If you've ever spent time in the Hamptons, you're likely aware this beautiful area of New York is a high-risk area for Lyme disease. A 2018 surveillance study found that 66% of adult deer ticks collected at one East Hampton location tested positive for Lyme disease bacteria.¹ This was one of the highest rates in Suffolk County. However, infection rates vary by location and year. The same study found only 24% of adult ticks in Southampton tested positive.¹ 

If you just found a tick on yourself or your child, it's valid to be concerned. This guide gives you clear steps on what to do in the hours after finding a tick bite. You'll learn how to remove it safely, when preventive medicine may help, and how to protect yourself going forward.

Understanding the Tick Threat in the Hamptons

The Hamptons is one of the most serious tick hotspots in the United States. The CDC classifies New York State as a "high incidence state" for Lyme disease.³ Suffolk County, where the Hamptons are located, has some of the highest rates in the state. Since 2014, Stony Brook Southampton Hospital has received over 7,000 calls from people seeking help with tick bites.²

Peak tick season, particularly for the tiny nymphal stage ticks responsible for most Lyme disease cases, runs from late May through July.³ However, ticks remain active from April through fall. In mild winters, they may be active year-round. Young ticks called nymphs cause most infections because they're very small. They're often the size of a poppy seed or a "walking freckle." Many people never see the tick that bites them. Nymphal ticks had infection rates around 40% in the 2018 Suffolk County study, lower than adult ticks but still significant.¹

Three main tick types live in the Hamptons:

• Deer tick (black-legged tick): This is the main carrier of Lyme disease.³ These ticks have reddish-brown bodies with black legs. They're most active during warm months.
• Lone star tick: You can spot these by the white dot on the female's back. This tick can cause alpha-gal syndrome. This is a serious red meat allergy that affects hundreds of thousands of Americans.³
• American dog tick: This tick is larger and easier to spot. It can spread Rocky Mountain spotted fever, but this disease is rare in the Hamptons.³

What to Do Right After a Tick Bite

When you find a tick attached to your skin, remove it quickly and properly. The longer a tick stays attached, the higher the chance of disease transmission.³

Safe tick removal steps:

1. Use fine-tipped tweezers to grasp the tick as close to your skin as you can.³

2. Pull straight up with steady pressure. Don't twist or jerk. This can break off the mouthparts.³

3. After removal, clean the bite area well with soap and water or rubbing alcohol.³

4. Save the tick in a sealed plastic bag. Write the date and location on it. This helps identify the species if symptoms appear later.⁴

What NOT to do: Don't twist or jerk the tick. Don't burn it with a match. Don't cover it with petroleum jelly, nail polish, or other substances. These methods can make the tick release more bacteria into the wound.³

What to do after removal: Mark your calendar with the bite date. Check the bite site each day for 30 days.⁴ Look for any growing redness, rash, or skin changes. Take photos of the bite site daily to track changes. Write down the date you found the tick. Estimate how long it was attached based on its size. Was it swollen (engorged) or flat? Note what the tick looked like.

Watch for symptoms over the next few weeks. These include:

• expanding rash at or near the bite (whether or not it looks like a bullseye)
• fever
• severe headache
• neck stiffness
• facial drooping
• heart palpitations
• joint swelling
• chills
• fatigue
• muscle pain.³

Symptoms usually appear 3 to 30 days after the bite.³ Contact your healthcare provider right away if any of these develop.

Understanding Lyme Disease Symptoms and Treatment

If you develop symptoms after a tick bite, seek prompt care. Early detection and treatment greatly improve results. When Lyme disease is caught early, treatment with antibiotics is highly effective.

For complete information on Lyme disease symptoms, stages of infection, testing, treatment options, and related infections like babesiosis, see our full guide: Lyme Disease in the Hamptons.

Prophylactic Treatment: The 36-Hour Window

Not every tick bite needs antibiotic treatment.⁴ For tick bites that don't meet all high-risk criteria, or if eligibility is uncertain, careful symptom monitoring (watchful waiting) is a valid and evidence-based approach.⁴

When certain conditions are met, preventive (prophylactic) antibiotic treatment is one option to consider. In one study, a single dose of doxycycline reduced the risk of developing the characteristic Lyme rash by 87%.⁵ However, the actual effectiveness could range from 25% to 98% based on the study's statistical analysis.⁵,⁶ This treatment is not 100% effective, and it's important to understand that medical experts don't universally agree on the best approach.

Important: Medical experts disagree on optimal approach

While the guidelines from the Infectious Diseases Society of America (IDSA) recommend single-dose prophylaxis and are widely followed in the US,⁴ other medical organizations take different positions. The International Lyme and Associated Diseases Society (ILADS) recommends against single-dose doxycycline, instead advising 20 days of treatment for tick bites.⁶ A systematic review found that guidelines recommending prophylaxis are based on inconsistent or limited-quality evidence, while other guidelines recommending against prophylaxis are also based on fragile conclusions of the available research.⁶ Discuss the options with your healthcare provider to determine what's right for your situation.

