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:
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
- 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:
- 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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Stage : Early Disseminated Lyme Disease Infection
This stage develops when the disease is not found and/or treated properly soon after infection. At this point, the infection can begin to attack the joints, heart, nervous system, and skin.
Symptoms may include:
- More rashes may start to appear in different parts of the body due to the infection spreading
- Heart murmur or valve prolapse
- Light-headedness, dizziness
- Menstrual irregularity
Now that youre familiar with the signs, symptoms, and stages of Lyme, lets take a look at some important factors about chronic Lyme, testing, and treatment.
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How Should A Tick Be Removed
Grasp the mouthparts with tweezers as close as possible to the attachment site. Be careful not to squeeze, crush or puncture the body of the tick, which may contain infectious fluids. Pull firmly and steadily upward to remove the tick. After removing the tick, thoroughly disinfect the bite site and wash hands. The NYSDOH has created a video on proper tick removal and a printable card with steps on how to remove ticks . See or call a doctor if there are concerns about incomplete tick removal. Do not attempt to remove ticks by using petroleum jelly, lit cigarettes or other home remedies because these may actually increase the chance of contracting a tick-borne disease.
Correctly Diagnosing Lyme Disease
A Lyme-literate doctor is a licensed board-certified medical doctor who also has a specialty in diagnosing and treating Lyme disease with the most advanced equipment and technologies.
Lyme-literate doctors know how to get the correct diagnosis early, so you are not at risk for developing late-stage Lyme disease, which can be debilitating.
Most family practitioners test for Lyme disease using the only two tests available today, the ELISA and the Western Blot. Unfortunately, these tests are only accurate if the Lyme antibodies are active at the time of your test. If they are not active, your test can offer a negative result.
The results do not mean you are negative for Lyme disease. It means you were negative for the antibodies associated with Lyme. Lyme-literate doctors know the truth that antibodies can go inactive at times and hide in the walls of your bloodstream, going undetected by insufficient tests.
There are Lyme-literate doctors available who can help you get an accurate diagnosis. Some of the best doctors are outside the U.S., like Mexico, where leaders in the industry practice.
Do whatever it takes to meet with a Lyme-literate doctor because if your Lyme disease is misdiagnosed or goes untreated, your body will suffer.
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What Are The Symptoms Of Chronic Lyme Disease
Despite some skepticism in the medical community, chronic Lyme disease is a growing epidemic in the U.S. This stems partly from the shortcomings of many of the officially recommended Lyme disease tests, which leave too many patients with untreated infections that then become persistent and debilitating.
The following article will cover what you should know about chronic Lyme and provide an introductory but non-exhaustive chronic Lyme disease symptoms checklist.
Can Lyme Disease Be Prevented
To prevent Lyme disease, you should lower your risk of getting a tick bite:
- Avoid areas where ticks live, such as grassy, brushy, or wooded areas. If you are hiking, walk in the center of the trail to avoid brush and grass.
- Use an insect repellent with DEET
- Treat your clothing and gear with a repellant containing 0.5% permethrin
- Wear light-colored protective clothing, so you can easily see any ticks that get on you
- Wear a long-sleeve shirt and long pants. Also tuck your shirt into your pants and your pant legs into your socks.
- Check yourself, your children, and your pets daily for ticks. Carefully remove any ticks you find.
- Take a shower and wash and dry your clothes at high temperatures after being outdoors
Centers for Disease Control and Prevention
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Treatment For Other Forms Of Lyme Disease
People with other forms of disseminated Lyme disease may require longer courses of antibiotics or intravenous treatment with antibiotics such as ceftriaxone. For more information about treating other forms of Lyme disease, see:
The National Institutes of Health has funded several studies on the treatment of Lyme disease that show most people recover within a few weeks of completing a course of oral antibiotics when treated soon after symptom onset. In a small percentage of cases, symptoms such as fatigue and myalgia can last for more than 6 months. This condition is known as post-treatment Lyme disease syndrome , although it is also sometimes called chronic Lyme disease. For details on research into chronic Lyme disease and long-term treatment trials sponsored by NIH, visit the visit the National Institutes of Health Lyme Disease web siteexternal icon.
How We Care For Lyme Disease
The Division of Infectious Diseases at Boston Children’s provides comprehensive care for children and adolescents with Lyme disease and other infections. Our services include consultation, evaluation, treatment, and management of long-term complications of Lyme disease.
The commitment and compassion with which we care for all children and families is matched only by the pioneering spirit of discovery and innovation that drives us to think differently, to find answers, and to build a better tomorrow for children everywhere.
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Lyme Disease And Anxiety
Anxiety, like depression, is a common psychiatric symptom that can be associated with Lyme disease. Like other neuropsychiatric symptoms, anxiety is triggered by inflammation and the metabolic changes that occur in tick-borne infections. Concern about ones health especially if causes have not been identified can also contribute to anxiety or panic disorders. Different types of anxiety can present in Lyme disease. These include hypervigilance, social anxiety disorder, panic disorder, obsessive-compulsive disorder , and post-traumatic stress disorder.
Of the tickborne co-infections, bartonellosis tends to cause an increase in anxiety. Bartonellosis requires a different treatment than Lyme disease, so it is important to test for all co-infections. I have seen generalized anxiety disorder and panic attacks resolve when patients are properly treated for Lyme disease and co-infections.
Of the associated tick-borne infections, Bartonella tends to contribute to anxiety more than the others.
