Table of ContentsView AllTable of ContentsStagesStage 1Stage 2Stage 3ComplicationsPreventionWhen to See a Healthcare ProviderSummary
Table of ContentsView All
View All
Table of Contents
Stages
Stage 1
Stage 2
Stage 3
Complications
Prevention
When to See a Healthcare Provider
Summary
Lyme diseaseis curable. Most people who are infected with the tick-borne illness make a full recovery after treatment with antibiotics.
This article discusses how early detection is the best way to ensure a full recovery. It also details treatment options, potential long-term complications of Lyme disease, and how to prevent this infection.
Verywell / Ellen Lindner
Stages of Lyme Disease
Lyme disease is a bacterial infection transmitted through the bite of an infected black-legged (deer) tick. In humans, the infection has three stages:
When detected and treated in the early stages, most people with Lyme disease make a complete recovery. Lyme disease that progresses to stage 3 is more difficult to treat and can lead to long-term complications.
The Centers for Disease Control and Prevention (CDC) estimates that approximately 476,000 people contract Lyme disease each year in the United States.
Lyme Disease Staging
Stage 1 Treatment
Early-stage Lyme disease is typically treated with a 10- to 14-day course of oral antibiotics. Such medications include:
Doxycycline and Young ChildrenDoxycycline is usually the first-line treatment for Lyme disease. However, due to concerns about tetracycline drugs causing tooth staining in younger children, some healthcare providers may choose to start children under 8 years of age on amoxicillin.
Doxycycline and Young Children
Doxycycline is usually the first-line treatment for Lyme disease. However, due to concerns about tetracycline drugs causing tooth staining in younger children, some healthcare providers may choose to start children under 8 years of age on amoxicillin.
Lyme Disease in Children
Treatment for stage 1 Lyme disease may be prescribed based on symptoms. In the early stages, the most common symptom is a bullseye rash. known asErythema migrans.About 90% of people with Lyme disease develop this rash within three to 30 days after being bitten.
In cases where you removed the tick or had a healthcare provider remove it, you might consider testing the parasitic arachnid (note: ticks are not insects). If the Lyme disease bacterium is detected in the tick, your healthcare provider may start you on antibiotics.
Even if test results show a tick is infected with LymeB. burgdorferibacteria, it may not have necessarily transmitted the bacteria when it bit you.A healthcare provider is being highly cautious if they prescribe antibiotics based on the test results alone.
Stage 2 Treatment
In stage 2 early disseminated Lyme disease, which occurs weeks to months after the bite, bacteria have spread out to other parts of the body. The nervous and cardiovascular systems may be impacted at this point. You may be first diagnosed at this stage, or you may reach this stage if antibiotic treatment in stage 1 wasn’t successful.
A more aggressive antibiotic treatment is recommended for those with stage 2 Lyme disease. A 14-21 day cycle of oral doxycycline, amoxicillin, cefuroxime, orazithromycin(another common antibiotic) may be prescribed.
Treatment for more severe Lyme disease typically requires intravenous (IV) antibiotics for 14 to 21 days.
If you experience these symptoms, talk to your healthcare provider right away.
How Lyme Disease Is Treated
Stage 3 Treatment
For those who are not diagnosed and treated early on or who do not respond to antibiotic treatment, more significant symptoms can begin months or years after the bite. Your healthcare provider may try a different antibiotic for 28 days or move from pills to IV antibiotics for 14-28 days.
Research shows that there is no benefit to increased dosage or long-term antibiotic treatment for those whose symptoms persist.However, studies have indicated that most people eventually feel well and symptoms resolve without additional treatment.
As in other stages of the disease, the late persistent stage of Lyme disease can leave you with neurological issues that have to be treated or managed. Vision problems are not uncommon, for instance, among people with stage 3 Lyme disease.
Lyme disease affects how the brain and eyes work together. Some people require rehabilitation to help them process visual images or enable them to managedepth perceptionproblems.
Treatment for Complications
Roughly one in 10 people with Lyme disease end up with post-treatment Lyme disease syndrome (PTLDS) and have ongoing symptoms after treatment.In addition, one in 100 people with Lyme disease develops a more severe complication known as Lyme carditis.
Post-Treatment Lyme Disease Syndrome
PTLDS symptoms are similar to those in the early stages of Lyme disease and include:
PTLDS symptoms can last for longer than six months and typically resolve over time.
Experts are uncertain why some people develop PTLDS and others don’t. One theory is theB.burgdorferibacteria responsible for Lyme diseases may trigger an autoimmune response. Another possibility is the symptoms are not due to Lyme disease but a different, difficult-to-detect infection.
There is no proven treatment for PTLDS. Studies have not found short-term antibiotic treatment effective, and long-term antibiotic treatment can have serious, negative health effects.
