Telehealth Rash Consultation Services
Tick bite and Lyme disease rash consultation* is available by telemedicine appointment at the Johns Hopkins Lyme Disease Research Center. A telehealth visit requires the ability to digitally photograph the patients skin rash for the evaluation and to meet certain State insurance parameters.
* Only available currently to patients in Maryland, Pennsylvania, Virginia, and Delaware.
If you are experiencing flu-like symptoms, please seek the advice of a healthcare practitioner.
What Are The Signs & Symptoms Of Lyme Disease
Lyme disease can affect different body systems, such as the nervous system, joints, skin, and heart. The symptoms of Lyme disease are often described as happening in three stages. Not everyone with Lyme has all of these, though:
The rash sometimes has a “bull’s-eye” appearance, with a central red spot surrounded by clear skin that is ringed by an expanding red rash. It also can appear as an growing ring of solid redness. It’s usually flat and painless, but sometimes can be warm to the touch, itchy, scaly, burning, or prickling. The rash may look and feel very different from one person to the next. It can be harder to see on people with darker skin tones, where it can look like a bruise. It gets bigger for a few days to weeks, then goes away on its own. A person also may have flu-like symptoms such as fever, tiredness, headache, and muscle aches.
What Treatment Is Available For Lyme Disease
Localised or early Lyme disease generally responds well to appropriate antibiotics. Full cure is usually achieved if the disease is diagnosed and treated promptly, but the cure rate decreases the longer treatment is delayed. The choice of antibiotic depends on bacterial sensitivity.
Antibiotics used for erythema migrans include doxycycline, amoxicillin and cefuroxime. Secondline treatments are the macrolides, azithromycin and erythromycin. Intravenous penicillin and cetriaxone are used for more advanced Lyme disease. The route of administration and the duration of the course of antibiotics depends on the stage and organ involvement. It varies between 10 and 30 days. Late stage Lyme disease, especially neuroborreliosis, should be treated with intravenous antibiotics.
Some patients have persistent or recurrent symptoms of unknown origin after apparently successful antibiotic treatment for Lyme disease. This is called post-treatment Lyme borreliosis syndrome. It is believed to be an auto-immune response. Prolonged antibiotic treatment does not improve cure rates.
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Signs Of Lyme Disease That Appear On Your Skin
Signs of Lyme disease
If you see a rash or another sign of Lyme disease on your skin, see your primary doctor right away. When caught early and treated, Lyme disease can be cured with antibiotics and most people recover fully.
Lyme disease is caused by a bite from a black-legged tick. If you are bitten by this tick and develop Lyme disease, you may see a bulls-eye rash. Its a common sign of Lyme disease, but its not the only sign.
Lyme disease occurs in stages. Heres what you may see on your skin during each stage.
Lyme Disease Tick Bite On Dog
Lyme disease, also known as Lyme borreliosis, is a vector-borne disease caused by the Borrelia bacterium which is spread by ticks in the genus Ixodes. The most common sign of infection is an expanding red rash, known as erythema migrans, that appears at the site of the tick bite about a week after it occurred. The rash is typically neither itchy nor painful.
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What If A Tick Bites My Dog
The more ticks in your region, the likelier it is that your furry pal will bring them home.
Your dog is much more likely to be bitten by a tick than you are. And where Lyme disease is common, up to 25% of dogs have had it at some point.
About 10% of dogs with Lyme disease will get sick. 7-21 days after a tick bite, your dog might seem like theyâre walking on eggshells. They also might have a fever and enlarged lymph nodes. Plus, they might seem tired. Dogs also get antibiotics for Lyme.
What if my dog brings ticks into my home?
Use a tick control product on your pet to prevent Lyme disease. Also, have your dog vaccinated against Lyme.
Check your dogâs whole body each day for bumps. If you notice a swollen area, see if thereâs a tick there. If you find a tick, wear gloves while you use tweezers to separate it from your dog. Then, put it in soapy water or alcohol, or flush it down the toilet.
Use alcohol to clean the spot on your dog where the tick was attached. Keep an eye on that spot, and also on your dog to make sure theyâre behaving normally. If you notice any changes, check with your vet.
John Aucott, MD, assistant professor of medicine, Johns Hopkins University School of Medicine director, Johns Hopkins Lyme Disease Clinical Research Center.
Morbidity and Mortality Weekly Report: âVital Signs: Trends in Reported Vectorborne Disease Cases — United States and Territories, 2004-2016.â
American College of Rheumatology.
How To Avoid Tick Bites
To reduce the chance of being bitten:
- cover your skin while walking outdoors and tuck your trousers into your socks
- use insect repellent on your clothes and skin products containing DEET are best
- stay on clear paths whenever possible
- wear light-coloured clothing so ticks are easier to see and brush off
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What Do You Do If There’s A Tick Under Your Skin
Use a pair of fine-tipped tweezers to remove it as soon as possible. Pull upward with steady pressure. If parts of the tick are still in your skin, try to get those with the tweezers, too. After everything is out, clean the bite area with rubbing alcohol or soap and water.
