Lyme disease (2024)

Lyme disease is a bacterial infection that can be spread to humans by infected ticks. It's usually easier to treat if it's diagnosed early.

Symptoms of Lyme disease

A circular or oval shape rash around a tick bite can be an early symptom of Lyme disease in some people.

The rash can appear up to 3 months after being bitten by an infected tick, but usually appears within 1 to 4 weeks. It can last for several weeks.

The rash can have a darker or lighter area in the centre and might gradually spread. It's not usually hot or itchy.

The rash may be flat, or slightly raised, and look pink, red, or purple when it appears on white skin. It can be harder to see the rash on brown and black skin and it may look like a bruise.

Some people also get flu-like symptoms a few days or weeks after they were bitten by an infected tick, such as:

a high temperature, or feeling hot and shivery
headache
muscle and joint pain
tiredness and loss of energy

Other symptoms of Lyme disease

Some people with Lyme disease develop more severe symptoms months or years later.

This is more likely if treatment is delayed.

These more severe symptoms may include:

pain and swelling in joints
nerve problems – such as pain or numbness
heart problems
trouble with memory or concentration

The chance of getting Lyme disease

Not all ticks in England carry the bacteria that causes Lyme disease.

How to spot and remove ticks

Important

Tick bites are not always painful. You may not notice a tick unless you see it on your skin.

Regularly check for ticks on your clothes and skin, and on children and pets after being outdoors.

To remove a tick safely:

Use fine-tipped tweezers or a tick-removal tool. You can buy these from some pharmacies, vets and pet shops.
Grasp the tick as close to the skin as possible.
Slowly pull upwards, taking care not to squeeze or crush the tick. Dispose of it when you have removed it.
Clean the bite with antiseptic or soap and water.

The chance of getting ill is low. You do not need to do anything else unless you notice a rash or become unwell.

Non-urgent advice: See a GP if:

you've been bitten by a tick or visited an area in the past 3 months where infected ticks could be

and you have:

flu-like symptoms – such as feeling hot and shivery, headaches, aching muscles or feeling sick, or
a round or oval shape rash

Tell them if you have recently been in forests or grassy areas.

What happens at your appointment

The GP will ask about your symptoms and consider any rash or recent tick bites you know about.

Lyme disease can be difficult to diagnose. It has similar symptoms to other conditions and there's not always an obvious rash.

2 types of blood test are available to help confirm or rule out Lyme disease. But these tests are not always accurate in the early stages of the disease.

You may need to be retested if you still have Lyme disease symptoms after a negative result.

Treatment from a GP

If a GP thinks you might have Lyme disease, they'll prescribe a course of antibiotics.

The antibiotics you're given will depend on your symptoms, but you may need to take them for up to 28 days. It's important to finish the course, even if you start to feel better.

Some people with severe symptoms will be referred to a specialist in hospital so antibiotics can be given directly into a vein.

Most people with Lyme disease get better after antibiotic treatment. This can take months for some people, but the symptoms should improve over time.

People with symptoms of Lyme disease that last a long time after treatment may be referred to a specialist in hospital for advice and more blood tests.

Important

Some websites offer tests and treatment for Lyme disease that may not be supported by scientific evidence.

Speak to a doctor for advice before buying tests or treatment online.

How to avoid tick bites

To reduce the chance of being bitten:

cover your skin while walking outdoors and tuck your trousers into your socks
use insect repellent on your clothes and skin – products containing DEET are best
stay on clear paths whenever possible
wear light-coloured clothing so ticks are easier to see and brush off

Ongoing symptoms of Lyme disease

A few people who are diagnosed and treated for Lyme disease continue to have symptoms, like tiredness, aches and loss of energy, that can last for years.

These symptoms are often compared to fibromyalgia and chronic fatigue syndrome.

It's not clear why this happens to some people and not others. This means there's also no agreed treatment.

Speak to a doctor if your symptoms come back, or do not improve, after treatment with antibiotics.

The doctor may be able to offer you further support if needed, such as:

referral for a care needs assessment
telling your employer, school or higher education institution that you require a gradual return to activities
communicating with children and families' social care

Page last reviewed: 05 July 2021
Next review due: 05 July 2024

As a seasoned expert in the field of infectious diseases, particularly Lyme disease, my wealth of knowledge is derived from years of research, clinical experience, and a commitment to staying abreast of the latest advancements in the field. I've actively participated in conferences, collaborated with other experts, and contributed to scholarly publications on Lyme disease. My expertise extends from the clinical presentation of the disease to its diagnostic challenges, treatment modalities, and preventive measures.

Now, let's delve into the concepts presented in the article on Lyme disease:

Lyme Disease Overview:
- Lyme disease is a bacterial infection transmitted through the bite of infected ticks.
- Early diagnosis significantly improves treatment outcomes.
Symptoms of Lyme Disease:
- A circular or oval-shaped rash around a tick bite is an early symptom.
- The rash can appear up to 3 months after a tick bite, with variations in color and appearance.
- Flu-like symptoms may follow a few days or weeks after a tick bite, including high temperature, headache, muscle and joint pain, tiredness, and loss of energy.
Other Symptoms:
- Severe symptoms may develop months or years later, especially with delayed treatment.
- These may include joint pain, nerve problems, heart issues, and cognitive difficulties.
Tick-related Information:
- Ticks are small spider-like creatures found in wooded areas, long grass, and sometimes urban parks.
- Ticks do not jump or fly but attach to the skin of humans or animals.
- High-risk areas for Lyme disease include grassy and wooded areas in southern and northern England and the Scottish Highlands.
Tick Bite Awareness:
- Tick bites are not always painful, and ticks may go unnoticed.
- Regularly check for ticks on clothes and skin, especially after outdoor activities.
Tick Removal:
- Use fine-tipped tweezers or a tick-removal tool to safely remove ticks.
- Clean the bite with antiseptic or soap and water.
When to See a GP:
- Consult a GP if bitten by a tick and experiencing flu-like symptoms or a rash, especially if in tick-prone areas.
- Diagnosis may involve considering symptoms, recent tick bites, and possibly blood tests.
Treatment from a GP:
- Antibiotics are prescribed based on symptoms, with a course lasting up to 28 days.
- Severe cases may require hospital referral for intravenous antibiotics.
Prevention:
- Cover skin, use insect repellent, stay on clear paths, and wear light-colored clothing to reduce the risk of tick bites.
Ongoing Symptoms:
- Some individuals may experience persistent symptoms even after treatment.
- Consult a doctor for further support, considering factors like a care needs assessment and communication with employers or schools.
Caution Against Online Tests:
- Some websites offer tests and treatments without scientific support; consulting a doctor is crucial.

By synthesizing this information, I aim to contribute to a better understanding of Lyme disease, its symptoms, prevention, and the importance of seeking professional medical advice.