If single-dose prophylaxis is considered, all four conditions should be met:⁴

1. Tick type: The tick is a deer tick (also called black-legged tick or Ixodes scapularis).

2. Time attached: The tick was attached for 36 hours or more. You can tell by engorgement. An engorged tick looks swollen, rounded, and darker in color.

3. Location: The bite happened in an area with high Lyme disease rates. The Hamptons qualifies as a high-risk region.³

4. Timing: Treatment can be given within 72 hours of tick removal.
   
   

Doxycycline safety information

Common side effects include nausea and vomiting, occurring in about 30% of patients.⁵ Doxycycline also causes increased sun sensitivity.⁷ Use sun protection during treatment. This is especially important in the Hamptons beach community.

Who should not take doxycycline prophylaxis: Prophylaxis may not be appropriate for pregnant or nursing women, people with tetracycline allergies, or those on certain medications.⁴,⁷ Children under 8 years old have different dosing considerations.⁴ Discuss alternatives with your healthcare provider if any of these apply to you.

Why symptom monitoring remains critical

Even after receiving prophylaxis, monitor carefully for symptoms over the next 30 days.⁴ The main study on single-dose prophylaxis measured prevention of the Lyme disease rash, which is an important early sign of infection.⁵⸴⁶ However, more research is needed to confirm whether single-dose treatment prevents all potential Lyme disease complications.

In the event of Lyme disease infection, it’s important to remember that early treatment with antibiotics is highly effective, with cure rates exceeding 90% when caught early.⁴ This is why symptom monitoring remains important even after prophylaxis.

How to tell attachment time: Engorged ticks look swollen, rounded, and darker.⁴ They may be several times their normal size. Flat ticks were likely attached for less than 24 hours. Partly engorged ticks may have been attached for 24 to 36 hours.

If any of these conditions are unclear, careful symptom watching may be the right approach. Not every tick bite requires antibiotic treatment.⁴ Talk with a healthcare provider about your specific situation and risk factors.

When to seek immediate help:

• The tick can't be safely removed at home

• The tick is in a sensitive area (eye, ear canal, or genitals)

• Multiple tick bites happened at once

• You have a known severe allergic reaction to tick bites

• You develop symptoms after a bite (even if you received prophylaxis)

If you're unsure whether you meet the criteria for prophylactic treatment, or if you need assistance with tick removal, Sollis Health provides same-day evaluation from physicians experienced in tick-borne illness assessment. Contact us within the 72-hour window to discuss your options and determine the right approach for your situation.

 

 

Working With Your Primary Care Physician

Sollis Health and your primary care physician play complementary roles in comprehensive tick-related care. Understanding how they work together will help you get the right care at the right time.

When you discover a tick bite, Sollis Health can provide immediate evaluation when time is of the essence. Our board-certified emergency medicine physicians offer expert tick removal, prophylaxis assessment based on clinical criteria, and initial symptom evaluation, all with minimal wait times. Instead of going to the urgent care, or waiting days for your primary care physician’s next free appointment, you can get answers within the critical 72-hour window for prophylactic treatment without long lines, crowded waiting rooms, and ER chaos. 

Once Sollis has addressed your urgent care needs, your primary care physician can provide ongoing longitudinal care that extends beyond the immediate tick bite concern. This includes annual wellness planning with tick prevention strategies, post-treatment monitoring if Lyme disease develops, chronic symptom management, and coordination with infectious disease specialists or other providers if needed.

These services work together seamlessly. Sollis Health communicates directly with your primary care physician to ensure continuity of care, providing complete documentation of tick bite evaluations, any treatments administered, and follow-up recommendations. For Sollis members, this integrated approach means you have both immediate access to tick bite expertise when urgency matters AND comprehensive primary care support throughout tick season and beyond.

If you don't currently have a concierge primary care provider, Sollis Health can recommend trusted local partners.

Preventing Tick Bites in the Hamptons

Prevention takes consistent effort. No strategy gives complete protection in a high-risk area like the Hamptons.³

Personal protection strategies

Wear protective clothing when outdoors in tick-prone areas. Long sleeves, pants tucked into socks, and light-colored clothing (which makes ticks easier to see) create a physical barrier.³ Permethrin-treated clothing can reduce tick encounters. However, it doesn't eliminate them entirely and effectiveness decreases with washing.³ Apply skin repellents with 20 to 30% DEET, picaridin, or oil of lemon eucalyptus to exposed skin.³

After outdoor activity, shower within two hours. Do a thorough tick check.³ Set realistic expectations. You can't be perfect with prevention. Even careful people get tick bites in high-risk areas.

How to do effective tick checks

Focus on areas where ticks like to attach. These include the scalp and behind the ears, armpits, groin, behind the knees, and the waistline.³ Use a mirror or ask someone to help check hard-to-see areas like your back. For children, make tick checks a routine rather than a scary event.

