Lyme disease is a bacterial infection transmitted through the bite of an infected tick. Early diagnosis and appropriate antibiotics usually lead to a good recovery and reduce the risk of complications.
Early signs and symptoms
An expanding rash called erythema migrans may appear days to weeks after a bite. It may be round or oval and can clear in the centre, but it does not always look like a classic bull’s-eye. It is usually not very itchy, hot or painful. Fever, headache, fatigue, muscle aches and joint pain may occur with or without a noticed rash.
Later symptoms
Untreated infection can sometimes affect the nervous system, joints or heart. Possible signs include facial weakness, severe nerve pain, numbness, a swollen painful joint, palpitations, fainting, breathlessness, severe headache or neck stiffness.
Tick removal and prevention
- Remove an attached tick promptly with fine-tipped tweezers, pulling steadily close to the skin.
- Clean the bite area and your hands.
- Do not burn, twist or cover the tick with oils or chemicals.
- Use insect repellent, wear protective clothing and check skin after time in grassy or wooded areas.
Diagnosis
A typical erythema migrans rash can be diagnosed clinically and treated without waiting for a blood test. When the presentation is less clear, blood testing may be used. Tests can be negative early in infection, and results must be interpreted alongside symptoms and exposure history.
Treatment
Lyme disease is treated with antibiotics. The medicine and duration depend on age, pregnancy, symptoms and which parts of the body are affected. Most people recover, although fatigue, aches or difficulty concentrating may persist for some time after treatment. Persistent symptoms need clinical review for Lyme-related and other possible causes; prolonged additional antibiotics have not been shown to help most people after recommended treatment.
When to seek urgent help
Seek prompt medical advice for an expanding rash or compatible illness after possible tick exposure. Urgent care is needed for facial weakness, severe headache with neck stiffness, fainting, new palpitations, chest pain, breathing difficulty or marked joint swelling.
Sources
Reviewed: 28 August 2026