Summer and the great outdoors go hand in hand, but unfortunately sometimes all that nature wants to hitch a ride back with you from vacation or camp. If you or your family notice insect bites, rashes, or other skin irritations, do you know what to do? The doctors at Methodist Health Family Centers do, and they are here to help.

Kelly Farris, MD has outlined below some basic first steps, though of course you should always see a physician if symptoms worsen or if you have further questions.

Ticks
Lyme disease — which can cause fever, headache, fatigue, and skin rash, and if left untreated can spread to joints, the heart, and the nervous system — is transmitted by ticks. A tick generally has to be attached for 48 hours in order for Lyme disease to be transmitted, and that can happen a lot easier than would think.

Do a full body check on children when they return from summer camp, outdoor athletic practice, or just playing outside. If you find an attached tick, this is the proper way to remove it:

• If available, use tweezers or small forceps to grasp the tick as close to the skin surface as possible. In the absence of tweezers, use paper or cloth to protect the fingers during tick extraction.
• Pull straight up, gently but firmly, using steady pressure. Do not jerk or twist.
• Do not squeeze, crush, or puncture the body of the tick, since its fluids may contain infectious agents.
• Disinfect the skin thoroughly after removing the tick and wash hands with soap and water.
• If sections of the tick's mouthparts remain in the skin, leave them alone. Your body will normally expel them spontaneously.
• After the tick removal and the skin cleansing, the person bitten (or the parents) should observe the area for the development of a rash for up to 30 days following exposure. Components of tick saliva can cause transient redness that should not be confused with rash that indicates Lyme disease.
• Since the tick usually needs to be attached for two to three days before transmission of the Lyme disease agent occurs, removal of the tick within this timeframe prevents the transmission.

If a child returns from camp with a rash and fever, they should be evaluated by a physician.

Preventing insect bites
Prevention is the best medicine. Use bug spray containing DEET and wear long-sleeve shirts and pants to help avoid bites and any diseases that might come with them. Not sure what DEET is or how to properly apply it? Read on:

• Use just enough repellent to lightly cover, but not saturate, the skin.
• Repellents should be applied to exposed skin, clothing, or both, but not under clothing.
• A thin layer can be applied to the face by dispensing repellent into the palms, rubbing hands together, and then applying to the face.
• Repellent should be washed from the palms after application to prevent contact with the eyes, mouth, and genitals.
• Do not use repellents over cuts, wounds, or inflamed, irritated, or eczematous skin.
• Do not inhale aerosols, spray them in enclosed spaces or near food, or get them into the eyes.
• Do not apply insect repellent to the hands of small children, as it will inevitably be rubbed into the eyes.
• Frequent reapplication of repellent is unnecessary.
• The areas treated with repellent should be washed with soap and water once the repellent is no longer needed.
• If both sunscreen and repellent are being applied, sunscreen should be applied first and repellent should be applied after. It is better to use separate sunscreen and repellent products, as sunscreen generally needs to be reapplied more frequently than repellent.

Poison ivy, oak, and sumac
If you can't find a bite or can safely rule out Lyme disease, there's another possible explanation for rashes: poison ivy, oak, or sumac. Caused by exposure to the oil on the plants, an itchy, blistering rash usually shows up 12-72 hours after contact.

This is not contagious and does not spread, but you should wash the affected area with soap and water and be aware of any swelling, hives, or trouble breathing or swallowing. See your physician immediately if any of these symptoms develop, or if there is any doubt about the cause of the rash.