When Does Lyme Rash Appear
There are three distinct stages of Lyme disease, all of which present with various symptoms and signs. During stage 1 of the disease, the bacteria has been most recently contracted and the initial symptoms begin to appear. The typical Lyme disease rash usually appears in stage 1, between a few days or weeks of the initial infection.
There are several different types of Lyme disease rashes that can appear during stage 1 of the infection. The first, a bulls-eye rash, appears circular around the tick bite. It has a central clear ring that expands as well. Other types of rash that could appear include a red lesion that expands and has a crusty center a red and circular-shaped rash that has a clear center and a red lesion that is oval-shaped.
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The early stages of the rash are typically easiest to see, and people may also notice that there is a small spot or lump that pops up in the center. The rash may also be associated with certain other characteristics, such as being warm to the touch or smooth on the skin. Scaly and crusty edges may also develop. In some rare cases, the Lyme disease rash could also be painful, itchy, and feel as though it is burning. Typically, Lyme rashes are small, but they can gradually grow to up to 12 or more inches.
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.
Who’s At Risk And Where Are Ticks Found
The risk of getting Lyme disease is higher:
- for people who spend time in woodland or moorland areas
- from March to October because more people take part in outdoor activities
Ticks are found throughout the UK and in other parts of Europe and North America. There are a high number of ticks in the Scottish Highlands.
It’s thought only a small proportion of ticks carry the bacteria that cause Lyme disease. Being bitten doesn’t mean you’ll definitely be infected. However, it’s important to be aware of the risk and speak to a GP if you start to feel unwell.
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How Can Lyme Disease Be Prevented
Unfortunately, there is currently no vaccine for Lyme disease. But you can avoid Lyme disease by avoiding tick bites, checking for ticks, and removing ticks promptly, before they become lodged in the skin. Some tips:
Avoid tick playgrounds: Ticks like low-level shrubs and grasses, particularly at the edges of wooded areas. If youre hiking, try to stay in the center of the trail and avoid bushwhacking. Walk on cleared paths or pavement through wooded areas and fields when possible.
Dress appropriately: Long pants with legs tucked into socks and closed-toed shoes will help keep ticks away from skin. Light-colored clothing helps make ticks visible.
Insect repellant: Products that contain DEET repel ticks but do not kill them and are not 100 percent effective. Use a brand of insect repellent that is designated as child-safe if your child is 1 year or older. For infants, check with your pediatrician about what brands are safe to use. You can also treat clothing with a product that contains permethrin, which is known to kill ticks on contact.
Shower after outdoor activities are done for the day. It may take four to six hours for ticks to attach firmly to skin. Showering will help remove unattached ticks.
- all parts of the body that bend: behind the knees, between fingers and toes, underarms and groin
- other areas where ticks are commonly found: belly button, in and behind the ears, neck, hairline, and top of the head
- anywhere clothing presses on the skin
The Importance Of Early Diagnosis Of Lyme Disease

Its hard to believe that our patient-driven big data project, MyLymeData, was launched just last November. In October and November of this year, we presented our first preliminary findings from the survey at the Columbia/LDA conference in Minnesota and at the conference of the International Lyme and Associated Diseases Society in Philadelphia.
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Regression And Other Symptoms In Children
Children are the largest population of Lyme patients.
The CDC study of reported Lyme cases from 19922006 found that the incidence of new cases was highest among 5- to 14-year-olds . About one quarter of reported Lyme cases in the United States involve children under 14 years old .
Children can have all the signs and symptoms of Lyme that adults have, but they may have trouble telling you exactly what they feel or where it hurts.
You may notice a decline in school performance, or your childs mood swings may become problematic.
Your childs social and speech skills or motor coordination may regress. Or your child may lose their appetite.
Children are more likely than adults to have arthritis as an initial symptom 01267-2/fulltext#sec0040″ rel=”nofollow”> 25).
In a 2012 Nova Scotian study of children with Lyme, 65 percent developed Lyme arthritis . The knee was the most commonly affected joint.
