Don’t Ignore These Lyme Disease Symptoms

Bitten by a tick? Know how to spot Lyme disease symptoms for fast action

Tick season goes hand-in-hand with warm summer months. But did you know these tiny pests can remain active well into the fall — and even year-round in warmer climates? That’s why it’s always a good idea to check your body, kids and pets for tiny, blacklegged ticks after spending time outside.

Also known as deer ticks, some of them like the juvenile nymphs can be as small as a poppy seed and easy to miss. But despite their size, these teensy creepy crawlies can have a big impact on your health: Many carry bacteria that cause serious diseases, including Lyme disease.

“One of the most challenging aspects of Lyme disease is that it can be difficult to diagnose,” says Stanley Martin, MD, system director of infectious diseases at Geisinger. “Many of the symptoms of Lyme disease are common to other diseases and illnesses.”

What is Lyme disease

Lyme disease is a bacterial infection caused by Borrelia bacteria and spreads through the bite of infected blacklegged (deer) ticks. Ticks usually need to be attached for at least 24 hours to pass the bacteria — and the risk rises the longer a tick remains attached.

“Ticks can attach to any part of your body, but they’re often found in hard-to-see areas like the groin, armpits and scalp,” says Dr. Martin. “And some immature deer ticks, called nymphs, are hard to spot and people may not even be aware they’ve been bitten.”

Anyone who spends time outdoors where ticks live can be at risk. If you hike, garden or camp, especially in wooded or grassy areas, you can increase your exposure. And pets that spend time outdoors can bring ticks into your home.

Cases are most common in the upper Midwest, northeastern and mid-Atlantic regions of the U.S., though ticks can be found in many parts of the country.

Spotting Lyme disease symptoms

If you’ve been bitten by an infected tick, Lyme disease symptoms can appear between 3 and 30 days later. You may have heard early symptoms lead to a “bullseye rash” that forms at the site of the bite. It’s known as an erythema migrans rash and often starts as a small red spot that gradually expands, sometimes clearing in the center to create a target-like appearance.

But only about half of people diagnosed with Lyme disease develop a rash. And some people don’t even remember being bitten at all. That’s because immature deer ticks (nymphs) are so small that you could fit more than 100 of them on a quarter.

“If you don’t experience the classic rash associated with Lyme disease, it doesn’t mean you’re free and clear,” says Dr. Martin. “Lyme is tricky that way. So, it’s good to be aware of the other symptoms it causes, too.”

In addition to the rash, other early symptoms of Lyme disease include:

Flu-like illness (fever and chills)
Joint pain, stiffness or swelling
Muscle aches and pains
Severe headaches
Extreme fatigue
Swollen lymph nodes

Without treatment, the infection can spread over weeks to months to the joints, nervous system and heart. Cases in later stages can lead to inflammation around the brain and spinal cord, facial paralysis (Bell’s palsy), heart palpitations and numbness and weakness in your muscles.

Recognizing symptoms early leads to faster care. If you develop any of these symptoms after a tick bite or spending time in an area known for deer ticks, contact your doctor right away.

How is Lyme disease diagnosed?

Lyme disease is often called “the great imitator” since many of its symptoms are common to other conditions, including multiple sclerosis, Alzheimer’s disease, chronic fatigue syndrome, fibromyalgia, ALS and even depression.

To diagnose Lyme disease if a patient doesn’t have the classic “bullseye” rash, a blood test may be required. This 2-step test measures antibodies your body creates in response to the bacteria that causes Lyme disease. The first step is a screening test. If results are positive, a second test is performed to confirm if you’re truly infected. The screening test can have false positives.

Your doctor may also diagnose you based on your symptoms and exposure to blacklegged ticks, while ruling out the possibility of other diseases that may cause similar symptoms.

“Diagnosing Lyme disease takes a bit of detective work from both the doctor and the patient,” says Dr. Martin. “As a patient, you can help your doctor get a clearer picture by providing as much information as possible about your symptoms, history and potential exposure through recent travel and outdoor activities.”

How is Lyme disease treated?

In most cases, Lyme disease can be easily treated with a 2- to 4-week course of antibiotics. Most people fully recover, especially when it’s caught and treated early.

However, some people can have lingering symptoms like fatigue, joint pain or brain fog for months — even after effective antibiotic treatment. In this case, your doctor can recommend ways to manage your ongoing symptoms and improve your quality of life.

“Clinical studies have shown prescribing long-term antibiotics does not provide any clear benefit,” says Dr. Martin.

Tips to prevent Lyme disease

Because Lyme disease can have serious impacts on your health, preventing tick bites in the first place is key. If you live in an area known for deer ticks, follow these tips to reduce your risk:

Stick to marked trails and avoid hiking where ticks live, like wooded, grassy or bushy areas.
Wear long sleeves, long pants and closed-toed shoes when outside.
Use an EPA-approved chemical insect repellent with DEET or picaridin on exposed skin.
Perform full-body tick checks after returning indoors, especially if you were in wooded or grassy areas. And don’t forget to check your pets daily for ticks.
Shower soon after spending time outdoors to wash away unattached ticks.

And if you do get a tick bite, removing the tick properly matters to protect yourself from Lyme disease. Then, clean the area well and note the date and location on your body to discuss with your doctor.

“If you think the tick has been there for at least 24 hours or more, talk to your doctor about your risks,” says Dr. Martin. “Prevention and early treatment are always best to prevent long-term problems.”