Lyme disease often causes a rash that can be distinctive and resemble a bull’s eye. The rash can also change over time as the bacteria spread.
Lyme disease can result from the bite of a black-legged tick that is carrying the bacterium.
In the early stages of the disease, many people develop a rash. The medical term for this distinctive rash is erythema migrans. Other people with Lyme disease may have a different type of rash or no rash at all.
The
- a distinctive bull’s-eye rash with a central clear ring that slowly expands — this is the “classic” type
- an expanding lesion with a crusty center
- a circular rash with a clear center
- an oval-shaped rash
People can also develop multiple rashes.
According to the American Academy of Dermatology, Lyme disease symptoms typically appear in three stages.
After exposure to the bacteria that cause Lyme disease, a person may notice some of the following skin changes:
Stage 1
Some people develop a quick-spreading rash that develops at or near the site of the bite. The time it takes for the rash to appear can vary.
The CDC states that the rash often develops
At first, individuals may notice a small spot or lump on the skin in the center of a rash. In the early stages, the rash may be:
- warm to the touch
- smooth
- scaly or crusty at the outer edges
- itchy, burning, or painful
The rash then spreads over the next few days, reaching up to 12 inches (30 centimeters) or more in size.
Stage 2
If a person does not receive treatment, the bacterium that causes Lyme disease spreads in the body. This is stage 2 of the disease.
When the disease is in the second stage, a person may develop a lump or several small oval-shaped rashes on the face, legs, and arms. These may have a dusky center. Other people develop a bluish rash without a clear center.
According to the AAD, the rash or lump can develop about 30 to 45 days after the bite, and in some cases, it can take 6 or more months to appear.
Stage 1 rashes grow quickly, but stage 2 rashes tend to remain the same size.
Stage 3
There are few skin changes in the third stage of Lyme disease. Those that can occur typically affect the hands and feet. Symptoms can include:
- pain
- skin discoloration
- swelling
In severe cases, usually months or years after developing an infection, skin symptoms may include:
- hardening of the skin
- loss of hair around the affected area
- loss of sweat glands
- thinning and tearing of the skin
- lymphoma tumors that form on the skin, though this is rare
The AAD specifies that these skin changes occur if a person’s tick bite takes place in Europe.
Not everyone with Lyme disease develops a rash. Other symptoms in the first
In the later stages, Lyme disease can cause:
- numbness or tingling in the hands and feet
- shortness of breath
- neck stiffness
- dizziness
- arthritis
- severe fatigue
- nerve-related pain
- pain in the bones, muscles, and joints
- a loss of muscle tone in one or both sides of the face that results in drooping (facial palsy)
- intense headaches
- chest pain
- short-term memory loss (dementia)
- an irregular heart rhythm
- inflammation of the brain and spinal cord
- heart failure
The
If a person is concerned that they are developing a rash after a potential tick bite, they should contact a doctor. A doctor will be able to identify a Lyme disease rash.
If a person develops a rash in stage 1, they may notice a rash that:
- feels smooth and warm
- burns, itches, or feels painful
- has a scaly or crusty outer edge
The rash will spread over several days.
If a person develops a rash in stage 2, they may notice small oval rashes or a discolored lump.
In 2022, the Environmental Protection Agency (EPA) reported that the incidence of Lyme disease in the United States was 18.8 per 100,000 people.
The CDC reports that approximately
Anyone who suspects that they have Lyme disease should contact a doctor for a diagnosis.
The doctor will ask about a person’s medical history and perform a physical examination. They may also order blood tests to help with diagnosis.
If a person believes they may have been bitten by a tick, and they notice a rash or other Lyme disease symptoms, they should get treatment immediately. Untreated Lyme disease can damage the nervous system, and cause arthritis and other serious conditions.
A doctor will prescribe antibiotics. People typically need to take oral antibiotics for
Examples of antibiotics for Lyme disease include:
- doxycycline
- amoxicillin
- cefuroxime
It is important to always finish a course of antibiotics to ensure that the infection is completely cleared.
Antibiotic treatments are effective for most people with Lyme disease. However, even after treatment, some people still experience symptoms, including fatigue. If this occurs, your care team can refer you to a specialist who can investigate further.
There are several types of Lyme disease rashes, and they can change over time.
It is important to recognize the symptoms, as untreated Lyme disease can cause complications that affect the nerves, joints, heart, and short-term memory.
Usually, people who receive treatment in the early stages make a
For some people, symptoms such as pain, fatigue, and difficulty thinking can last for a long time. The medical community is unsure why this happens.
More research is necessary to understand how to treat and manage these symptoms.
