Maryland Ticks Coming Soon: Get Ready

| March 10, 2016

Maryland Ticks Evolve Medical Clinics Urgent Care Primary Care

Maryland Ticks Coming Soon: Get Ready

In Maryland and specifically the Annapolis area, ticks begin to reappear now and will reach their most voracious feeding time in April to June. Read Evolve Medical Clinics quick summary.

How to remove a tick

  1. Use tweezers to grab the tick as close to the skin as possible.evolve medical clinics primary care and urgent care removing a tick
  2. Pull upward – don’t twist or jerk the tick. If the mouth remains,  try to remove with tweezers.
  3. If you can’t get the mouth easily, leave it alone and let the skin heal.
  4. Next, clean the area and your hands with soap and water.
  5. Dispose of a live tick by placing in a sealed bag, wrapping evolve medical clinics primary care and urgent care removing a tickin tape, or flushing it down the toilet. Do NOT crush a tick with your fingers.
  6. Other ways to remove ticks, such as using a hot match head or painting the tick with nail polish, gasoline, or other materials, are not advised. Such treatments can cause the tick to release more fluids back into the bite.
  7. If you can’t remove it safely, swing by an urgent care for a quick removal (you can schedule online here).

What to do after a tick bite

Lyme disease is not usually transmitted within the first 48 to 72 hours of tick attachment. The likelihood of transmission is increased if the tick is engorged and/or has been attached for at least 72 hours.

For children 8 years old or younger, NO antibiotics are recommended according to the Infectious Disease Society of America and the CDC

For adults, all following criteria must be met for prophylactic antibiotics:
•  Attached tick is a deer tick
•  Tick is estimated to have been attached for ≥36 hours
•  Antibiotic is started is within 72 hours of tick removal
•  Local infection rate is ≥20% (Annapolis, Maryland qualifies)

If you are unsure how long the tick was there or if you should or should not take medication, please feel free to call Evolve (844-322-4222) or schedule a visit. 

What are the symptoms of tick disease such as Lyme?

The most common symptoms of tick-related illnesses are:

  • Fever/chills
  • Headache, fatigue, and muscle aches
  • Rash: Depends on whether Lyme, Rocky Mountain spotted fever, Ehrlichiosis or Tularemia (see below)


  • The rash of Lyme Disease occurs in 75-80% of people, usually at the site of the tick bite.

    Evolve Medical Clinics Primary Care and Urgent Care Lyme Disease rash

    Rash of Lymes can be a “Bullseye” but it can also be confluent.”

  • Rash shows up between 3-30 days
  • Rash is usually a circular rash (“bullseye” but may be solid too!)
  • Rash is warm, but not usually painful.
  • Some people develop additional rashes in other areas.

Rocky Mountain spotted fever (RMSF)

  • evolve medical clinics urgent care and primary care Rocky Mountain Spotted Fever Rash

    RMSF petechial rash

    Rash can vary greatly 

  • About 10% of people with RMSF don’t get a rash.
  • A red-purple rash begins 2-5 days after onset of fever as small, flat, pink, non-itchy spots on wrists, forearms, and ankles and spreads to the trunk. It can also be on the palms and soles.
  • Rash occurs in only 35-60% of patients with the infection.

Tularemia evolve medical clinics primary care and urgent care

Ulcer of Tularemia


Ulcer forms at the site of the tick bite. Lymph glands of the armpit or groin may swell considerably.

Ehrlichia rash evolve medical clinics primary care and urgent care

Rash of Ehrlichia


  • Rash occurs in only 30% of adults (up to 60% of children) 
  • Rash is red to pink in small pin point areas with some areas forming more patches

If you have been bitten by a tick and experience any of the symptoms described above, we encourage you to contact your doctor or schedule a visit with Evolve immediately (schedule on-line here). 

How to prevent tick bites

  • Ticks CAN be present all year.
  • Baby ticks (nymphs) go on a feeding frenzy April to June: Be extra vigilant
  • Avoid wooded/bushy areas with high grass.
  • Walk in the center of trails–brushing against bushes/grasses is the easiest way to pick up a tick.
  • Use DEET (20-30%) on skin and clothing 
  • Use Permethrin on clothing and gear (It remains protective through several washings.)
  • Pre-treated clothing is available and may be protective longer.

Find and remove ticks ASAP

  • Bathe or shower as soon as possible after coming indoors (preferably within two hours)
  • Conduct a full-body tick check using a hand-held or full-length mirror.
  • Parents: check kids under arms, ears, belly button, behind knees, between the legs, around the waist, and especially in their hair.
  • Examine gear and pets. Ticks can hitch-hike home on clothes and pets. 
  • Great tip: Tumble clothes in a dryer on high heat for an hour to kill remaining ticks
Disclaimer: At Evolve Medical, we are aware that current scientific understanding of Lyme and other tick related illnesses is far from established, particularly as it relates to Chronic Lyme Disease. We remain very open and receptive to new understandings and advancements and make every effort to stay abreast of the latest information. 

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Evolve Medical Clinics is Annapolis’ highest rated urgent care and primary care. Designed for busy people tired of long waits and rushed providers. The peaceful, healing atmosphere is designed to reflect their emphasis on patient respect, convenience as well as excellence in care. Evolve sees patients for only $95/visit and they provide all you may need for reimbursement. They also offer an amazing and affordable monthly membership for only $49/mo wherein members receive all their primary and urgent care either free or at heavily discounted prices. Members enjoy virtual visits or in-person with wait times usually less than 10 minutes on the same day. Members can also easily email or text their provider to get results or avoid visits when possible. Evolve also helps patients save money by finding less expensive medications, avoiding unnecessary procedures and tests and improves help by cutting down on the medical errors which are so common elsewhere. Find out why everyone loves Evolve: or call 844-322-4222.

Comments (2)

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  1. Jeff Levy says:

    This article makes reference to treatment recommendations from the Infectious Diseases Society of America (IDSA). Readers should know that IDSA guidelines for diagnosing and treating Lyme disease and other tick-borne diseases have been removed by the National Guideline Clearinghouse, a branch of the U.S Department of Health and Human Services and have been replaced by guidelines recommend by the International Lyme and Associated Diseases Society (ILADS). These guidelines can be found at

  2. GoodbyeLyme says:

    The 48-72 hours transmission estimate is based upon one mouse study several decades old. More recent animal studies show that transmission can occur in <16 hours: In other studies, tick co-infections can be transmitted through tick saliva at the time of the initial tick bite: Unfortunately, early symptoms of Lyme and co-infections may not appear for several months, which enables the infections to get deeper into the system.