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Originally published Sunday, July 7, 2013 at 5:30 AM

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Be careful with tick removal

People’s Pharmacy on tick removal, hot flashes and lice.

Syndicated columnists

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Q: What is the best way to remove a tick that has attached itself to your skin? I have read on the Internet that you should put liquid soap on a cotton ball and dab it on the tick. In theory, this is supposed to get the tick to let go and back out.

A: A reader in the Netherlands saw the same Web story you did and responded: “We have ticks in Europe, but we are warned not to use soap or alcohol on the tick. That could cause the tick to spit the contents of its stomach into your skin and maybe cause Lyme.”

We also heard from an emergency-department physician, who said: “Ticks actually glue their mouthparts into the skin during a feed. It takes them several hours to accomplish this, so if you find the tick early, it can be removed intact. If you find them about 12 hours or so later, the mouthparts will generally be impossible to remove intact and don’t need to be.”

He added a recommendation for an inexpensive tick-removal device called Pro-Tick Remedy, available at camping stores. Other readers have recommended The Tick Key, the Ticked Off spoon and the O’Tom/Tick Twister.

Q: I’ve been taking estradiol Mondays, Wednesdays and Fridays for hot flashes for many years. (I used to take Premarin.)

My doctor asked me to stop the estrogen because she said she would get in trouble. Now I have hot flashes day and night. I am desperate. What else can I do?

A: We’re not quite sure why your doctor thinks she would get into trouble for prescribing estradiol for hot flashes. Although estrogen has the potential to increase the risk for blood clots, high blood pressure, migraines and breast cancer, it is the most effective way to control menopausal symptoms. Stopping estrogen suddenly can trigger rebound hot flashes (Maturitas, August 1983).

One alternative is Pycnogenol. This compound is derived from the bark of French maritime pine trees and is rich in procyanidins. A randomized placebo-controlled trial found that Pycnogenol was especially helpful for hot flashes and sleep problems associated with menopause (Journal of Reproductive Medicine, February 2013).

Q: About 10 years ago, our daughter did her practice teaching in an elementary school and got head lice. We tried all the treatments, but the lice kept coming back.

She finally found an electronic comb (Robi Comb) that electrocutes the lice. It was a bit pricey, but not as much as multiple bottles of lice shampoo that didn’t work.

A: We have heard from many frustrated parents that standard lice shampoos frequently fail because lice have become resistant to the pesticides. A dermatologist described his own success with Robi Comb in a similar situation (Journal of the American Academy of Dermatology, February 2005). Daily use for two weeks is required to zap the lice and remove the nits.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them c/o King Features Syndicate, 300 W. 57th St., 15th floor, New York, NY 10019, or via their website:www.peoplespharmacy.org

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