You're more likely to get Lyme disease if you live or spend time in grassy and heavily wooded areas where ticks carrying Lyme disease thrive. It's important to take common-sense precautions in tick-infested areas.
Where you live or vacation can affect your chances of getting Lyme disease. So can your profession and the outdoor activities you enjoy. The most common risk factors for Lyme disease include:
Spending time in wooded or grassy areas. In the United States, deer ticks are found mostly in the heavily wooded areas of the Northeast and Midwest. Children who spend a lot of time outdoors in these regions are especially at risk. Adults with outdoor jobs also are at increased risk.
Having exposed skin. Ticks attach easily to bare flesh. If you're in an area where ticks are common, protect yourself and your children by wearing long sleeves and long pants. Don't allow your pets to wander in tall weeds and grasses.
Not removing ticks promptly or properly. Bacteria from a tick bite can enter your bloodstream if the tick stays attached to your skin for 36 to 48 hours or longer. If you remove a tick within two days, your risk of getting Lyme disease is low.
Early signs and symptoms
A small, red bump, similar to the bump of a mosquito bite, often appears at the site of a tick bite or tick removal and resolves over a few days. This normal occurrence doesn't indicate Lyme disease.
However, these signs and symptoms can occur within a month after you've been infected:
Rash. From three to 30 days after an infected tick bite, an expanding red area might appear that sometimes clears in the center, forming a bull's-eye pattern. The rash (erythema migrans) expands slowly over days and can spread to 12 inches (30 centimeters) across. It's typically not itchy or painful but might feel warm to the touch.
Erythema migrans is one of the hallmarks of Lyme disease, although not everyone with Lyme disease develops the rash. Some people develop this rash at more than one place on their bodies.
Other symptoms. Fever, chills, fatigue, body aches, headache, neck stiffness and swollen lymph nodes can accompany the rash.
Seek immediate treatment If the tick has been attached for more than 24 hours, or you see a red, bullseye spot emerge at the site or anywhere on the body or experience flu-like symptoms
Later signs and symptoms
If untreated, new signs and symptoms of Lyme infection might appear in the following weeks to months. These include:
Erythema migrans. The rash may appear on other areas of your body.
Joint pain. Bouts of severe joint pain and swelling are especially likely to affect your knees, but the pain can shift from one joint to another.
Neurological problems. Weeks, months or even years after infection, you might develop inflammation of the membranes surrounding your brain (meningitis), temporary paralysis of one side of your face (Bell's palsy), numbness or weakness in your limbs, and impaired muscle movement.
Less common signs and symptoms
Several weeks after infection, some people develop:
Heart problems, such as an irregular heartbeat
Liver inflammation (hepatitis)
When to see a doctor ...
If you've been bitten by a tick and have symptoms, only a minority of tick bites lead to Lyme disease. The longer the tick remains attached to your skin, the greater your risk of getting the disease. Lyme infection is unlikely if the tick is attached for less than 36 to 48 hours.
If you think you've been bitten and have signs and symptoms of Lyme disease — particularly if you live in an area where Lyme disease is common — contact your doctor. Treatment for Lyme disease is more effective if begun early.
Visit your doctor even if signs and symptoms disappear — the absence of symptoms doesn't mean the disease is gone. Untreated, Lyme disease can spread to other parts of your body for several months to years after infection, causing arthritis and nervous system problems. Ticks can also transmit other illnesses, such as babesiosis and Colorado tick fever.
The best way to prevent Lyme disease is to avoid areas where deer ticks live, especially wooded, bushy areas with long grass. You can decrease your risk of getting Lyme disease with some simple precautions:
Cover up. When in wooded or grassy areas, wear shoes, long pants tucked into your socks, a long-sleeved shirt, fitted at the wrists, a hat, tuck in hair if possible and gloves.
Wear white or light-colored clothing to make it easier to see ticks.
Try to stick to trails and avoid walking through low bushes and long grass. Keep your dog on a leash.
Wear shoes, no bare feet or sandals.
Use insect repellents. Apply insect repellent with a 20% or higher concentration of DEET to your skin. We recommend Deep Woods Off. Parents should apply repellant to their children, avoiding their hands, eyes and mouth.
Keep in mind that chemical repellents can be toxic, so follow directions carefully. Apply products with permethrin to clothing or buy pretreated clothing.
Do your best to tick-proof your yard. Clear brush and leaves where ticks live. Mow your lawn regularly. Stack wood neatly in dry, sunny areas to discourage rodents that carry ticks.
Check your clothing, yourself, your children and your pets for ticks. Be especially vigilant after spending time in wooded or grassy areas. Deer ticks are often no bigger than the head of a pin, so you might not discover them unless you search carefully.
It's helpful to shower as soon as you come indoors. Ticks often remain on your skin for hours before attaching themselves. Showering and using a washcloth might remove unattached ticks.
Don't assume you're immune. You can get Lyme disease more than once.
Remove a tick as soon as possible with tweezers. Gently grasp the tick near its head or mouth. As close to the skin as possible. Don't squeeze or crush the tick, but pull carefully and steadily. Once you've removed the entire tick, dispose of it by placing it in a container marked with the name of its host, area location, and the place of attachment on the body.
Then call your physician to determine if treatment is warranted. Most doctors will send the suspect on to a state lab for analysis at no charge