Found a tick? What to do next, and when medicine can help prevent Lyme disease

• Use clean, fine-tipped tweezers to grab the tick as close to the skin as you can.
• Pull straight up with steady, even pressure. Do not twist or jerk it. If part of the tick's mouth breaks off in the skin, your body will push it out over time, or you can remove it with tweezers. If it does not come out easily, leave it alone.
• Clean the bite and your hands with soap and water, rubbing alcohol or hand sanitizer.
• Check your whole body for other ticks and remove them.
• Get rid of the tick: put it in a sealed bag or container, wrap it tightly in tape, flush it, or put it in alcohol. Do not crush it with your fingers.

Do not use petroleum jelly, nail polish, heat or other things to make the tick let go. Remove it right away instead of waiting to see a doctor.

In the United States, only small blacklegged ticks (also called deer ticks) spread the germ that causes Lyme disease. A flat tick that has not fed is unlikely to have spread it. A tick that is swollen with blood is a higher risk.

After a higher-risk bite, a doctor may suggest a single dose of an antibiotic called doxycycline. It can lower the chance of getting Lyme disease. It works best within 72 hours after the tick is removed.

It does not treat Lyme disease that has already started, and it does not prevent every tick-borne illness.

For 30 days after the bite, check the bite area every day and watch for:

• A red rash at the bite that grows over several days, sometimes with a clear center like a target
• Fever, chills, headache, feeling very tired, muscle or joint aches, or swollen glands

A small red bump right after the bite, like a mosquito bite, is common. It usually goes away in 1 to 2 days and is not a sign of Lyme disease.

If you get a rash or fever in the days or weeks after a tick bite, see a doctor. Get care right away for drooping of the face, a very bad headache with a stiff neck, swollen and painful joints, or a racing or uneven heartbeat.

If you are in Virginia or West Virginia, you can start a visit online at any time. It is for adults 18 and older who removed a tick that was attached for 36 hours or more, when it has been less than 72 hours since the tick came off.

A board-certified physician reviews your answers. A preventive dose is only given if it is within 72 hours of removing an identified deer (blacklegged) tick that was attached for 36 hours or more, you were bitten in an area where Lyme disease is common, and doxycycline is safe for you. If not, the doctor tells you what to watch for. The visit answers your question either way, but it does not always end in a prescription.

It is not the right fit if you have:

• Fever, chills, headache, bad tiredness, or muscle or joint aches starting now
• A spreading red rash, or a rash that looks like a target or is bigger than 2 inches
• Drooping of the face, swollen joints, or a racing or uneven heartbeat
• An allergy to doxycycline or similar antibiotics (tetracyclines)
• More than 72 hours since the tick was removed
• More than one tick bite
• A bite in an area where other illnesses spread by ticks are common (ask the doctor if you are not sure)

If any of these apply, see your own doctor or get care in person. If you are pregnant or breastfeeding, tell the doctor. For a child, or if you are not sure what kind of tick it was, ask your own doctor whether medicine makes sense.

Visits start at $59. You see the price before you pay, and you do not need insurance.