The Lyme Prevention Checklist

As part of our deep dive into some of the complexities of Lyme disease, we turned to Heather Hearst, the founder and now president of Project Lyme, a global advocacy organization focused on prevention and early detection. Hearst outlines their prevention guidelines below—essential for staying as safe as we can in the first place—and we’re also sharing EWG’s tips on choosing an insect repellent, which we learned via their senior scientist, David Andrews, Ph.D.

Heather Hearst on Preventing Lyme Disease

The bacteria that causes Lyme is carried by ticks, specifically black-legged or deer ticks. Ticks transmit Lyme disease by biting you and entering your skin through the bite. If you can avoid tick bites entirely, or remove a tick that has bitten you right away, you can largely protect yourself from this debilitating disease. The sooner you remove the tick, the better off you will be.

Bigger picture: We need more funding to solve this epidemic: most importantly, for a better test and better treatments for patients who do not fully recover from Lyme and other tick-borne diseases. There is still so much we don’t know about ticks and tick borne diseases, and there are also some studies looking at other potential carriers and ways the bacteria is transmitted to humans. (For research donations, I recommend Bay Area Lyme Foundation, and Project Lyme for awareness and education.)

Project Lyme’s Checklist

Prep Yourself First

• Wear light-colored clothing.

• Cover wrists and ankles. Tuck pants into socks and opt for long-sleeves.

• Spray with insect repellant. [See goop tips below.]

While Outside

• Know your surroundings. Avoid tall grasses and humid, wooded, leaf-littered areas.

• If hiking, stay on trails.

• Do not sit on logs.

• Remember: Ticks aren’t just in the woods, they’re also in backyards and in parks.

When You Get Inside

• Shower after being outdoors to wash off ticks that have not attached.

• Put clothing into the dryer on high heat for 10-15 minutes—heat kills ticks.

Tick Check

Make checking yourself or your family for ticks a habit in the spring, summer, and fall. Always check yourself and your family for ticks after being outdoors, and do it as part of your routine before dressing for bed, paying special attention to the below spots:

• Sides of body

• Groin area

• Back of your knee

• Under armpits

• Back of neck

• Tight places (belt area, watch strap, underneath hairline)

• Scalp

• Check pets too!

Removing a Tick Safely

1. Use point-y tip tweezers (we recommend Tick Ease).

2. Disinfect with rubbing alcohol.

3. Grab tick close to skin and use slow, steady motion to pull tick out.

4. Disinfect again.

5. Save the tick in a plastic bag and go to a doctor ASAP to get both the tick and you tested.

10 Symptoms of Lyme Disease

May occur earlier:

1. Fever, chills, fatigue, swollen lymph nodes

2. Bulls eye rash (not always present)

3. Severe headaches and neck stiffness

4. Rashes

5. Joint pain or swelling

May occur in later stages:

1. Intermittent pain in tendons, muscles, joints, and bones

2. Heart palpitations or an irregular heartbeat

3. Dizziness or shortness of breath

4. Shooting pains, numbness, or tingling in the hands or feet

5. Problems with short-term memory

Talk to Your Doctor

If you think you might have Lyme disease, be your own advocate. Contact your physician, pay attention to symptoms, and request testing.

Protecting Pets

• Check with your pet’s veterinarian for the best, safest tick prevention product for your animal. You can also learn more here.

• Keep them off furniture.

• This is easier said than done, but the best way to keep ticks off your pets and prevent them from bringing them into the home is to keep your pets away from ticks… At home, that means creating a (relatively) tick-safe zone: As may be applicable, remove all leaves and brush from your yard. Create a buffer between your lawn and the woods with either crushed gravel or wood chips. (Ticks love to live right on the lawn’s edge in areas of high humidity, in areas of brush and tall grass.)

For more tips, visit ProjectLyme.org.

The goop Guide to Choosing an Insect Repellent with EWG

Not all insect repellants are made equally, and some contain potentially harmful ingredients. The Environmental Working Group (EWG) has several insect repellant guides, which are helpful when considering different risks and scenarios (i.e. are you sitting on the back patio for a half-hour, going on a two-hour hike in a Lyme-prone area, or traveling while pregnant and worried about Zika?). The EWG reminds people that, of course, no repellant is 100 percent effective (hence the importance of the other tips here, like covering up and doing daily tick checks).

Here’s a summary of how the EWG and their senior scientist, David Andrews, Ph.D., see the pros and cons of the main repellent ingredient options for protecting against Lyme disease:

“In 2013, the Centers for Disease Control and Prevention recommended only DEET of 20 percent or greater for tick protection,” Andrews explains. “But has since added IR3535 and picaridin, also at 20 percent or greater, to their recommended list.” The EWG also includes oil of lemon eucalyptus with their recommendations, which Andrews explains is approved for tick protection by the EPA, along with the other three active ingredients.

If you’re shopping for repellents, here’s a bit more from Andrews on brand comparisons and recommendations: “EWG provides guidance based on the active ingredients because we’re unable to find any information to indicate differences in efficacy or differences in toxicity concern (the inactive ingredients for these products are not typically made public). The Environmental Protection Agency provides a database of all the registered products; we recommend searching using the percent active ingredient and not by protection time.”

A few other tips: A general, common sense guideline is to wash hands after applying repellent, and the body at the end of your outing/day. The EWG recommends steering clear of sunscreens mixed with repellent; as you’re reapplying sunscreen, you’re more likely to be overexposed to the repellent ingredients, whereas the EWG suggests using products with the lowest effective concentration of repellent chemicals for the time you’ll be outside.

For more from the EWG, see: their detailed write-up on Lyme protection, this breakdown of repellent ingredients, their outline to adult protection from Lyme, and their kid-focused guide.