Lyme disease is a bacterial infection. You can get it when a blacklegged tick, also called a deer tick, bites you and stays attached for 36-48 hours. If you remove the tick within 48 hours, you probably won’t get infected.

If you do get infected, the bacteria travel can through your bloodstream and affect various tissues in your body. If you don’t treat Lyme disease early on, it can turn into an inflammatory condition that affects multiple systems, starting with your skin, joints, and nervous system and moving to organs later on. 

The chances you might get Lyme disease from a tick bite depend on the kind of tick, where you were when it bit you, and how long the tick was attached to you. You’re most likely to get Lyme disease if you live in the Northeastern United States. The upper Midwest is also a hot spot. But the disease now affects people in all 50 states and the District of Columbia.

Symptoms can start anywhere from 3 to 30 days after the bite. They may look different depending on the stage of your infection. In some cases, you won’t notice any symptoms until months after the bite.

Early symptoms include:

All of those symptoms are also common in the flu. In most Lyme infections, one of the first symptoms you’ll notice is a rash.

Without treatment, symptoms can get worse. They might include:

  • Severe headache or neck stiffness
  • Rashes on other areas of your body
  • Arthritis with joint pain and swelling, particularly in your knees
  • Drooping on one or both sides of your face
  • An irregular heartbeat
  • Inflammation in your brain and spinal cord
  • Shooting pains, numbness, or tingling in your hands or feet

What does the rash look like?

Some Lyme rashes look like a bull's-eye with circles around the middle. But most are round, red, and at least 2 inches across.

It may not look as red on darker skin tones and may not stand out as much as it does on lighter skin. This can make it hard to spot. Black people may be more likely than white people to have the disease spread throughout the body more when diagnosed. Research shows that the difference in how the rash appears has caused some people to receive a later diagnosis. If you don't treat Lyme disease, it can get worse and cause complications, so an early diagnosis is critical.  

The rash slowly gets bigger over several days. It can grow to about 12 inches across. It may feel warm to the touch, but it’s usually not itchy or painful. It can show up on any part of your body.

If you know what the rash looks like on the color of your skin, you may be able to catch it early. 


How small are ticks?

Ticks come in three sizes depending on their life stage. They can be the size of a grain of sand, a poppy seed, or an apple seed.

Your doctor will diagnose you based on your symptoms and whether you’ve been exposed to a tick. You may also get a blood test. In the first few weeks of infection, the test may be negative because antibodies take a few weeks to show up. It may take 4-6 weeks to see a positive result.

Hopefully soon, there will be tests that can diagnose Lyme disease in the first few weeks after you’re exposed. The earlier you get treated, the less likely it’ll get worse.

There are three stages:

  • Early localized Lyme: Flu-like symptoms such as fever, chills, headache, swollen lymph nodes, sore throat, and a rash that looks like a bull's-eye or is round and red and at least 2 inches long. This stage typically starts 3-30 days after a tick bite.
  • Early disseminated Lyme: Flu-like symptoms like pain, weakness, or numbness in your arms and legs, changes in your vision, heart palpitations and chest pain, a rash (that may nor may not be a bull’s-eye rash), and a type of facial paralysis known as Bell’s palsy
  • Late disseminated Lyme: This can happen weeks, months, or years after the tick bite. Symptoms may include arthritis, severe fatigue and headaches, dizziness, trouble sleeping, and confusion.

About 10% of people treated for Lyme infection don’t shake the disease. They may go on to have three core symptoms: joint or muscle pain, fatigue, and short-term memory loss or confusion. This is called post-treatment Lyme disease syndrome. It can be hard to diagnose because it has the same symptoms as other diseases and there isn't a blood test to confirm it.

Experts aren’t sure why Lyme symptoms don’t always go away. One theory is that your body keeps fighting the infection even after the bacteria are gone, like an autoimmune disorder.

With early-stage Lyme disease, you’ll take antibiotics for about 10 days to 3 weeks. The most common ones are amoxicillin, cefuroxime, and doxycycline. The antibiotics will almost always cure your infection. If they don’t, you might get other antibiotics either by mouth or as a shot.

If you don’t treat your Lyme infection, you might need oral antibiotics for symptoms like weakened face muscles and irregular heartbeat. You may need antibiotics if you have meningitis, inflammation in your brain and spinal cord, or more severe heart problems.

If your Lyme is late stage, the doctor might give you antibiotics either by mouth or as a shot. If it causes arthritis, you’ll get arthritis treatment.

There’s no therapy for post-treatment Lyme disease syndrome.

The tick that causes Lyme disease has been moving from the Northeast and upper Midwest into the Southern and Western U.S., Mexico, and Canada. 

In 2020, the states with the most reported cases were Pennsylvania, New Jersey, New York, Wisconsin, and Maine, according to the CDC. 


In the Southern U.S., where it’s hotter, ticks stay under leaves so they don't dry out. This means people in the South don’t get Lyme from ticks very often because the ticks don't usually come out to bite.

Even though people only report about 30,000 cases of Lyme infection in the U.S. each year, there are actually around 476,000 a year. The same tick also can spread other diseases, including babesiosis, anaplasmosis, and Powassan virus. Those diseases are also on the rise in the U.S.

Who is most likely to get Lyme disease?

Boys up to age 15 and men between the ages of 40 and 60 are more likely to get Lyme disease. The reasons for that aren't clear, but those groups may be more likely to spend time outside. 

Why are there more ticks now than there used to be?

There are several reasons why Lyme is spreading. Some of these are:

  • New trees being planted, especially in the Northeastern U.S.
  • Climate change and very hot or cold temperatures
  • People moving away from large cities
  • More contact with white-tailed deer (the blacklegged tick's favorite way to travel)

In the last century, many trees were cut down to make way for buildings. That led to a drop in the deer population. But in the past few decades, people have planted more trees, so both the deer and tick populations have grown.

