If the ticks are a few, they can be removed by hand. It is recommended not to twist them, but rather to use firm, straight backward pressure. Twisting can result in the head remaining in the horse, causing infection and disease. A tick comb may be quite useful.
We recently had a horse come into our rescue with hundreds of ticks. This prompted us to do some research about the best approach to eliminate them. There are many recommendations and we do not discredit any of them. This is just what we did and what worked for this specific horse.