Be vigilant

Where possible, keep to paths and avoid walking through deep vegetation. Keep covered up to make it harder for ticks to reach your skin. Check for ticks regularly and brush off any you see on your clothing before they have a chance to bite.

Habitat management

It is not practical to treat large areas with acaricides to kill ticks, as it is difficult to reach into the leaf litter and large numbers of harmless and beneficial creatures will also be killed. Practical steps to managing woodland, heath and other potential tick habitat include keeping clear paths with closely mown borders. Alert users to the risks of tick bites. See Natural places: Lyme disease risk management and communication

Using repellents

Insect repellents containing the active ingredients DEET and Picaridine are also effective against ticks. DEET is widely available and is thought to be safe for most people, but has been associated with adverse reactions in sensitive individuals. It can also damage synthetic clothing if applied to the fabric. Picaridine has a slightly lower toxicity and does not damage synthetic fabrics but some studies have shown it to be less effective against ticks. There are many brands available which use these ingredients. Repellents should generally be applied sparingly directly to the skin, but follow the instructions supplied by the manufacturer. Other active ingredients might be effective, but have had little or no testing against ticks.

Clothing can be treated with the insecticide Permethrin. Again, a number of products are available, which are often primarily intended for treating clothing and mosquito nets. Permethrin is safe for humans in normal doses, but is dangerous to cats and to aquatic creatures, so should be used with care.

When you get home

Brush over clothing to remove loose ticks before going inside. Check skin carefully all over for ticks. Pay attention to folds in the skin and other areas where a tick could hide, especially behind the knee and in the groin. On small children pay attention to the hairline.

It is possible for ticks to remain in clothing. Clothing from an unknown source (eg charity shops) should be washed well before use. The US CDC currently recommend an hour in a tumble drier on high heat to kill any that are there but this has several disadvantages including high energy use and possible damage to synthetic materials. There have been indications that shorter cycles may also be effective, but more research is needed before formal recommendations can be made.

Refs.

Expert review of the evidence base for arthropod bite avoidance. Journal of travel medicine. 2010;17(3):182–92.Goodyer LI, Croft AM, Frances SP, Hill N, Moore SJ, Onyango SP, et al.