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Lyme Disease

What Are The Symptoms Of Lyme Disease?

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Contributing Author: Guy Slowik FRCS

The classic symptom of Lyme disease is a characteristic rash, called erythema migrans, near the bite. An estimated 85% of people with Lyme disease get this rash.

  • The rash starts as a small red spot at the site of the tick bite.
  • Over the next few days or weeks, the rash expands into a circle or oval.
  • Sometimes the rash resembles a bull's eye (a red ring surrounding a clear area with a red center).
  • The rash can range from the size of a dime to more than a foot in diameter.
  • As infection spreads, the rash can appear at different locations on the body.

Nice To Know:

Recognizing the Lyme Disease Rash

The characteristic rash of Lyme disease appears in more than 8 out of 10 cases. It begins as a red dot and then expands. Sometimes the redness fades in the center area, leaving a rash often described as looking like a "bull's-eye."

Anyone with an unusual rash should see a physician. It's best to photograph the rash if possible, in case it disappears by the time of the appointment.

With or without the rash, the infection is often accompanied by:

  • A generalized feeling of illness (malaise)
  • Fatigue
  • Fever
  • Headache
  • Stiff neck
  • Overall aching

If Lyme disease is untreated, about 60% of people will experience symptoms of arthritis (joint inflammation) within several months of being infected:

  • In Lyme disease, arthritis is most commonly felt in the knees.
  • The arthritis can shift from one joint to another.
  • Arthritis symptoms may persist or may occur intermittently.
  • About 10% to 20% of people with untreated Lyme disease will go on to develop chronic arthritis.

Other symptoms also may appear, caused by inflammation in various areas of the body:

  • Neurological (nervous system) symptoms are seen in about 15% of people with Lyme disease. They can include partial paralysis of the face (a condition called Bell's palsy), numbness or weakness of the limbs, and a change in mood or sleeping habits.
  • Less than 10% of the time, the heart can be affected by disorders that include irregular heartbeats (arrhythmias) and inflammation of the sac around the heart.
  • Less commonly, Lyme disease can result in eye infection, hepatitis (a disease that affects the liver), or encephalitis (inflammation in the brain).




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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.