When To Contact Your Doctor
See your doctor as soon as possible to find out if any treatment is necessary, based on the type of tick that bit you. Different parts of the country have different risks when it comes to diseases from tick bites.
If any of the following become noticeable in the weeks following a tick bite, seek consultation with a healthcare professional:
- You develop EM rashes.
- You have fever, drowsiness, aching muscles, or a headache within 6 weeks of a tick bite.
- A tick bit you in a geographical location known for severe tick-borne diseases, like the Western or Northeastern United States.
Its important to see your doctor as soon as you can after a tick bite, even if you dont have symptoms.
For example, in areas of the country where Lyme disease is common, doctors may recommend under certain conditions that you receive treatment for Lyme disease after a tick bite before symptoms start.
People who suspect they may have Rocky Mountain spotted fever should seek treatment as soon as they suspect it.
Your doctor can explain your risks, what complications to look for, and when to follow up. Your doctor will also complete a thorough history, exam, and testing to determine whether your symptoms are the result of a tick-borne disease.
- , which is also available online.
- Take a shower or bath within two hours of being outdoors.
- Check skin closely after being in tick-prone areas, especially under arms, behind ears, between legs, behind knees, and in hair.
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.
Unexplained Pain And Other Sensations
Some people with Lyme may have sharp rib and chest pains that send them to the emergency room, suspecting a heart problem 00090-7/abstract%20″ rel=”nofollow”> 27).
When no problem is found, after the usual testing, the ER diagnosis is noted as an unidentified musculoskeletal cause.
You can also have strange sensations like skin tingling or crawling, or numbness or itchiness 00090-7/abstract%20″ rel=”nofollow”> 27).
Other symptoms have to do with cranial nerves.
- Ear-ringing . Tinnitus can be a nuisance, especially at bedtime when it seems to get louder as youre trying to fall asleep. About 10 percent of people with Lyme experience this (
- Hearing loss. One study reported that 15 percent of Lyme patients experienced loss of hearing .
- Jaw pain or toothaches that are not related to actual tooth decay or infection.
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Where Do Ticks Live
Ticks live outdoors. They hide in grass, trees, shrubs, and underbrush.
If youre outside hiking or playing, a tick might attach itself to you or your pet. Ticks may stay attached to your pet, or they can migrate to you while youre touching or holding your pet. They can also leave you and attach themselves to your pets.
Various kinds of ticks live in large populations throughout the country. Most states have at least one type of tick that lives there. Ticks are at their peak population in the spring and summer months, typically April through September.
How Do I Remove A Tick
You should know how to remove a tick just in case one lands on you or a friend. To be safe, remove the tick as soon as possible.
If you find a tick:
- Use tweezers to grasp the tick firmly at its head or mouth, next to your skin.
- Pull firmly and steadily on the tick until it lets go of the skin. If part of the tick stays in your skin, don’t worry. It will eventually come out. But call your doctor if you notice any irritation in the area or symptoms of Lyme disease.
- Swab the bite site with alcohol.
Note: Don’t use petroleum jelly or a lit match to kill a tick. They won’t get the tick off your skin quickly enough, and may just cause it to burrow deeper into your skin.
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Stage : Quickly Expanding Rash
After being bitten by a black-legged tick, a quickly growing rash can appear. This is the earliest stage of Lyme disease, known as stage 1.
Most people who develop a rash, get it within days or weeks of being bitten by a tick.
Where you see the rash: If you develop a rash, it appears near the tick bit you. For most people, that means the back, groin, armpit, or a lower leg. However, a tick can bite you anywhere.
What the rash can look like: You may see a spot or bump on the skin, which is the bite mark. Around or near the bite mark, a rash develops. Some people see the bulls-eye rash . You can also have one of the other rashes shown here.
Early rash caused by Lyme disease
Notice the bite mark in the center of this early rash, which will expand quickly.
Bull’s-eye rash on woman’s upper arm
This is another early sign of Lyme disease.
Lyme disease rash with lighter color on the outside
This rash has expanded, but you can still see the bite mark in the center.
Rash from Lyme disease has begun to clear
As the rash begins to clear, the redness fades.
If you develop a rash during this stage, you may notice that it:
Feels smooth and warm to the touch
Causes a burning sensation
Itches or feels painful
Has an outer edge that feels scaly or crusty
When the rash and symptoms begin: According to the Centers for Disease Control and Prevention , the rash begins 3 to 30 days after the tick bites you.
About 50% of people who have Lyme disease develop flu-like symptoms , which include:
What To Do If You Have A Blacklegged Tick Bite
Remove the tick by pulling it directly out with fine-tipped tweezers. Lift upward with slow and even pressure. Dont twist when removing it. Dont crush it or put soap or other substances on it. Dont apply heat to it.
Place the tick in a resealable container. See if you can identify what kind of a tick it is.
Immediately after removing the tick, wash your skin well with soap and water or with rubbing alcohol.
Not all ticks carry Lyme. The Lyme bacteria is transmitted only by blacklegged ticks in their nymph or adult stage.
