Lyme Basics
Early Lyme Disease
Early (Acute) Lyme disease may feel like the flu, fever, sore muscles, headache and fatigue. Some people may develop a highly distinctive rash, which may look like a bull’s-eye. (EM rash- erythema migrans rash) Statistics show that less than 25% of patients with Lyme develop the EM rash.
However, many people with Lyme never knew they were bitten and never developed a rash or developed a rash in an area that they cannot see (such as on the scalp).
In LymeDisease.org’s survey of 4,000 patients with chronic Lyme, 40% of the patients in the survey reported a rash. EM (Erythema migrans) rashes can be the classic round “bulls eye rash” or it can take several different forms and shapes. Rashes on darker skin may be harder to detect and go unnoticed. The rash doesn’t have to appear at the place of the bite and can spread over a larger portion of body.
What does the Lyme disease rash look like?
It starts a few days or even several weeks after the bite and then expands over a period of days or weeks to several inches across, perhaps with a central clearing. Untreated, it can last for weeks before fading, or it may fade and recur. The rash may have an irregular shape, blistering or a scabby appearance. Some rashes look like a bruise. Lyme rashes may resemble spider bites, ringworm, or cellulitis. Multiple, so-called “satellite” rashes may appear on different parts of the body.
Please note that if you have an EM rash- you have Lyme disease and should be seen by a medical practitioner ASAP.
If you develop a rash, take a photo of it and see a doctor as soon as possible. Other symptoms of early Lyme disease may include a fever, headache, fatigue, muscle aches, bells palsy and in some cases no symptoms at all. The lucky patients who experience no symptoms might initially have a stronger immune system but might experience symptoms even years later after a stressful incidence, another chronic illness or a motor vehicle accident.
Unfortunately, diagnostic testing is unreliable in the early stages of infection, often giving false negatives. Treatment should not be delayed pending a positive test result if the suspicion of Lyme disease is high (exposure, tick bite, possible rash). Many Lyme practitioners will see acute patients after a tick bite and prescribe antibiotics to help slow the spread of the disease. Early intervention is critical.
Early diagnosis and treatment restore most patients to health and reduces the number of patients who progress to late/chronic Lyme disease—which, in turn, reduces medical and societal costs of the disease. This is a winnable battle, but it requires that barriers to early diagnosis (absence of a rash, failure to recognize the growing geographic expansion of the disease, and the inadequacy of current laboratory tests) be acknowledged and addressed.
Note: The information presented on this page has been reviewed and approved by a member of our Medical Leadership Board.