Summary:
What Are Signs And Symptoms Of The Third Stage Of Lyme Disease
Late stage Lyme disease can result when treatment is unsuccessful or started too late due to unrecognized symptoms or misdiagnosis. The late disseminated stage occurs months or years after initial infection and can have a major impact on a patients health and quality of life. Late Lyme arthritis is a third stage Lyme disease manifestation that involves fluid accumulation and pain in joints, particularly in the knee joints. Late neurologic disease is a 3rd stage condition that can also be debilitating and difficult to diagnose. Late disseminated Lyme disease symptoms include a variety of symptoms that are often neurologic in origin including: numbness in extremities, mental fogginess and concentration problems, and difficulty following conversations or processing information.
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Facts About Lyme Disease
An important fact to remember about Lyme disease is that it can vary in appearance, length of time, signs, and symptoms for each person infected. So, if you hear your friend discussing their Lyme disease symptoms and they are different than yours, dont doubt that you have Lyme and avoid getting treatment. Your symptoms may be different, less severe, or more severe.
One thing that is the same among all people with Lyme disease they acquired it by being bitten by a deer tick infected with the bacteria Borrelia Burgdorferi.
Another fact is that not everyone gets a red rash when bitten by a deer tick. Or, they may get a rash in a place that isnt seen too often. Rashes are common, though, for many who have contracted the disease.
Furthermore, a rash can show up anywhere between a day of being bitten up to four weeks later.
You should know that just because you see a tick on your body, even if it seems to be latched on, it is not a guarantee that you will get Lyme disease, fortunately. Some reports claim the deer tick needs to be latched on to you for 36 hours to effectively transfer the infection into your bloodstream.
For this reason, you must check your body for ticks often if you are in an environment in which they live and thrive, or have pets who enjoy the outdoors daily.
If you do happen to become infected, the first stage you will experience is called the early localized stage.
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Learn The Stages Of Lyme Disease
Lyme disease occurs in three stages: early localized, early disseminated and late disseminated. However the stages can overlap and not all patients go through all three. A bulls-eye rash is usually considered one of the first signs of infection, but many people develop a different kind of rash or none at all. In most cases, Lyme symptoms can start with a flu-like illness. If untreated, the symptoms can continue to worsen and turn into a long-lived debilitating illness.
Stage 1: Early Localized Disease
Symptoms with early localized Lyme disease may begin hours, a few days or even weeks after a tick bite. At this point, the
infection has not yet spread throughout the body. Lyme is the easiest to cure at this stage.
Symptoms may include:
- skin rash, which may or may not look like a bulls eye
- flu-like illness, including chills and fever
- fatigue
- muscle soreness and joint pain
- swollen lymph nodes
- sore throat
Stage 2: Early Disseminated Lyme
Early disseminated Lyme may occur several weeks or months after the tick bite. Bacteria are beginning to spread throughout the body. In addition to flu-like symptoms, this stage is often characterized by increase in symptoms such as:
- chills
- pain, weakness or numbness in the arms, legs
- vision changes
- heart problems, such as palpitations, chest pain
- rash may appear on body
- facial paralysis
Stage 3: Late Disseminated Lyme Disease
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How To Prevent Lyme Disease From Progressing
Learn the symptoms of early Lyme disease so that you can seek treatment promptly if you contract the infection. If you get timely treatment, you can avoid the potential complications of early disseminated Lyme disease and later stages.
The symptoms of early Lyme disease can occur between 3 and 30 days after an infected tick bites you. Look for:
- rash, such as:
- a red, expanding bulls-eye rash at the site of the tick bite
- a round or oval rash that can be as wide as 6 to 8 inches
Joint Pain And Swelling
About half of people with untreated Lyme get chronic arthritis. Joint pain and damage most commonly occur in the knee. But Lyme can also affect other joints, like the:
-
Shoulders
-
Wrists
These joints may feel swollen and warm to the touch. Lyme arthritis is more common in older people with Lyme disease.
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Who Gets Lyme Disease
Anyone bitten by an infected deer tick can get Lyme disease. Most U.S. cases of Lyme disease happen in Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin. But Lyme disease is found in other parts of the U.S., Europe, Asia, and Australia too.