Save the tick to show your doctor. The doctor will want to determine if its a blacklegged tick and if theres evidence of feeding. Ticks enlarge as they feed. Your risk of getting Lyme from an infected tick increases with the length of time that the tick fed on your blood.
Pull the tick out with tweezers and save it in a resealable container for identification.
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Can You Treat Ptlds
Thats a conundrum, Lewis says. It is frustrating for everybody, including for the doctors, to conclude that they dont have a treatment.
In his lab, Lewis is working on two approaches to treating PTLDS. At the root of both is his discovery that the microbiome of patients with PTLDS has changed.
If that is causal to the disease, or at least an important component of the disease, then theres a possibility to interfere by restoring a proper microbiome in those people, he says. So his team is working to develop a treatment to restore the microbiome balance in patients suffering from PTLDS.
But thats not all. Lewis is also developing a way to treat acute Lyme disease to prevent it from progressing into a long-term condition. The broad-spectrum antibiotics that are used to treat the disease harm the human microbiome, so if a healthy microbiome is part of our resistance mechanisms, then I think that may very well increase the probability of getting chronic Lyme, he says. So Lewiss team has created an experimental compound that can specifically target Lyme disease without killing off the beneficial microbes.
We have high hopes that this is going to be perhaps the first specific or dedicated treatment for Lyme disease, he says.
How To Avoid Getting A Tick Bite
You might be at risk if you live, work in, or visit a wooded area, or an area with tall grasses and bushes .
You may also be at risk if you are involved in outdoor activities such as hiking, camping and gardening.
You may be bitten by a tick and not even know it.
Heres what you can do to avoid getting a tick bite.
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Stage : Small Oval Rashes Or A Reddish Lump
When a tick that causes Lyme disease bites you, it infects you with bacteria. Without treatment, the bacteria can spread to other areas of your body. Stage 2 begins when the bacteria spread to other parts of your body.
During this stage, you may see small, oval rashes on your skin. Some people develop a bluish-red lump.
Where you see these signs: Because the infection has spread, small rashes can appear anywhere on your skin, except for your palms and soles. Most rashes appear on the arms, legs, and face.
Some people develop a lump, which your doctor may refer to as borrelial lymphocytoma. In children, this lump tends to appear on an earlobe. Adults often see a raised growth form around a nipple.
Borrelial lymphocytoma on a childs ear
This can appear in stage 2 of Lyme disease.
What you may see on your skin: The rashes that appear during stage 2 differ from the rash that can appear in stage 1. In stage 2, the rashes stay the same size rather than grow larger.
When the rashes, lump, and symptoms begin: About 30 to 45 days after the tick bites you, you may notice rashes or a lump. These can also take longer to appear, sometimes six months or more.
Some people develop symptoms, which make them feel ill, including:
Shortness of breath and dizzy spells
Bells palsy, which causes one half of the face to droop
Heart problems, such as chest pains or an irregular heartbeat
What Is The History Of Lyme Disease
Interestingly, the disease only became apparent in 1975 when mothers of a group of children who lived near each other in Lyme, Conn., made researchers aware that their children had all been diagnosed with joint pain from rheumatoid arthritis. This unusual grouping of illnesses that appeared “rheumatoid” eventually led researchers to the identification of the bacterial cause of the children’s condition, which was then named “Lyme disease” in 1982.
The only vector for Lyme disease in the U.S. is the black-legged tick, or deer tick, known as Ixodes scapularis. These ticks are carriers of the Lyme disease spirochete in their stomachs Ixodes ticks may also transmit the Powassan virus. The ticks are vectors that can transmit the bacterium to humans with a tick bite. The number of cases of tick-borne illness in an area depends on the number of ticks present and how often the ticks are infected with the bacteria. In certain areas of New York, where Lyme disease is common, over half of the ticks are infected. Lyme disease has been reported most often in the northeastern United States, but it has been reported in all 50 states, as well as China, Europe, Japan, Australia, and parts of the former Soviet Union. In the United States, it is primarily contracted in the Northeast in the states from Maine to Maryland, in the Midwest in Minnesota and Wisconsin, and in the West in Oregon and Northern California. What those children actually had was Lyme arthritis.
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What Are The Subtypes Of Lyme Disease
There are different types of Borrelia in each continent resulting in various forms of Lyme disease in North America and Europe.
In North America, the infection is due to the subspecies B. burgdorferi sensu stricto and most often presents as:
- Erythema migrans
- Lyme arthritis
In Europe, Lyme disease is due to the subspecies B. burgdorferi sensu stricto, B. afzelii and B. garinii, and most often presents as:
- Erythema migrans
- Acrodermatitis chronica atrophicans
- Lyme neuroborreliosis.
What Are The Symptoms Of Lyme Disease In Humans
People who spend time outdoors, particularly in wooded, brushy, or grassy habitats, in areas where the disease is common, have a higher chance of tick bite and getting Lyme disease.
Tick bites are frequently never felt. Only 25-30% of United States patients with early stages of the disease can recall the tick bite. The signs and symptoms of Lyme disease depend upon the three stages of the infection, which are:
The first two stages are part of the early infection, whereas persistent disease is considered a late infection.
