What does a Lyme disease rash look like?

A rash is a common symptom of Lyme disease. These types of rashes can change over time, as the bacteria spread.

Lyme disease can result from the bite of a black-legged tick that is carrying the bacterium.

In the early stages of the disease, around 70–80 percent of people develop a rash that resembles a bull’s-eye. The medical term for this distinctive rash is erythema migrans.

Other people with Lyme disease may have a different type of rash or no rash at all.

In this article, we describe Lyme disease rashes, other symptoms, and the stages of the illness. We also look at treatment options.

Symptoms and stages of Lyme disease rashes

There are three stages of Lyme disease.

After exposure to the disease bacterium, a person may notice some of the following skin changes:

Stage 1

Lyme disease rash

Lyme disease commonly causes a bull’s-eye rash.

In the first stage of Lyme disease, a quick-spreading rash often develops at or near the site of the bite.

The rash tends to appear within a few days or weeks of infection.

According to the Centers for Disease Control and Prevention (CDC) in the United States, there are several types of Lyme disease rash. These include:

  • a distinctive bull’s-eye rash with a central clear ring that slowly expands — this is the “classic” type
  • an expanding red lesion with a crusty center
  • a red, circular rash with a clear center
  • a red, oval-shaped rash

Ticks can bite any area of the body, but they usually target the:

  • armpit
  • back
  • groin
  • lower leg

Individuals may notice a small spot or lump on the skin in the center of a rash. In the early stages, the rash may be:

  • warm to the touch
  • smooth
  • scaly or crusty at the outer edges
  • itchy, burning, or painful, in rare cases
  • small, but it may gradually expand to 12 or more inches

Stage 2

If a person does not receive treatment, the bacterium that causes Lyme disease spreads in the body. This is stage 2 of the disease.

Stage 2 rashes generally appear 1–6 months (or more) after infection.

When the disease is in the second stage, a person may develop several small oval-shaped rashes on the face, legs, and arms. These may have a dusky center. Other people develop a bluish rash without a clear center.

Stage 1 rashes grow quickly, but stage 2 rashes tend to remain the same size.

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