by Dr. Bill Rawls
Updated 6/25/21

Considering that my life was totally disrupted by chronic Lyme disease for more than ten years, you might find it alarming to learn that I walk in the woods with bare legs. And although this might sound risky, I haven’t had any tick bites since my recovery. I’ve had ticks on me, but I haven’t been bitten.

Like many people who contract Lyme, my aversion to ticks kept me removed from nature. So what finally changed my fear?

I became tick aware — doubling down on prevention and keeping tabs on where I go, how I go, when I go, and what I do before and after I go to minimize risk factors. And in the end, my love of the outdoors prevailed. Being in nature is where I’ve always gained strength, and I had to find my way back to heal fully.

Finding My Way Back Nature

My first foray back into nature began at the beach at a state park near my home. Long walks were perfect for generating endorphins, and the sea air did me good. However, as my strength improved, I needed more of a challenge, so I began venturing onto the trails that wove through the tall grasses of the sand dunes and maritime forests of the park.

Being keenly aware that ticks were prevalent in the thick brush surrounding the trails, I went fully clad in heavy clothing and doused myself with chemicals. But heavy clothing was uncomfortable, especially in warmer months, and the insect and tick repellent DEET lit my skin on fire and caused me to feel terrible.

Eventually, I was back to shorts and sandals for all my hikes. I found that I could see and feel ticks on my skin much better than I could see them on clothing, even tiny nymph ticks the size of a poppyseed. In addition, I always wore light-colored clothing that would show ticks.

I also developed a habit of periodically inspecting my body, especially my torso and legs, for unwanted intruders. I was especially vigilant if any branches or brush touched my body. I never sat down on the ground or in the grass, and after a hike, I immediately took a thorough shower or jumped into the ocean — an important step for washing off ticks before they attach.

Now, hiking is a regular part of my life again. I’ve hiked trails throughout North Carolina and beyond. I’ve taken three summer vacations to Maine, often considered Lyme central, without getting a tick bite. I’ve even been blackberry and blueberry picking — one of the most “ticky” things you can do — without being bitten.

10 Tips for Getting Back Outside

People often get bitten by ticks because they enjoy being in nature — ticks and the microbes they carry are part of nature’s cycle. Fear of ticks, however, shouldn’t keep you from enjoying a deep and often healing connection with the outdoors.

Enjoying nature without being harmed by it is about recognizing the risks and taking steps to minimize them. Ease back in at a level that’s comfortable to you — there’s no need to push yourself faster than you’re prepared to handle mentally or physically.

Here are the personal guidelines I follow to stay safe:

#1 Practice Extreme Vigilance.

Extreme vigilance is essential when you’re outside. Not only are regular tick inspections crucial when hiking or doing outdoor activities, but developing a hyperacute sense of touch can be your best protection. This is almost like a sixth sense — or a “tick sense,” as I like to call it.

For example, if anything touches my skin while I’m out in nature, I pay attention to it immediately. I also make a habit of sweeping my hands across my arms, torso, and legs frequently. Of course, this isn’t a guarantee of knocking off a tick, but it helps and prompts me to keep a watchful eye out for them.

#2 Use Tick Repellants.

Chemical warfare works, but synthetic insect repellents can be quite toxic. When the risk is higher than average, I use essential oils on my body and clothing. There are a variety of essential oil products on the market that work. I haven’t found one that’s better than another. Permethrin-impregnated clothing is also an option, but I’ve never used it personally.

#3 Dress Appropriately.

In summer, I prefer to hike in shorts. I can see and feel ticks on my skin better than on clothing. You, however, may feel more comfortable with nothing exposed. If you wear full clothing, be sure and brush clothes off thoroughly before coming inside. Then, wash your clothes in hot water and dry them in the dryer on high heat to kill the remaining ticks. Warm and cold water won’t be enough to wipe them out.

#4 Take a Shower.

After hiking or doing other outdoor activities, always take a shower. It’s a perfect time for me to check all the nooks and crannies where ticks can hide, brush my skin, and thoroughly inspect my scalp. An easy rule of thumb to follow is to begin at the top of your head and work your way down; inconspicuous spots to check are:

• Scalp
• Hairline
• Ears and surrounding skin
• Armpits
• Belly button
• Around the waist
• Groin and genital region

#5 Stay on the Beaten Path.

Choose trails and paths that are wide and well maintained. I skip overgrown trails or sitting on grass or next to bushes altogether. Sitting on the edge of a bench on the trail is okay, but I’m even careful about that. Carrying a folding stool might be an option for you if you’d like to sit. Activities like camping and gardening may be a bit more challenging because you’re close to grass and other vegetation. If you choose to do these activities, I suggest laying down a large ground cloth to create a barrier between you and ticks.

#6 Reconnect with Nature.

Ticks don’t tend to gravitate toward the sand, so beaches are a relatively safe bet as long as you stay out of tall grasses in the dunes and the maritime forests. Watersports, including surfing, paddleboarding, and kayaking, are great active outdoor activities where you’re less likely to come into contact with ticks. If you want to hike with a bit less concern for ticks, desert hiking or staying above the treeline at higher elevations out West are better options.

#7 Maintain Your Environment.

Ticks prefer overgrown brush and unkempt grass, so prioritize lawn care and cut back brush and foliage near your living spaces, especially if you live in a tick-prone area. Open up the landscape as much as possible. Install decks and patios to create tick-free outdoor areas.

#8 Treat Your Animals.

There are a variety of collars, chewables, and sprays on the market, to protect your pet from ticks and tick bites. If you’re unsure of what product is right for your furry friend, you might want to consult with your vet. But no matter what you use, recognize that your pet can still bring ticks inside on their fur. My dog, a frequent companion on outdoor outings, doesn’t have the same vigilance about ticks that I do. So after every outing, he gets a thorough brushing before coming inside. He’s not allowed on furniture or beds — no exceptions. Much to his chagrin, he’s bathed regularly.

#9. Consider the Time of Year.

Ticks are on the move mostly in spring and fall, but it’s possible to be bitten any time of the year, especially in locations where temperatures stay above freezing. Global warming is also influencing tick populations, but I don’t let that keep me from enjoying nature. In the Northeast, everyone says ticks seem most prevalent after the spring snowmelt. Therefore, that’s the time to stay out of the woods. When tick counts are high, I stick to beaches, waterways, and places where the environment is less hospitable to ticks. The same applies to mosquitos — in summer and early fall, I avoid still, damp woodland areas where mosquito counts are high.

#10 Support Your Immune System.

Most likely, I’ll be bitten by another tick at some point. But I have confidence that herbs keep my immune system strong. I still take the same herbs I used for Lyme recovery on a daily basis. If I were bitten tomorrow, I would double up on herbs like cat’s claw, andrographis, garlic, reishi mushroom, and others. If I became symptomatic, I’d use antibiotics along with my herbal protocol.

Enjoying Nature’s Healing Powers

Reconnecting with nature became an essential part of my recovery — as much for my mental health as my physical health. I felt lost without it. Natural spaces have a healing quality that is hard to describe.

If you’ve ever had a deep connection to nature, you likely feel the same way. Fear of ticks shouldn’t keep you from the things you love. You can go back in the woods again. But when you go, go wisely. Take time to develop that “tick sense,” so ticks are no longer an obstacle to reap the benefits of nature’s healing powers.

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.

You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.