• Infections

A Comprehensive Guide to Lyme Disease: Causes, Symptoms, and Treatment Options

Medically reviewed and edited by Jeffrey Vacek, DNP, FNP-C

With spring and summer around the corner, people spend more time outdoors, which can cause many seasonal diseases to flare up.

One such condition is the tick-borne Lyme disease.

Although it’s not a life-threatening condition, Lyme disease can pose a significant health threat if left untreated.

That’s why it’s essential to understand the potential causes and signs of Lyme disease to know when to seek treatment.

In this article, we’ll look at everything you need to know about Lyme disease, including how to prevent it and care for your health.

What is Lyme Disease?

Lyme disease is a common bacterial infection caused by Borrelia burgdorferi. It’s usually transmitted through the bite of infected blacklegged ticks — commonly known as deer ticks.

The ticks acquire the bacteria by biting into infected animals — like mice or deer — which allows them to pass the disease to humans.

Lyme disease also has a seasonal pattern and is most prevalent in late spring and early summer when ticks are most active.

What are the symptoms of Lyme disease?

The symptoms of Lyme disease can vary, depending on the stage of the infection, which is typically divided into three phases. These are:

Early localized disease

This is the most distinct stage of Lyme disease and can involve developing a circular skin rash that resembles a bull’s-eye, known as erythema migrans.

The rash occurs at the site of the tick bite and can begin appearing anywhere from 3 to 30 days after being bitten.

It typically expands over several days — usually reaching up to 12 inches — and may be warm to the touch.

During this stage, you may also experience flu-like symptoms, including fever, chills, fatigue, body aches, and headaches.

While up 70-80% of patients experiencing this rash, some people who have Lyme disease will never present with a rash. Additionally while the rash may reach up to 12 inches some are as small as 2.25 inches. The side does increase with time peaking at 14 days.

High risk states are Connecticut, Delaware, Maryland, New Jersey, New York, Pennsylvania, Rhode Island, and Wisconsin.

Moderate risk states are Maine, Massachusetts, Minnesota, New Hampshire, Vermont.

Early disseminated Lyme disease

This stage occurs weeks to months after the initial infection when bacteria begins to spread throughout the body.

You might experience early symptoms like:

• Erythema migrans rashes on other parts of the body

• Facial palsy (loss of muscle tone on one or both sides of the face)

• Severe headaches and neck stiffness

• Pain and swelling in the large joints

• Heart palpitations

• Dizziness

Late disseminated disease

Untreated Lyme disease in this stage can cause more serious symptoms to develop in the following months or years. These can include:

• Arthritis with severe joint pain and swelling

• Shooting pains in the hands or feet

• Numbness or tingling in the hands or feet

• Problems with short-term memory

Causes of Lyme Disease

Lyme disease is primarily caused by tick bites from those infected with Borrelia burgdorferi bacteria.

Before transmitting bacteria, a tick must be attached to its host for 36 to 48 hours.

If the tick is removed from the skin before then, your chances of getting infected decrease.

Is Lyme disease contagious?

This disease is not contagious and cannot be transmitted from person to person through any form of touching, kissing, or sexual contact.

Lyme disease also can’t be transmitted through air, food, water, or contact with infected surfaces. The only known method of transmission is through tick bites.

You can safely have direct contact with infected or uninfected people without increasing their risk of contracting Lyme disease.

Risk factors for Lyme disease

Although Lyme disease can infect anyone, certain factors may increase your chances of coming into contact with infected ticks. These include:

• Living in or visiting areas where Lyme disease is common, such as Connecticut, Massachusetts, New Jersey, New York, and Pennsylvania.

• Engaging in outdoor activities — such as hiking, camping, gardening, or hunting — in areas where the disease is prevalent

• The time of year, since most cases of Lyme disease are reported during the late spring and early summer when young ticks are most active

• Not wearing protective gear in tick-infested regions

• Failing to use tick repellants in areas where the disease is prevalent

• Forgetting to perform regular and thorough tick checks after being outdoors

• Having pests that roam your house or yard in areas where ticks are prevalent

Understanding these risk factors can help you take the necessary steps to prevent Lyme disease by reducing the likelihood of getting bitten by infected ticks.

How Is Lyme Disease Diagnosed?

Lyme disease is challenging to diagnose because its symptoms mimic those of many other conditions.

To diagnose Lyme disease accurately, your healthcare provider will use a comprehensive approach that involves:

• Evaluating your medical history

• Performing a physical examination to look for erythema migrans

• Checking for any other Lyme disease symptoms

If you don’t have any visual symptoms of Lyme disease, your doctor may recommend blood tests to detect antibodies.

