An early sign of Lyme disease, caused by a tick bite (blacklegged/deer tick). The first symptom is often a spreading red rash called erythema migrans.
Where it happens
- Common in certain regions (parts of North America and Europe) during warmer months.
- Ticks are tiny; many people don’t notice the bite.
What the rash looks like
- Starts at the site of the bite after 3–30 days (often 7–14 days).
- Expands over days to more than 2 inches (5 cm), sometimes much larger.
- Usually not very itchy or painful.
- Can be uniformly red or have central clearing (“bull’s-eye”), but not always.
- You may also feel like you have the flu: fatigue, headache, low fever, body aches.
Important: A small red bump right after a bite that stays under 2 cm and fades in a day or two is usually just a normal bite reaction, not Lyme.
When to see a clinician
- Any expanding rash after a possible tick bite or outdoor exposure in a Lyme area.
- If you have multiple rashes, severe headache, neck stiffness, facial droop, or joint swelling.
Diagnosis and treatment
- In early rash stage, doctors often diagnose clinically without waiting for blood tests.
- Antibiotics are very effective (for example, doxycycline for most adults; amoxicillin or cefuroxime in others). Courses are typically 10–21 days depending on the case.
- Early treatment usually leads to full recovery.
Tick bite prevention
- Use EPA-registered repellents (like DEET or picaridin).
- Wear long sleeves and tuck pants into socks in brushy areas.
- Treat clothing/gear with permethrin.
- Do tick checks after being outdoors; shower soon after.
- To remove a tick: use fine tweezers to grasp close to the skin and pull straight out; clean the area.
If you bring me your region, I can tailor prevention tips and typical tick activity timing for your area.