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Outdoor activities like swimming and hiking are a great way to stay healthy. But they can also sometimes lead to rashes, sunburns, bug bites, and parasites like leeches.

Finding a leech on your body can be scary, but you don’t need to panic. We’ll give you simple steps that can help you calmly and safely remove a leech without any pain or complications from the bite.

Leeches are parasites that belong to the same family of organisms as worms. They can have both male and female reproductive organs, which means they can reproduce sexually, fertilize themselves, or both.

There are more than 600 species of leeches. You can encounter them most often in grasses or fresh water, though some species live in marine water. As parasites, they need to feed off a host in order to survive.

Many leech species are sanguinivorous, which means that they feed on blood. Once they attach themselves to a human, they’ll begin to suck their blood.

Leeches can also expand up to 10 times their size while feeding, allowing them to consume a lot of your blood at one time.

Leech vs. tick

Ticks are similar to leeches only in that they both can feed on blood.

But unlike leeches, ticks belong to the spider family and only attach to the skin. Though most leech bites are external, it’s possible for a leech to attach internally. Neither leeches nor ticks are insects.

Learn how to remove a tick.

Your first step in removing a leech is finding it.

If you spot a leech on your skin, check the rest of your body to see if any more have attached themselves to you. Once you find a leech, you can begin to safely remove it.

Steps for removing a leech

The basic leech removal steps are:

  1. Locate the head and mouth. A leech’s head is smaller and slimmer than the rest of its body. Look for the narrowest part of the leech to locate its mouth. This is usually the part attached to your skin.
  2. Pull the skin under the leech taut. Use one hand to gently pull your skin under the leech until it’s taut.
  3. Slide a fingernail underneath the mouth. Gently slide a fingernail under the leech’s mouth to separate it from your skin.
  4. Flick the leech away. Use your fingers to flick the leech away before it reattaches.
  5. Clean the wound. Clean your wound with rubbing alcohol or a first-aid cleanser to help avoid infection.
  6. Bandage your wound. You’ll see a lot of bleeding when you remove the leech. Clean the wound and then use a sterile bandage to cover it. Change the bandage frequently for the first few hours until bleeding stops.
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You can also try these alternative methods for removing a leech:

  • Using a piece of paper or a credit card instead of your fingernail. For this method, you’ll follow all the same steps as above, but you’ll slide a thin piece of paper or a credit card under the leech’s mouth instead of your finger.
  • Letting the leech fall off naturally. Usually, this can take about 30-45 minutes. You can wait for the leech to detach itself when it’s finished feeding, especially if you’re having trouble removing it. If the leech does not fall off for a long time or attaches to a hard to reach area, having it medically removed is the best course of action.

Removing leeches from difficult locations

Leeches will sometimes attach to hard-to-reach areas, like your ear canal, nose, or mouth. This can make it difficult to use the above methods for removal. If this happens, try one or more of the following:

  • Use rubbing alcohol or hydrogen peroxide. To remove a leech from your mouth, gargle with alcohol or hydrogen peroxide for about 30 seconds. Swish the alcohol or peroxide in your mouth like mouthwash, then spit it out. Check to see if the leech comes out with it.
  • Puncture the leech. Leeches can grow up to 10 times their original size when they’re feeding. Sometimes, this can cause them to block an area like your nose or ear. Use a sharp object to pop the leech, killing it and making it easier to remove.

In some cases, the removal method will depend on the location the leech attaches to and may need the help of a medical professional to remove. Leeches that attach internally may require surgery to remove. This can happen if a person swallows contaminated water.

What not to do

Do not remove a leech using any of the following methods. These can cause the leech to vomit blood into your wound and increase your risk of infection:

  • salting
  • fire
  • shampoo
  • bug repellant
  • pulling the leech

Many leech bites can lead to itching at the affected site, as well purpura. This is not necessarily dangerous. Most leech bites are harmless. Usually, the leech can be removed easily without the need for medical attention.

But the bite can cause extended bleeding at the attachment site even after the leech is removed. This is because the saliva from leeches is an anticoagulant and interferes with the blood’s normal clotting.

