Medically reviewed on February 4, 2022 by Jasmine Thompson. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
Lyme disease is the most common tick-borne disease in the United States, and it has the potential to cause some severe symptoms. The good news is that it can be treated. Learn more about Lyme disease and its treatments below (you can check for Lyme disease from the comfort of home with the Everlywell Lyme Disease Test).
While a tick bite is how Lyme disease is transmitted, it is technically caused by bacteria. In the United States, the two bacteria responsible for Lyme disease are Borrelia burgdorferi and Borrelia mayonii. These bacteria can enter the bloodstream via the saliva of an infected deer tick, also known as a black-legged tick . The tick must be attached to the skin for about 36 to 48 hours before the Lyme disease bacteria can enter the system .
The symptoms of Lyme disease typically appear in stages. In early Lyme disease, a rash referred to as erythema migrans typically begins at the site of the bite. The rash often forms a bullseye pattern — red at the center, unaffected skin surrounding the red center, and a red outer ring. The rash typically isn’t painful or itchy.
A Lyme disease rash can often be mistaken for other kinds of rash, like the rash that often presents with ringworm. While they may look similar, there are ways to tell them apart. Both are circular, but the Lyme disease rash is usually clear in the middle, while a ringworm rash is entirely red, scaly, and/or cracked.
The rash from Lyme disease may also be accompanied by the other general symptoms of Lyme disease infection, including:
Symptoms typically occur within the first 30 days of getting bitten. Left untreated, similar rashes may continue to appear on different parts of the body. There may also be swelling and/or pain in the joints, similar to arthritis. In more severe cases, neurological symptoms may develop months or even years after the initial infection. These symptoms may include:
Less commonly, some people experience heart problems or inflammation in the liver or eyes .
There are three critical stages of Lyme disease. The first is early localized Lyme disease, which occurs in the days or weeks after the appearance of erythema migrans. If the first stage has not been treated with oral antibiotics, it can develop into early, disseminated Lyme disease. In the second stage, the Lyme bacteria can spread to other parts of the body. Late Lyme disease is the last and most damaging stage. In late Lyme disease, it is possible for more severe types of the disease, such as post-treatment Lyme disease syndrome (PTLDS) or chronic Lyme disease, to develop.
Oral antibiotics are the standard treatment for Lyme disease that is still in its earlier stages. This can include doxycycline, amoxicillin, and/or cefuroxime. The exact course of treatment will vary, but most healthcare providers recommend a course of 14 to 21 days .
Lyme disease that has progressed to later stages can potentially affect the central nervous system and may be treated with intravenous antibiotics. Your healthcare provider may recommend a round of intravenous antibiotics for up to 28 days, which should effectively eliminate the infection. However, depending on the severity of the infection, recovering from neurological symptoms may take some time, even if the bacteria have been eliminated from the body .
It should be noted that some people develop chronic Lyme disease even after receiving treatment. This is known as post-treatment Lyme disease syndrome (PTLDS). The exact cause of PTLDS is not well understood, but it can result in symptoms that include pain, fatigue, or difficulty concentrating .
The earlier treatment is received for Lyme disease, the more likely the possibility of recovery. This makes early detection of Lyme disease important. If you believe you might have Lyme disease, consider using an at-home Lyme disease test from Everlywell to help provide clarity. If your lab test results are positive, a care coordinator will contact you to discuss next steps and how a physician may diagnose and treat Lyme disease (if appropriate).
What happens if Lyme disease goes untreated?
Lyme disease vs. ringworm: what are the differences?
1. Lyme disease - symptoms and causes. Mayo Clinic. URL. Accessed February 4, 2022.
2. Transmission. Centers for Disease Control and Prevention. URL. Accessed February 4, 2022.
3. Post-Treatment Lyme Disease Syndrome. Centers for Disease Control and Prevention. URL. Accessed February 4, 2022.