the area with alcohol or soap and water. You should also save the tick in a zip-top bag with a damp cotton ball for a few weeks in case you start to develop odd symptoms. This way, your doctor can send it to a lab to see what diseases it’s carrying—which can help confirm a diagnosis for Lyme or another tickborne disease.
Whatever you do, though, don’t panic! "I actually believe that our fear can be a powerful undermining force on the immune system, so taking steps to manage that and stay out of the 'freak-out zone' in whatever way you can is a good idea," says Reihman.
6. If you notice these symptoms, see a doc ASAP.
"We know that early treatment gives you the best opportunity to get rid of Lyme," says Ingels. So, if you know you’ve been bitten by a deer tick, especially if it was engorged when you found it, call your doctor right away. You also want to call your doctor ASAP if you’re noticing any of these early symptoms of Lyme disease, which usually show up within the first 30 days: fever, chills, sweats, muscle aches, fatigue, nausea, joint pain, facial drooping (Bell's palsy), or a bull’s-eye rash, which looks like a bug bite with a circle around it. (Check out this interactive symptoms checklist from LymeDisease.org that can help you gauge your likelihood of having Lyme.)
Even if you don’t remember being bitten, though, it’s still important to watch for these symptoms—especially if you’re in an endemic area and like to spend time outdoors. That’s because, often, a deer tick will bite you, drink your blood, and fall off without you ever even noticing.
Another thing to consider: It’s possible for your immune system to keep Lyme at bay for months or even years after you’ve been bitten by an infected tick. That’s why you need to continue to be mindful of late-stage or chronic Lyme symptoms (fatigue, difficulty focusing, joint pain, muscle pain, problems sleeping, nerve pain, depression, heart palpitations, headaches), even if you never experienced the initial acute symptoms mentioned above.
If at any point you don’t feel like you’re getting the care or attention you need from your current doctor, both Ingels and Reihman recommend seeking out a doctor who specializes in Lyme and has a treatment approach that aligns with your values (some doctors use strictly antibiotics, some use a combo of antibiotics and herbs, and some use solely natural herbal protocols). The LymeDisease.org physician referral tool is a useful resource for finding a qualified doc in your area.