In rare cases, some people may experience an allergic reaction to leech bites. People with a history of allergies or anaphylaxis need to be extra careful. Those who are taking anticoagulant medications are at risk for more prolonged bleeding after a bite.

In addition, most leeches carry the bacteria Aeromonas in their gut, which could infect the leech site. A person who has been exposed to a leech can get prophylactic antibiotics as a precaution.

Research has shown that a person can potentially contract other infectious diseases from a leech bite like Hepatitis B or Malaria. But these kinds of infections also appear to be rare.

Additional research has found that some leeches may carry other viruses like HIV. But there isn’t evidence to suggest that humans have actually been infected with HIV from a leech.

Is a leech bite painful?

Despite the use of the term “bite,” leeches don’t actually bite with a mouth or teeth. Instead, they have very strong suckers that attach to the skin and extract the blood.

In addition, leech saliva has analgesic properties that numb the area where it attaches. This means you may not even feel the leech before you see it on you.

Leech therapy

Although getting bitten by a leech while outdoors may not be pleasant and comes with some risks, people have actually used leeches for medicinal purposes for thousands of years.

Because leech saliva contains a substance that stops your blood from clotting, it can promote blood flow and wound healing.

Medicinal leeches can be used in plastic surgery to help tissues heal. They’re also sometimes used to treat conditions like blood clots and varicose veins, and to help prevent diabetic tissue death.

But leech therapy should only be done with medicinal leeches under controlled conditions. Do not try this type of therapy at home without supervision from a medical professional in a sterile environment.

Learn more about leech therapy.

Leeches are long, tube-shaped animals. They’re similar in appearance to worms and can be anywhere from just a few millimeters to up to 20 inches long.

Most leeches have visible eyes on the top of their bodies and round mouths with several rows of teeth. Leeches can be spotted, striped, or solidly colored. They have two suckers on each end of their bodies. Leeches use their suckers to grasp, feed, and move around.

Additionally, leeches are generally:

  • flat
  • wide
  • segmented
  • dark in color

Leeches are commonly found in freshwater lakes and tall grasses. Check out the gallery below to get an idea of how to spot a leech.

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Freshwater leech.
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Marine (sea) leech.
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Terrestrial (land) leech.
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You should contact a doctor if you can’t remove the leech yourself or if your wound becomes infected. Signs of infection include:

  • fever
  • pain
  • redness
  • discharge from the wound

If you experience a mild allergic reaction, take an over-the-counter antihistamine. A severe allergy is rare, but it’s best to be on the lookout for symptoms, including:

  • painful and persistent rash around the bite area
  • swelling near the bite
  • dizziness
  • trouble breathing

Seek immediate medical attention if you have trouble breathing or feel confused, disoriented, or about to lose consciousness.

Another reason to seek medical attention is if your bleeding appears unusually heavy or prolonged, especially if you’re taking anticoagulant drugs.

When you need medical attention or have trouble removing a leech, a doctor can use medical instruments to remove leeches in hard-to-reach places.

Once a doctor removes the leech and cleans the wound, treatment will depend on the wound and your reaction to it. Your doctor might suggest:

  • specialized bandages to cover and protect wounds in places prone to infection
  • antibiotic medications, creams, or ointments to prevent or stop an infection
  • prescription-strength antihistamines to stop allergic reactions
  • ice or cool compresses to help with any swelling

Before you enter a body of water, ask or research to learn if the water may have leeches. If yes, you may choose to avoid entering the water.

If you do enter freshwater or go walking in an area where leeches may be present, some precautions can be helpful.

They include:

  • wearing anti-leech protective socks
  • using a salt spray
  • using insect repellants like DEPA or DEET
  • timur oil
  • lemon-eucalyptus extract

Use any repellant spray, salt, or oil only as a protective spray. Never put them on an attached leech.

Finding a leech on your skin can be alarming. But except in rare cases, leeches aren’t generally harmful.

You can carefully remove a leech by using your fingernail or a sheet of paper to separate the leech’s mouth from your skin. Don’t use methods like salting, burning, or drowning to remove a leech, as these can lead to infection.

Contact a medical professional if you’re unable to remove a leech, experience any signs of infection, or have an allergic reaction.