Many methods of tick removal that have been reported in the literature have proved to be unsatisfactory in controlled studies. Some methods may even cause harm by inducing the tick to salivate and regurgitate into the host. Ticks are best removed as soon as possible, because the risk of disease transmission increases significantly after 24 hours of attachment. The use of a blunt, medium-tipped, angled forceps offers the best results. Following tick removal, the bite area should be inspected carefully for any retained mouthparts, which should be excised. The area is then cleaned with antiseptic solution, and the patient is instructed to monitor for signs of local or systemic illness. Routine antibiotic prophylaxis following tick removal generally is not indicated but may be considered in pregnant patients or in areas endemic to tick-borne disease.