Check pets after they've been outside. Even pets with tick prevention can bring ticks into your home on their fur.³

Pay close attention to nymphal ticks. They're very small. They may look like a new freckle or speck of dirt. If you see what looks like a new freckle that wasn't there before, look more closely. It might be a tick.

Property management basics

Keep grass cut short. Remove leaf litter where ticks thrive.³ Create barriers between wooded areas and your lawn using gravel or wood chips. Professional tick spraying services are available. Costs vary widely. These services can reduce but not eliminate ticks on your property.

Get Immediate Expert Evaluation for Tick Bites

Early action matters when dealing with tick bites in the Hamptons. Within 72 hours after tick removal, you have a window to discuss prophylactic treatment options with a healthcare provider.⁴ Quick, accurate species identification and risk assessment provide clarity when you're unsure about next steps.

Seek evaluation from a healthcare provider familiar with tick-borne diseases. Look for providers who offer same-day appointments, have expertise in Lyme disease, and can perform on-site tick species identification. A thorough evaluation should include assessment of attachment time, discussion of treatment risks and benefits, contraindication screening, and clear symptom monitoring instructions. Sollis Health specializes in this exact type of urgent evaluation without wait times and with the personal touch that’s so often missing in healthcare. 

 

 

Expert Tick Bite Care at Sollis Health

When you find a tick bite, waiting days for an appointment or hours in an emergency room adds unnecessary stress to an already worrying situation. Sollis Health offers a different approach: immediate access to board-certified emergency medicine physicians who specialize in exactly this kind of urgent evaluation.

Unlike traditional urgent care centers staffed by general practitioners, Sollis physicians bring emergency medicine training and specific expertise in tick-borne illness assessment. Our members receive same-day appointments with no waiting, or simply walk in when they need care. With 24/7 membership access, you can reach a Sollis physician directly when concerns arise, whether that's at 2 PM or 2 AM, without waiting for callbacks or navigating phone trees.

Our comprehensive tick bite evaluation includes expert tick species identification to determine whether you were bitten by a deer tick or another species, individualized risk assessment based on attachment time and your medical history, prophylactic treatment when clinical criteria are met, and on-site diagnostic capabilities if testing is needed. Your physician will walk you through the evidence, explain your options clearly, and help you make an informed decision about your care.

For Hamptons residents and visitors, our Water Mill location provides convenient access during peak tick season and year-round. You'll receive thorough evaluation from physicians who take tick bites seriously, give you the time you deserve, and provide clear guidance on next steps and symptom monitoring.

 

References

1. Suffolk County Department of Health Services. Tick Pathogen Surveillance Program. Data collected 2016-2018, published 2019. Results showed 66% Lyme disease infection rate among adult deer ticks at one East Hampton collection site, 24% at Southampton site, and approximately 40% among nymphal ticks. https://www.suffolkcountyny.gov/Departments/Health-Services/Health-Bulletins/Tick-Related-Information

2. Regional Tick-Borne Disease Resource Center, Stony Brook Southampton Hospital. Help Line statistics: 7,000+ calls received since 2014. https://southampton.stonybrookmedicine.edu/services/tick-borne-disease-resource-center

3. Centers for Disease Control and Prevention. Lyme Disease: Prevention, Symptoms, and Treatment. New York State classified as high-incidence state. https://www.cdc.gov/lyme/index.html

4. Lantos PM, Rumbaugh J, Bockenstedt LK, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease. Clin Infect Dis. 2021;72(1):e1-e48. DOI: 10.1093/cid/ciaa1215. https://academic.oup.com/cid/article/72/1/e1/6010652

5. Nadelman RB, Nowakowski J, Fish D, et al. Prophylaxis with single-dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite. N Engl J Med. 2001;345(2):79-84. DOI: 10.1056/NEJM200107123450201. Note: Study showed 87% risk reduction with wide 95% confidence interval (25-98%). Adverse events (primarily nausea) occurred in 30.1% of doxycycline group. https://www.nejm.org/doi/full/10.1056/NEJM200107123450201

6. Canadian Agency for Drugs and Technologies in Health. One Dose of Doxycycline for the Prevention of Lyme Disease: A Review of Clinical Effectiveness and Guidelines. CADTH Rapid Response Report. May 2019. Note: Systematic review found evidence-based guidelines offer conflicting recommendations; ILADS recommends against single-dose prophylaxis based on wide confidence intervals and use of erythema migrans as unvalidated surrogate endpoint; Prescrire guideline advises against routine prophylaxis. https://www.ncbi.nlm.nih.gov/books/NBK545493/

7. U.S. Food and Drug Administration. Doxycycline Drug Information. Includes photosensitivity warnings, pregnancy category D classification, and contraindications. https://www.accessdata.fda.gov/scripts/cder/daf/

Medical Disclaimer: This content is for educational purposes only and does not constitute medical advice. Tick bite management decisions should be made in consultation with a qualified healthcare provider who can assess your individual circumstances, medical history, and risk factors. Treatment recommendations may vary based on evolving medical evidence and individual patient factors.