Symptoms in stage-1 Lyme disease
This stage occurs one to 30 days after the tick bite and comprises of the following symptoms:
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Can Lyme Disease Be Prevented
People aren’t able to become immune to Lyme disease. So even if you’ve had Lyme disease, you can get it again. No vaccine is available currently to prevent the disease.
The FDA approved a Lyme vaccine called LYMErix in 1998. The vaccine was not 100% effective, however. The FDA still recommended preventing the disease in other ways. In 2002, the company that made LYMErix said it would no longer offer the vaccine.
To help prevent Lyme disease, follow these guidelines.
Do All Ticks Carry Lyme Disease
No. Commonly known as deer ticks, the tiny blacklegged ticks are the ones that carry Lyme disease. Immature ticks, called nymphs, are about the size of a poppyseed and adults are about the size of a sesame seed. Ticks at both of those life stages can transmit the bacteria that causes the disease.
But not all blacklegged ticks will give you Lyme disease. It depends on the area, Lewis says, but you can have up to half of the ticks carrying bacteria.
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What Are Complications Of Lyme Disease
Lyme disease can be complicated by permanent damage to joints, the heart, the brain, and the nervous system. There is recent research that demonstrates an increased risk for autoimmune forms of arthritis, including
Medically Reviewed on 12/22/2021N Engl J MedPrimer on the Rheumatic DiseasesN Engl J MedAmerican Academy of Family Physicians
A Tick Bite Is Never Something To Brush Off Forget About And Deal With Later Many Ticks Carry Microbes That Can Cause A Variety Of Diseases
If diseases caused by tick bites are left untreated, they can lead to serious health problems that could potentially affect your muscles, joints, brain, heart, vision, and nervous system. Many tick-borne illnesses can have serious consequences that alter your lifestyle and activities by limiting your mobility, cognition, and overall quality of life. Knowing how to identify a tick bite and recognizing the general symptoms of tick-borne diseases can alert you to possible health risks sooner, so you can consult with your healthcare provider about appropriate next steps as soon as possible.
What a tick looks like
The first step in identifying tick bites is to know what ticks look like. Ticks will look different at each stage of their life cycle. Belonging to the arachnid class , ticks begin their life as an egg then hatch as a larva, which grows into a nymph and finally an adult tick. Dozens of tick species exist, but all are similar in appearance.
Photo taken by Christopher Paddock. Image Source:
Ticks generally have four stages of life: egg, larvae, nymph and adult. Ticks advance through each of these stages by molting, a process during which they shed their outer skin.
What does a tick bite look like?
If youre worried you may have been exposed to a tick-borne illness, its obvious to wonder what a tick bite looks like. Unless a rash appears, a tick bite is likely to look much like any other bug bite.
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Seek Medical Care Early To Prevent Lyme Disease From Progressing
Its easy to get bit by a tick and not know it. Most people dont feel a tick on their skin or the bite. Checking your skin for ticks after spending time outdoors can help you find a tick and remove it.
Removing a tick can prevent Lyme disease. A tick must be attached to your skin for at least 36 hours to infect you with the bacteria that cause Lyme disease.
Its not always possible to find a tick, so its important to pay close attention to your skin. If you notice any signs of Lyme disease or develop a rash, get medical care right away. Ticks can cause other serious diseases, such as Rocky Mountain spotted fever.
Related AAD resources
ImagesImage 1: Centers for Disease Control and Prevention, Public Health Image Library, Last accessed May 11, 2017.
Images 2, 3, and 7: Used with permission of the Journal of the American Academy of Dermatology. J Am Acad Dermatol. 2011 64:619-36.
Image 6: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
ReferencesBhate C and Schwartz RA.
Lyme disease: Part I. Advances and perspectives. J Am Acad Dermatol. 2011 64:619-36.
Lyme disease: Part II. Management and prevention. J Am Acad Dermatol 2011 64:639-53.
Centers for Disease Control and Prevention:
Signs and symptoms of untreated Lyme disease. Page last updated October 26, 2016. Last accessed May 2, 2018.
Lyme disease: transmission. Page lasted updated March 4, 2015. Last accessed May 2, 2018.
Researcher Seeks Better Picture Of Lyme Disease Cases In Texas
More than 30,000 new cases of Lyme disease are reported each year to the Centers for Disease Control and Prevention , although this number is believed to be an underestimate of the total number of cases of Lyme disease actually diagnosed in the U.S.
State-level surveillance is one way of tracking when and where the disease occurs, but recent estimates using other methods suggest that the actual number of patients may be more than 10 times higher than the number reported to the CDC.
In a study published June 21 in the journal Healthcare, a researcher from The University of Texas at Dallas employed new approaches to tick-borne disease surveillance in Texas with the goal of linking differing forms of surveillance data into one comprehensive picture.
Dr. Sarah Maxwell, corresponding author of the study and associate professor of public and nonprofit management in the School of Economic, Political and Policy Sciences , and her co-authors found that mapping the geographic locations of self-reported tick bite encounters with CDC-confirmed Lyme disease cases could offer a granular-level surveillance method and aid in assessing Lyme disease risk in areas perceived to be nonendemic to the tick-borne pathogen.
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