Lyme disease: Symptoms and treatment

Symptoms of Lyme disease

Signs and symptoms of Lyme disease can vary from person to person after being bitten by a tick.

Lyme disease occurs in stages. The signs and symptoms of each stage can overlap. In some people, Lyme disease may present in a later stage without a history of prior signs or symptoms.

Early signs

The most commonly reported sign of Lyme disease is an expanding skin rash that typically begins at the site of the tick bite. This rash is called erythema migrans. It slowly grows to more than 5 cm in diameter over several days, and can sometimes:

be circular or oval-shaped
look like a target or bull's eye
go unnoticed, especially if it's on:
- dark skin
- a part of the body that's difficult to see

Some people may not develop a rash.

Other early signs and symptoms include:

fever
chills
fatigue
headache
swollen lymph nodes
muscle and joint aches

If left untreated, the infection could spread to the joints, heart and nervous system.

Images of erythema migrans rash

Image 1^{Footnote a}: A rash that looks like a bull's eye at the site of a tick bite.

An oval-shaped red rash. A tape measure is placed beneath it and shows that the rash is over 7 cm wide. — Image 2^{Footnote a}: An oval-shaped red rash.

A red rash that has expanded across the width of a limb. A tape measure is placed beneath it and shows that the rash is 8 cm wide. — Image 3^{Footnote a}: A red rash that has expanded across the width of a limb.

A red rash and blisters on a forearm, with a tape measure showing that the rash is 13 cm wide and the blister over 2 cm wide. — Image 4^{Footnote a}: A red rash and blisters on a forearm.

Image 5^{Footnote b}: A rash on a shoulder.

Image 6^{Footnote c}: A rash on the back of a knee.

Footnote a

For images 1,2,3,4:
Dr. John Aucott, Johns Hopkins University

Return to footnote a referrer

Footnote b

For image 5:
U.S. Centers for Disease Control and Prevention, Public Health Image Library

Return to footnote b referrer

Footnote c

For image 6:
Professor Gary Wormser, New York Medical College

Return to footnote c referrer

Later signs

Later symptoms of Lyme disease can appear days to months after an infected tick bite, and may include:

more rashes
dizziness
severe headaches
migratory pain that spreads in the:
- joints
- bones
- tendons
- muscles
arthritis in the:
- knees
- ankles
- elbows
- wrists
thinking and reasoning symptoms, such as:
- memory loss
- inability to think clearly

Other later stage symptoms include:

nerve pain, weakness, tingling or loss of sensation in limbs
drooping of one or both sides of the face (facial paralysis or Bell's palsy)
heart palpitations and an abnormal heartbeat
swelling of the brain and spinal cord
eye problems, such as pink-eye

In very rare cases, death could occur due to the complications involving an infection of the heart.

If you become ill

Early diagnosis and treatment of Lyme disease can prevent complications. Consult your health care provider right away if you've been:

bitten by a tick and develop symptoms of Lyme disease
to an area where blacklegged ticks may be found and develop symptoms of Lyme disease

You may not feel a tick attach to your skin or notice being bitten by a tick because ticks are tiny and their bites are usually painless.

Tell your health care provider:

where on your body the tick was attached
how long you think the tick was attached to you
where you were (city and province) at the time you were bitten by the tick or may have been exposed to ticks

Diagnosing Lyme disease

Diagnosing Lyme disease can be challenging as symptoms vary from person to person.

Symptoms of Lyme disease can be similar to other illnesses. A diagnosis of Lyme disease is based on:

symptoms
travel history
blood tests, when required
exposure to blacklegged ticks

Your health care provider will assess if you need a blood test. You usually won't need a blood test if you:

have the characteristic expanding rash and
were exposed to blacklegged ticks

Only get tested by a licensed public health laboratory. Testing by private, non-licensed laboratories may not be reliable.

Treating Lyme disease

Lyme disease is treated with antibiotics. The earlier you receive treatment for Lyme disease, the greater the chance of a successful recovery.

Some people who are treated for Lyme disease may continue to have symptoms after treatment. The cause of these symptoms isn't currently clear, but continued antibiotic treatment:

may produce unwanted side effects
hasn't been shown to improve symptoms or outcomes

Provincial, territorial and international resources

For local information on Lyme disease, consult your provincial or territorial public health authority:

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Date modified:: 2022-12-22

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