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Lyme Disease

You've probably heard of Lyme disease. It's the leading tick-borne disease in the United States, and is most common in the Northeast, the Pacific Northwest, and the northern midwestern states.

What Is Lyme Disease?

Lyme disease is caused by a type of bacteria found in small animals like mice and deer. Ixodes ticks (also called black-legged or deer ticks) that feed on these animals can then spread the bacteria to people through tick bites.


You probably won't see it happening. Deer ticks are tiny, so it's very hard to see them. Immature ticks (called "nymphs") are about the size of a poppy seed. Adult ticks are about the size of a sesame seed.

It's easy to overlook a tick bite. Many people who get Lyme disease don't remember being bitten. The good news is that most tick bites don't lead to Lyme disease. But it still helps to know the signs of Lyme disease.

What Are the Signs 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 experiences all of these stages, though:

  1. A circular rash at the site of the tick bite, typically within 1–2 weeks of infection, often is the first sign of infection. Although it's considered typical of Lyme disease, many people never develop one.Signs of Lyme Disease

    The rash sometimes has a characteristic "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 expanding 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 appear and feel very different from one person to the next, and it might be more difficult to see on people with darker skin tones, where it can look like a bruise. It gets bigger for a few days to weeks, and eventually disappears on its own. Along with the rash, a person may have flu-like symptoms such as fever, tiredness, headache, and muscle aches.

  2. Symptoms of the initial illness may go away on their own. But in some people, the infection can spread to other parts of the body. Symptoms of this stage of Lyme disease usually appear within several weeks after the tick bite, even in someone who didn't have the initial rash. The person may feel very tired and unwell, or may have more areas of rash that aren't at the site of the bite.

    Lyme disease can affect the heart. This can lead to an irregular heart rhythm, which can result in dizziness or heart palpitations. It can also spread to the nervous system, causing facial paralysis (Bell's palsy), or meningitis.
  3. The last stage of Lyme disease happens if the early stages were not found or treated. Symptoms of late Lyme disease can appear anytime from weeks to years after an infectious tick bite. In kids and teens, this is almost always in the form of arthritis, with swelling and tenderness, particularly in the knees or other large joints.

Having such a wide range of symptoms can make Lyme disease hard for doctors to diagnose, although blood tests can look for signs of the body's reaction to Lyme disease.

When Should I Call My Doctor?

If you think you may be at risk for Lyme disease or a tick has bitten you, contact your doctor. Although conditions other than Lyme disease can cause similar symptoms, it's always a good idea to discuss them with your doctor. That way you can get further evaluation and treatment if necessary, before the disease gets worse. This is especially true if you develop a red-ringed rash, prolonged flu-like symptoms, joint pain or a swollen joint, or facial paralysis.

How Is Lyme Disease Treated?

Lyme disease is usually treated with a 2- to 4-week course of antibiotics. Cases of Lyme disease that are diagnosed quickly and treated with antibiotics almost always have a good outcome. A person should be feeling back to normal within several weeks after beginning treatment.

Is Lyme Disease Contagious?

Lyme disease is not contagious, so you can't catch it from another person. But you can get it more than once from ticks that live on deer, in the woods, or travel on your pets. So always be cautious, even if you've already had Lyme disease.

Can Lyme Disease Be Prevented?

There's no sure way to avoid getting Lyme disease. But you can minimize your risk. Be aware of ticks when you're in high-risk areas. If you work outdoors or spend time gardening, fishing, hunting, or camping, take precautions:

If you use an insect repellent containing DEET, always follow the recommendations on the product's label and don't overapply it. Place DEET on shirt collars and sleeves and pant cuffs, and only use it directly on exposed areas of skin. Be sure to wash it off when you go back indoors.

No vaccine for Lyme disease is currently on the market in the United States.

How Do I Remove a Tick?

You should know how to remove a tick just in case one lands on you or a friend. First, don't panic. The risk of Lyme disease after a tick bite is very low. Also, it takes at least 24 to 48 hours for the tick to transmit the bacteria that causes Lyme disease.

To be safe, though, you'll want to remove the tick as soon as possible. That's why a daily tick check is a good idea for people who live in high-risk areas.

If you find a tick:

Tick bites don't usually hurt — and that can make it hard to find a bite early because pain usually helps call attention to problems. So be on the lookout for ticks and rashes, and call your doctor if you think a tick bit you.

Date reviewed: September 2015

Note: All information on TeensHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

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