Bartonellosis requires a different treatment than Lyme disease, so it is important to properly test for all co-infections. I have seen generalized anxiety disorder and panic attacks resolve when patients are properly treated for Lyme disease and co-infections.
Chronic Lyme: What Happens When Lyme Goes Untreated
The Lyme community typically uses the term chronic Lyme disease to describe a range of physical, cognitive, and emotional symptoms that crop up after getting Lyme disease and persist for months to years after infection.
The risk of chronic Lyme increases the longer a Lyme infection goes untreated or undertreated. In other words, patients are more likely to recover fully if their Lyme infection is detected and treated as early as possible after the discovery of a tick bite. This stage is usually marked by symptoms such as fevers, chills, muscle aches, and sometimes rashes.
When left untreated or undertreated, however, Lyme disease can spread throughout the body and affect:
- The central nervous system
- Muscles and joints
As Lymedisease.org points out, these symptoms can evolve, disappear, and reappear at different times.
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How Lyme Disease In Cats Is Diagnosed
While you can watch for signs and symptoms, the only way to know if your cats may has this condition is through laboratory tests.
The CatWatch Newsletter reports that Lyme disease can be diagnosed by examining blood samples. You will have to get a SNAP-4DxPlus test for your cat. If your feline has Lyme disease, laboratory tests will show the presence of a certain antibody.
How Is Lyme Disease Diagnosed
To make a diagnosis, your health care provider will consider:
- Your symptoms
- How likely it is that you were exposed to infected blacklegged ticks
- The possibility that other illnesses may cause similar symptoms
- Results of any lab tests
Most Lyme disease tests check for antibodies made by the body in response to infection. These antibodies can take several weeks to develop. If you are tested right away, it may not show that you have Lyme disease, even if you have it. So you may need to have another test later.
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More About Symptoms And Stages Of Lyme
Several years ago when I had many of the symptoms above and none of the doctors could figure out what was wrong with me I was desperate for answers. I spent many hours researching on my own, working to figure out what was causing all of my health problems.
Thankfully, I was eventually tested for Lyme and co-infections and diagnosed with Lyme, tularemia, and rocky mountain spotted fever. Yet, so many people are still searching and wondering why theyre suffering from the symptoms above.
Maybe youve been diagnosed with fibromyalgia, myofascial pain syndrome, autoimmune conditions, or chronic fatigue syndrome as I was at first. I was even referred to be tested for Multiple Sclerosis.
But, like me, you wonder, what is causing all of this? Why am I in pain and exhausted all the time?
How Is Lyme Disease Treated
Nearly all people with Lyme disease can be effectively treated with antibiotics, usually doxycycline or amoxicillin. The duration of treatment depends on the stage of infection. In general, the sooner such therapy is initiated following infection, the quicker and more complete the recovery.
Pregnant women should be treated for Lyme disease as well. There is, however, no evidence that a fetus can be infected from its mother. Additionally, NO strong evidence exists to suggest miscarriages are more likely after Lyme.
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Make Your Cat Stay Indoors
Outdoor cats, even those who split their time indoors and outdoors, are much more likely to get Lyme disease than strictly indoor cats. Because ticks transmit this condition, felines usually acquire it from roaming around outside.
With this in mind, you should know that indoor felines are not immune to the disease. Other pets may bring ticks into your yard or home. You and your family can also inadvertently track these arachnids indoors via your clothing.
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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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.
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
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 bull’s 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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Questions To Ask Your Doctor
- I found a tick embedded in my skin, but I cant get it out. What should I do?
- Ive been bitten by a tick. Do I need to be seen?
- Do I need a blood test to confirm Lyme disease?
- Which antibiotic is best for me?
- How long will I have to take the antibiotic?
- What tick or insect repellent should I use for me or my child?
- How long will the symptoms last?
- What should I do if I still dont feel well a long time after I was bitten?
What Are The Second Stage Signs And Symptoms Of Lyme Disease
The symptoms of second stage, early disseminated, Lyme disease can be difficult to attribute. Symptoms include severe fatigue, fever, pain, intermittent weakness and achiness of the muscles and joints, numbness in arms and legs, vision changes, and cognitive dysfunction such as short-term memory difficulties and problems multitasking. These symptoms are not specific for Lyme disease and can make the diagnosis of second stage Lyme disease very challenging.
More recognizable Lyme disease nervous system manifestations include facial paralysis , or meningitis with severe headache and stiff neck. Notable cardiac manifestations include passing out or feeling faint from an abnormally slow heart rate, irregular heart palpitations, or unexplained difficulty tolerating exercise. Meningitis and carditis are both potentially serious Lyme disease conditions and warrant immediate medical attention.
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Stage : Early Localized Disease
Symptoms of Lyme disease usually start 1 to 2 weeks after the tick bite. One of the earliest signs of the disease is a bulls-eye rash.
The rash occurs at the site of the tick bite, usually, but not always, as a central red spot surrounded by a clear spot with an area of redness at the edge. It may be warm to the touch, but it isnt painful and doesnt itch. This rash will gradually fade in most people.
The formal name for this rash is erythema migrans. Erythema migrans is said to be characteristic of Lyme disease. However, many people dont have this symptom.
Some people have a rash thats solid red, while people with dark complexions may have a rash that resembles a bruise.
The rash can occur with or without systemic viral or flu-like symptoms.
Other symptoms commonly seen in this stage of Lyme disease include: