I Found a Tick Behind My Knee After a Hike — Here Is What I Learned About Prevention

After my fourth hike this spring, I found a tick embedded behind my knee. I had no idea how long it had been there. I pulled it off with tweezers, spent an anxious week watching for a bullseye rash, and started researching everything I should have known before I hit the trail. Here is what I learned about tick prevention, tick removal, and why I now treat insect repellent as seriously as I treat blister prevention.

Why Ticks Are Worth Taking Seriously

Ticks transmit more diseases than any other insect in the world. Lyme disease is the most famous, but there is also anaplasmosis, babesiosis, ehrlichiosis, and the alpha-gal allergy that makes you allergic to red meat. That last one is relatively new and increasingly common. A single tick bite can permanently change what you can eat.

The good news: most ticks need to be attached for 24 to 36 hours before they transmit Lyme disease. This means if you check your body thoroughly after every hike and remove ticks promptly, your risk drops significantly. The bad news: most people do not check thoroughly enough, and nymph ticks (the size of a poppy seed) are easy to miss.

What I Use Now

I tested three repellents this season:

DEET 30% 鈥?effective but melts synthetic fabrics and smells terrible. I use it only on my socks and boots, not on skin.
Picaridin 20% 鈥?my current go-to. It repels both ticks and mosquitoes, does not damage gear, and does not smell. I spray it on exposed skin before every hike.
Oil of lemon eucalyptus 鈥?natural alternative that works for about two hours. Good for short walks, not for full-day hikes.

I also treated my hiking boots and socks with permethrin spray. Permethrin is not for skin 鈥?you spray it on fabric and let it dry. It kills ticks on contact and lasts through several washes. This was the single most effective change I made.

The Post-Hike Tick Check

After every hike, I do a systematic tick check that takes about five minutes:

Strip down in a well-lit area.
Start at the head: run fingers through scalp, check behind ears.
Check armpits, groin, behind knees, and waistband 鈥?ticks love warm, dark areas.
Inspect the back with a hand mirror or ask someone to check for you.
Throw hiking clothes in the dryer on high heat for 10 minutes before washing. The heat kills any ticks you might have missed.

I missed the tick behind my knee because I checked visually but did not run my fingers over the area. Ticks can look like a new freckle or a scab. You have to feel for them too.

If You Find One Attached

I used to think you should burn it off with a match or smother it with petroleum jelly. Both are wrong and dangerous. The correct method:

Use fine-tipped tweezers. Not the blunt ones from a cheap first aid kit.
Grasp the tick as close to your skin as possible.
Pull straight upward with steady, even pressure. Do not twist or jerk.
Clean the area with soap and water, then apply antiseptic.
Save the tick in a ziplock bag or take a photo. If you develop symptoms, this helps with identification.

If a rash develops at the bite site within 30 days, or if you experience fever, fatigue, or muscle aches, see a doctor. Early-stage Lyme disease is treatable with antibiotics. Late-stage Lyme is much harder to manage.

What I Carry Now

A tick removal kit weighs nothing and costs under $10. Mine contains:

Fine-tipped tweezers (I use the same pair from my first aid kit)
A small bottle of picaridin spray
One resealable sandwich bag for storing a tick if I need to show a doctor

I keep it in the same pouch as my blister kit, so I grab both before every hike. Total prevention time: two minutes. Total cost of ignoring ticks: potentially years of chronic health issues.

One More Thing About Insects

Mosquito bites are more than annoying. In some regions, they carry dengue, West Nile, and Japanese encephalitis. The same picaridin spray that repels ticks also works for mosquitoes. I also carry a small tube of antihistamine cream for bites I inevitably miss. Scratching a bite with dirty fingernails is how skin infections start — I learned that lesson the hard way too.

Ticks are not a reason to stay indoors. They are a reason to prepare. Five minutes of prevention saves you from weeks of anxiety.