Your results will display two types of antibodies — called enzyme-linked immunosorbent assay (ELISA) and Western blot — if you have Lyme disease.

Once your diagnosis has been confirmed, your doctor will recommend appropriate treatment options.

What are the Treatment Options for Lyme Disease?

Treatment for Lyme disease depends on the stage of your condition when you are diagnosed.

The later stages have more aggressive treatment regimes to stop the disease’s progression. Let’s take a closer look at what this means.

Early localized stage

In the early stages of Lyme disease, treatment usually involves oral antibiotics — like doxycycline or amoxicillin.

These antibiotics can help to kill harmful bacteria in the body, providing symptomatic relief.

The typical antibiotic course for Lyme disease lasts 10 to 21 days, depending on your diagnosis.

Early and late disseminated disease stage

If the disease is diagnosed during the early disseminated stage, oral antibiotics can still be highly effective. However, your course may last for up to 28 days.

In cases where the central nervous system (CNS) is affected — such as during late disseminated Lyme disease — your doctor may recommend intravenous antibiotics.

These may include stronger antibiotics like ceftriaxone or penicillin, designed to ensure the medicine reaches the CNS. An intravenous antibiotic treatment usually lasts 14 to 28 days.

Persistent or chronic Lyme disease

Some patients may experience symptoms that persist despite antibiotic treatments — this is often referred to as post-treatment Lyme disease syndrome (PTLDS).

These symptoms could include fatigue, general discomfort, and joint or muscle aches.

In these cases, additional rounds of antibiotics may be considered despite the concerns of long-term medication use.

Symptomatic treatment

For secondary symptoms — such as joint pain or arthritis — your doctor may recommend the following:

• Over-the-counter (OTC) medications like ibuprofen to manage pain

• Physical therapy to strengthen muscles and alleviate discomfort

Can Lyme Disease Be Prevented?

It may be possible to prevent Lyme disease by minimizing your exposure to ticks and reducing your risk of infection.

Preventative strategies to avoid tick bites may include:

• Using tick repellants on exposed skin to prevent parasites from attaching to your body

• Dressing appropriately when in tick-infested areas

• Wearing light-colored clothing in tick-infested areas to easily spot any parasites on your body before they attach to the skin

• Avoiding walking through high grass

• Maintaining a neatly trimmed lawn to minimize tick habitats

• Placing wood chip barriers or gravel between lawns and wooded areas to restrict tick migration

• Performing regular and thorough tick checks after being outdoors – including inspecting the armpits, in or around the ears, inside the belly button, behind the knees, and between the legs

• Showering within two hours of coming indoors to help remove any attached ticks

• Inspecting your pets for ticks regularly

If you do find a tick attached to your skin, don’t panic. The first thing you should do is to remove it with fine-tipped tweezers.

After removing the tick, thoroughly clean the affected area and your hands with rubbing alcohol, soap, and water.

We advise against using home remedies for tick removal — such as painting the tick with nail polish or using heat to make it detach from the skin.

Your goal should be to remove the tick as quickly as possible instead of waiting for it to detach by itself.

When Should You See a Doctor About Lyme Disease?

Consulting your doctor is essential when it comes to effectively treating and managing Lyme disease.

You should schedule an appointment with your doctor if you:

• Have been bitten by a tick and are unsure of how long it was attached, especially if it’s been more than 24 hours

• Identified an attached tick to be one that often causes Lyme disease

• Notice a rash that resembles a bull’s-eye or one that expands over time

• Develop flu-like symptoms in addition to the rash

• Experience worsening or persistent symptoms, despite receiving previous treatment for Lyme disease

These symptoms could either indicate that you’ve been infected with Lyme disease or that your current condition has worsened.

Your doctor can help determine the cause of your symptoms and recommend an appropriate treatment method.

It’s also recommended to see your doctor if you are considering preventative antibiotics for Lyme disease or if you are pregnant and suspect that you may be infected.

Where Can You Learn More about Lyme Disease?

While LifeMD doesn’t provide medical care for Lyme disease, we can help you manage any unpleasant symptoms you may be experiencing.

A team of medical professionals can assist you with medications, prescriptions, and advice to cope with painful or uncomfortable symptoms caused by an infected tick bite.

Make your appointment and take control of your health — all from the comfort of your own home.

Jeffrey Vacek, DNP, FNP-C

Jeffrey graduated from Missouri State University with his Doctor of Nursing Practice and a specialization in Family Nurse Practitioner. He has practiced in primary care for the past seven years, with a focus on telehealth the past three years. Outside of work, Jeffrey keeps busy playing disc golf and pickleball with his wife and five children. He is also an avid reader, often finishing two to three books per week.

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