What Are The Signs And Symptoms Of Lyme Disease

Early symptoms usually appear within 3 to 30 days after the bite of an infected tick. In 60-80 percent of cases, a circular bulls eye rash about two inches in diameter, called erythema migrans, appears and expands around or near the site of the tick bite. Sometimes, multiple rash sites appear. One or more of the following symptoms usually mark the early stage of Lyme disease: chills and fever, headache, fatigue, stiff neck, muscle and/or joint pain, and swollen glands. If Lyme disease is unrecognized or untreated in the early stage, more severe symptoms may occur. As the disease progresses, severe fatigue, a stiff aching neck, and tingling or numbness in the arms and legs, or facial paralysis can occur. The most severe symptoms of Lyme disease may not appear until weeks, months or years after the tick bite. These can include severe headaches, painful arthritis, swelling of the joints, and heart and central nervous system problems.
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Symptoms Of Early Disseminated Lyme Disease
The onset of early disseminated Lyme disease can begin days, weeks, or months after a person is bitten by an infected tick. The symptoms reflect the fact that the infection has begun to spread from the site of the tick bite to other parts of the body.
At this stage, the infection causes specific symptoms that may be intermittent. They are:
- multiple erythema migrans lesions, which are circular or oval rashes that occur near the bite site and can be solid or resemble a bulls-eye
- Bells palsy, which is paralysis or weakness of muscles on one or both sides of the face
- meningitis, which is inflammation of the protective membranes around the brain and spinal cord
- neck stiffness, severe headaches, or fever
- severe muscle pain or numbness in the arms or legs
- pain or swelling in the knees, shoulders, elbows, and other large joints
Lyme Disease Rashes And Look
Circular, expanding rash with target-like appearance.
Expanding rash with central crust
Expanding lesion with central crust on chest.
Expanding erythema migrans
Photo Credit: Reprinted from Bhate C, Schwartz RA. Lyme disease: Part I. Advances and perspectivesexternal icon. J Am Acad Dermatol 2011 64:619-36, with permission from Elsevier.
Description:Early, expanding erythema migrans with nodule.
Multiple rashes, disseminated infection
Early disseminated Lyme disease multiple lesions with dusky centers.
Red, oval plaque
Red, expanding oval-shaped plaque on trunk.
Expanding rash with central clearing
Circular, expanding rash with central clearing.
Bluish hued rash, no central clearing
Bluish hued without central clearing.
Expanding lesion, no central clearing
Expanding lesion without central clearing on back of knee.
Red-blue lesion with central clearing
Red-blue lesion with some central clearing on back of knee.
Insect bite hyper-sensitivity
Large itchy rash caused by an allergic reaction to an insect bite.
Fixed drug reaction
Description:A skin condition that occurs up to two weeks after a person takes a medication. The skin condition reappears at the same location every time a person takes that particular medication.
Ringworm
Description:Ringworm is a common skin infection that is caused by a fungus. Its called ringworm because it can cause a ring-shaped rash that is usually red and itchy with raised edges.
Pityriasis rosea rash
Granuloma annulare rash
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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.
These symptoms are often compared to fibromyalgia and chronic fatigue syndrome.
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
What Is Normal Range For Lyme Disease
Reference Range Normal levels vary depending on the laboratory assay performed, as follows. Borrelia burgdorferi antibody enzyme immunoassay : < 0.9 = negative. 0.91-1.09 = equivocal. Normal levels vary depending on the laboratory assay performed, as follows. Borrelia burgdorferiBorrelia burgdorferiThe Ixodes tick progresses through four stages of development: egg, larva, nymph, and adult . Only larvae, nymphs, and adult female ticks require blood meals, and only ticks in the nymphal and adult stages can transmit B burgdorferi.https://www.medscape.com answers what-is-the-infectious-What is the infectious cycle of Borrelia burgdorferi? Medscape antibody enzyme immunoassay : < 0.9 = negative. 0.91-1.09 = equivocal.20 Nov 2019
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Disclaimer: The above material is provided for information purposes only. The material is not nor should be considered, or used as a substitute for, medical advice, diagnosis, or treatment, nor does it necessarily represent endorsement by or an official position of Global Lyme Alliance, Inc. or any of its directors, officers, advisors or volunteers. Advice on the testing, treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patients medical history. Global Lyme Alliance, Inc. makes no warranties of any kind regarding this Website, including as to the accuracy, completeness, currency or reliability of any information contained herein, and all such warranties are expressly disclaimed.
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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