Ticks live for 2-3 years and don't move very far, so it takes a while to see large changes.

Deer and white-footed mice give Lyme disease to ticks that bite them. As their habitats shrink, they live closer to people. Dogs also carry ticks into homes and spread them to their humans.

As the climate warms, some people spend more time outside. That raises the odds of being bitten, particularly in areas where Lyme is common.

That doesn't mean you should avoid outdoor activities, as long as you take steps prevent tick bites and check for them, just in case.

Ticks can't fly or jump. But they live in shrubs and bushes and can grab onto you when you pass by. To avoid getting bitten:

  • Wear pants and socks in areas with lots of trees and when you touch fallen leaves.
  • Wear a tick repellent on your skin and clothing that has DEET, lemon oil, or eucalyptus.
  • For even more protection, use the chemical permethrin on clothing and camping gear.
  • Shower within 2 hours after coming inside. Look for ticks on your skin, and wash ticks out of your hair.
  • Put your clothing and any exposed gear into a hot dryer to kill whatever pests might be on them.

How do you know if you've been bitten?

Ticks are small, so you've got to have pretty good eyes to see them.

If you have a small, reddish bump on your skin that looks like a mosquito bite, it could be a tick bite. If it goes away in a few days, it’s not a problem. Remember, a tick bite doesn’t necessarily mean you have Lyme disease.

If you notice a rash in the shape of a bull's-eye, you might have a tick bite. Talk to your doctor about treatment.

If you have an allergic reaction to ticks, you'll notice a bite right away.

Use a pair of fine-tipped tweezers to remove it as soon as possible. Pull upward with steady pressure. If parts of the tick are still in your skin, try to get those with the tweezers, too. After everything is out, clean the bite area with rubbing alcohol or soap and water.

You probably won’t get infected if you remove the tick within 36-48 hours.

How do you throw away a tick?

Put it in soapy water or alcohol, stick it to a piece of tape, or flush it down the toilet.

The rash is a pretty good indication that you may have been bitten. Take a photo of the rash and see your doctor. At this stage, treatment with antibiotics will probably work.

If you don't have the rash but have symptoms like fatigue, fever, and headache but no respiratory symptoms like a cough, you may want to talk to your doctor.

In 2017, a French company called Valneva started testing a Lyme disease vaccine on adults in the U.S. and Europe. The vaccine is in the third and final phase of clinical trials.


The more ticks in your region, the likelier it is that your furry pal will bring them home.

Your dog is much more likely to be bitten by a tick than you are. And where Lyme disease is common, up to 25% of dogs have had it at some point.

About 10% of dogs with Lyme disease will get sick 7-21 days after a tick bite. Your dog might seem like they’re walking on eggshells. They also might have a fever and enlarged lymph nodes. Plus, they might seem tired. Dogs also get antibiotics for Lyme.

What if my dog brings ticks into my home?

Use a tick control product on your pet to prevent Lyme disease. Also, have your dog vaccinated against Lyme.

Check your dog’s whole body each day for bumps. If you notice a swollen area, see if there’s a tick there. If you find a tick, wear gloves while you use tweezers to separate it from your dog. Then, put it in soapy water or alcohol, or flush it down the toilet.

Use alcohol to clean the spot on your dog where the tick was attached. Keep an eye on that spot, and also on your dog to make sure they’re behaving normally. If you notice any changes, check with your vet.

Show Sources


John Aucott, MD, assistant professor of medicine, Johns Hopkins University School of Medicine; director, Johns Hopkins Lyme Disease Clinical Research Center.

CDC: “Lyme Disease,” "Lyme Disease Top 10 State Cases by Year," “Lyme Disease Frequently Asked Questions (FAQ)," "Signs and Symptoms of Untreated Lyme Disease,” “Tickborne Disease," "Lyme Disease Surveillance Data.”

Morbidity and Mortality Weekly Report: “Vital Signs: Trends in Reported Vectorborne Disease Cases -- United States and Territories, 2004-2016.”

Alan Taege, MD, department of infectious disease, Cleveland Clinic.

EPA: “Climate Change Indicators in the United States.”

American College of Rheumatology.

Infectious Diseases Society of America.

Eisen, R. J Med Entomol, March 2016.

Paul Mead, MD, chief of epidemiology and surveillance activity, Bacterial Diseases Branch, CDC.

Valneva SE.

MSPCA-Angell: “Lyme Disease in Dogs.”

VCA Hospitals: “Lyme Disease in Dogs.”

UpToDate: “Lyme Disease Treatment.”

Global Lyme Alliance.

Entomology Today, Sept. 28, 2017.

U.S. Global Change Research Program: “Climate and Health Assessment.”

Government of Canada: “Surveillance of Lyme disease.”

American Lyme Disease Foundation.

TickEncounter Resource Center: "Top 10 Things Everyone Should Know About Ticks These Days."

Quest Diagnostics: "Lyme Disease Health Trends."

American Lyme Disease Foundation: “Lyme Disease.”

Facial Palsy UK: “What is Facial Palsy?”

Mayo Clinic: “Lyme disease.” “Phase 2 Study Of VLA15, A Vaccine Candidate Against Lyme Borreliosis, In A Healthy Peadiatric And Adult Study Population.”

The Humane Society of the United States: “Getting a Tick Off of Your Dog.”

American Journal of Epidemiology: “Racial Differences in Reported Lyme Disease Incidence.”

Journal of General Internal Medicine: “Black-white differences in the clinical manifestations and timing of initial Lyme disease diagnoses." “Early diagnosis necessitates Lyme-savvy doctors.”

© 2023 WebMD, LLC. All rights reserved. View privacy policy and trust info