You probably wonât get infected if you remove the tick within 36 to 48 hours.
How do you throw away a tick?
Put it in soapy water or alcohol, stick it to a piece of tape, or flush it down the toilet.
Lymepolicywonk: How Many Of Those With Lyme Disease Have The Rash Estimates Range From 27
Have you ever wondered how many patients with Lyme disease have a rash? You would think the answer would be straight-forward. Its not. Estimates range from 27-80%.
For example, in our recently published study of over 3,000 Lyme patients approximately 40% of people with chronic Lyme recalled a rash. The CDC website reports that between 60-80% of those included in its surveillance system report a rash. Some estimates are as low as 27%. Whats the difference?
There are a number of factors at play. A major factor is how the rate is reported. Surveillance definitions by their very nature increase the percentage of rash cases reported because one of the criteria for meeting the surveillance definition is a rash. The measuring stick is skewed towards rash reporting. This means surveillance cases may reflect a higher percentage of people with a rash than are present in the normal population of people with Lyme disease. Without a rash, their cases are less likely to be diagnosed by physicians or meet surveillance criteria. The result is the rashless cases of Lyme disease are undercounted.
Even the CDC estimates vary widely depending on geography. Their estimates range from 51% to 87% depending on the state. Some states report even lower rates of rash. For example, Maine reports only 43% of its cases of Lyme have the Erythema Migrans rash. It is not known whether these variations reflect reporting anomalies or geographical strain diversity of B. burgdorferi.
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Even Be Careful When This Typical Lyme Disease Rash Doesnt Appear
When a bullseye rash doesnt occur, this doesnt indicate that someone doesnt have Lyme disease. The disease might also be present when the characteristic Lyme disease rash is not. According to the literature, this is even the case for 30 to 70% of the infections. It is, therefore, important to watch for flulike symptoms after a tick bite, for this might be an indication for Lyme disease.
Examples of a bullseye rash after a tick bite
Where Is Lyme Disease Found
Lyme disease is present in all 50 states, but the illness is most commonly found in the Northeastern US. Lyme disease is prevalent in areas with a high population of ticks, especially ticks infected with the Lyme disease bacteria. More than 50% of ticks in New York State carry the bacteria that cause Lyme disease. The illness has been reported all over the world including Australia, China, Europe, and Japan.
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When Should You See A Doctor If You Think You Have Lyme
The rash is a pretty good indication that you may have been bitten. Take a photo of the rash and see your doctor. At this stage, treatment with antibiotics will probably work.
If you don’t have the rash but have symptoms like fatigue, fever, and headache but no respiratory symptoms like a cough, you may want to talk to your doctor.
Vaccination To Prevent Lyme Disease
Several vaccinations have been developed to prevent canine Lyme disease. You should administer the vaccine to your unexposed pet annually if your area of residence and your pets lifestyle increase therisk of contracting Lyme disease. These vaccines can cause reactions orside effects and should only be administered if necessary, particularlyafter consulting the vet. Vaccination is contraindicated in a dog that is already suffering from Lyme disease.
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Living With Lyme Disease
Most people treated in the early stages of Lyme disease make a quick and complete recovery. Some may experience symptoms for a few weeks after treatment. If you were treated for Lyme disease but you still dont feel well, call your family doctor. He or she can make sure there isnt something else wrong. They can help you find ways to ease your symptoms. Some patients have found relief with treatments typically used for chronic fatigue syndrome or fibromyalgia.
Other things you can do to help manage Lyme disease include:
- Educate yourself.There is a lot of inaccurate information to be sorted through, especially on the internet. Ask your doctor if you have questions.
- Track your symptoms.Keep a diary of your sleep patterns, eating habits, exercise routines, and how youre feeling. You or your doctor may be able to make connections between them.
- Take care of yourself.Eat a healthy diet. Exercise as regularly as you can. Get plenty of rest.
Find support. It can be hard to not feel well and not know why. Some people may think your symptoms arent real. Talk to friends and family. If they cant offer support, talk with a counselor who can help you.
How Do You Know If Youll Get Lyme Disease From A Tick Bite
Lyme disease is an infection caused by a a species of bacteria called Borrelia burgdorferi. This bacteria is most commonly transmitted by the bite of a tick of the Ixodes genus. People who spend a lot of time outdoors in areas where ticks with this bacterium are present, are considered to be more at risk of Lyme disease, especially during the summer season.
If youre outdoors and youre bitten by a tick, one of the hallmark symptoms showing you may have been infected with Borrelia is whats known as a bullseye rash around the tick bite.
By bullseye, we mean the rash looks like a circle with some concentric rings expanding out from the insect bite. It may also just look like a red rash but it usually does look more brightly colored red at the outer edges. Take a look here to see some examples.
There is data to suggest only 30-50% of people infected with Borrelia get the bullseye rash so its important to note that absence of this rash does not mean you are safe from infection.
A red rash can be caused by other bites
Because some people are particularly sensitive to insect bites, at times people could be bitten by an insect and a standard rash gets confused with a rash signifying Lyme disease. So at this stage its very difficult to tell if the person whos been bitten will develop Lyme disease.
The acute stage of Lyme disease
If youre in an area prone to Lyme disease
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Symptoms: As The Infection Spreads
If the disease goes untreated in its early stages, over several weeks or months it can spread to other areas of the body like your:
- Nervous system
You could also have more rashes and periods of pain and weakness in your arms or legs. Other symptoms include:
- Facial muscle paralysis
- Inflamed brain and spinal cord
When Should I Call The Doctor
If a tick bites you, call your doctor. Other conditions can cause similar symptoms, so it’s always a good idea to discuss them with your doctor. That way you can get checked and treated, if needed. Call right away if you get a red-ringed rash, lasting flu-like symptoms, joint pain or a swollen joint, or facial paralysis.
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Touched By Lyme: When Lyme Disease Isnt Caught Early
The question was posed on one of LymeDisease.orgs online discussion groups. A mother had found a bulls-eye rash on her 5-year-old son. She took him to urgent care and was given two weeks worth of antibiotics. Is that enough, she wondered, or should she pursue something more?
The following remarkably detailed response was posted by another mother on the group. I feel there are many lessons to be learned from her hard-earned wisdom. With her permission, I share it with you here. In the interest of protecting her familys privacy, she prefers to remain anonymous.
What Does A Lyme Disease Rash Really Look Like These Pictures Explain It
You know the classic bulls-eye rashbut Lyme causes other types, like these.
A telling sign of Lyme disease is a red, circular or oval rash that expands over time like a bulls-eye. Doctors call it erythema migrans. But if youre looking for a bulls-eye pattern and ignoring other types of skin rashes and lesions, youre probably missing an important clue to your diagnosis. Surprise, surprise: relatively few Lyme rashes mimic the concentric circles of a dart board.
The classic target pattern represents just 20% of Lyme-related skin lesions in North America, notes John Aucott, MD, associate professor of medicine at Johns Hopkins University School of Medicine in Baltimore and director of the Johns Hopkins Lyme Disease Research Center.
Eighty percent dont look like that, and they constantly get misdiagnosed as spider or bug bites, he tells Health.
The fact is that Lyme disease rash can present itself in different ways, according to the Bay Area Lyme Foundation. How it appears on your body may depend, in part, on how long youve had it and where it shows up on your body.
Generally, erythema migrans is circular, because it spreads centrifugally from the point of the tick bite, says Dr. Aucott. But it can be more oval or elongated in shape if, for instance, the tick took its blood meal in the groove of your groin.
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Atypical Lyme Rashes And Less
In some cases, the Lyme disease rash doesnt look like a bulls eye at all. It can be blistered , cause a bluish swelling , be uniform in color instead of banded, be oval or triangular in shape, or just look like a large red area . You can see a picture of atypical Lyme disease on a black man here.
There are also many instances of Lyme rashes which are considered to be bulls-eye shaped, but dont have the white band inside. The message? Dont expect a Lyme rash to look like a perfect bulls eye. If you suspect Lyme, contact your doctor!
Time Is Of The Essence
This doctor needs to be seen immediately. Within a week after exposure, Lyme bacteria can move into the central nervous system and become much harder to eradicate with treatment.
My daughter is only one of many examples of undiagnosed/untreated Lyme disease in a child. Her first symptoms were at eight years old. A horrific headache lasted three months, along with some fatigue and low-level fever and viral symptoms.
It looked like a sinus infection and after three rounds of various antibiotics, it slowly limped away and we were so glad that was over, whatever it was. We never saw a tick, never saw a bulls-eye rash.
At 10, my daughter started having periodic episodes with bad headache, low-level fever, viral symptoms and fatigue. In between these, she was perfectly fine for weeks at a time.
Not enough to get her pediatrician interested, but she was missing enough school and sports activities that it was starting to be a life issue. She also seemed to heal very slowly from injuries such as bruises and muscle pulls and strains. And though she hid it well and no one noticed at the time, she was dealing with some emotional and psychiatric issues.
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Ongoing Symptoms Of Lyme Disease
A few people who are diagnosed and treated for Lyme disease continue to have symptoms, like tiredness, aches and loss of energy, that can last for years.
It’s not clear why this happens to some people and not others. This means there’s also no agreed treatment.
Speak to a doctor if your symptoms come back, or do not improve, after treatment with antibiotics.
The doctor may be able to offer you further support if needed, such as:
- referral for a care needs assessment
- telling your employer, school or higher education institution that you require a gradual return to activities
- communicating with children and families’ social care
Page last reviewed: 05 July 2021 Next review due: 05 July 2024