Most people with PTLDS do get better over time, but it can take several months for a complete recovery.
Lyme Carditis
Lyme carditis is a serious complication that develops when bacteria enter the heart tissues. Bacteria can interfere with electrical signals that control the beating of the heart.
Symptoms of Lyme carditis may include:
If you develop Lyme carditis, your healthcare provider may prescribe oral or IV antibiotics depending on the severity of your case. Some people with Lyme carditis may require a temporarypacemaker.
Most people recover fully from Lyme carditis within one to six weeks. Lyme carditis can be fatal, although with 11 cases of fatal Lyme carditis between 1985 and 2019, it is rare.
Limiting your exposure to ticks is the best prevention of Lyme disease. Cases have been reported in nearly all U.S states, but it is most common in the Northeast, upper Midwest, and Northwestern states.
Although Lyme disease can happen any time of year, ticks are most active between April and October.Spending time in grassy and heavily wooded areasincreases your risk of exposure. If you are going into the woods, the CDC advises wearing long sleeves and pants, tucking your pants into your socks, and treating your clothing and gear with products containing 0.5% permethrin.
You should also apply tick repellant to your skin and clothes prior to spending time in the woods and try to stay in the center of the trails. Ingredients proven to repel ticks include:
If you are spending a lot of time outdoors or in the woods, reapply tick repellant every six hours.
The Best Bug Sprays, Tested and Reviewed
Checking for Ticks
After leaving potentially tick-infested areas, check your clothing, gear, and pets. If you find any ticks, remove them before entering your home.
Once inside, conduct a full body check for ticks using a full-length or handheld mirror to view your back. If you share your home with family members, you might consider enlisting their help.
Common places ticks can hide include:
In addition, take a shower. Rinsing off within two hours of coming indoors has been shown to reduce the risk of Lyme disease.
Signs and Symptoms of a Tick Bite
Removing Ticks
If you find a tick attached to your skin,remove it as soon as possible. In order for you to contract Lyme disease, a tick typically needs to remain attached to you for 36 to 48 hours.
To remove a tick, use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible. Then pull upward with steady, even pressure. If the tick’s mouth breaks off and remains in the skin, try to remove it with tweezers.
Once the tick is removed, clean the bite area and your hands with rubbing alcohol or soap and water.
Factors that may cause your provider to prescribe prophylactic antibiotics—that is, those given when there’s just a potential for tick-borne illness—include:
If you’ve been diagnosed with Lyme disease but still experience symptoms after completing antibiotic treatment, talk to your healthcare provider. Additional treatment may be required.
Complications resulting from Lyme disease include PTLDS, which does not respond to treatment but often resolves on its own. Lyme carditis occurs in 1% of cases and may require additional medication or a temporary pacemaker, but most people recover completely.
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Moore A, Nelson C, Molins C, Mead P, Schriefer M.Current Guidelines, Common Clinical Pitfalls, and Future Directions for Laboratory Diagnosis of Lyme Disease, United States. Emerg Infect Dis. 2016 Jul;22(7):1169–77. doi: 10.3201/eid2207.151694Centers for Disease Control and Prevention.Treatment of Lyme disease.Centers for Disease Control and Prevention.How many people get Lyme disease?.Sanchez E, Vannier E, Wormser GP, Hu LT.Diagnosis, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: a review.JAMA. 2016;315(16):1767-1777. doi:10.1001/jama.2016.2884American Academy of Pediatrics.When can doxycycline be used in young children?Shapiro ED.Borrelia burgdorferi (Lyme disease).Pediatr Rev. 2014;35(12):500-9. doi:10.1542/pir.35-12-500Hofhuis A, van de Kassteele J, Sprong H, et al.Predicting the risk of Lyme borreliosis after a tick bite, using a structural equation model.PLoS One. 2017;12(7):e0181807. Published 2017 Jul 24. doi:10.1371/journal.pone.0181807National Institute of Neurological Disorders and Stroke.Neurological complications of Lyme disease information page.National Institute of Allergy and Infectious Diseases.Chronic Lyme Disease.Ścieszka J, Dąbek J, Cieślik P.Post-Lyme disease syndrome.Reumatologia. 2015;53(1):46-48. doi:10.5114/reum.2015.50557Centers for Disease Control and Prevention.Post-treatment Lyme disease syndrome.Centers for Disease Control and Prevention.Lyme carditis.John Hopkins Medicine.Ticks and Lyme disease.Centers for Disease Control and Prevention.Preventing tick bites on people.Centers for Disease Control and Prevention.Lyme disease: transmission.Centers for Disease Control and Prevention.Tick removal and testing.Centers for Disease Control and Prevention.Lyme disease prophylaxis after tick bite.
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Moore A, Nelson C, Molins C, Mead P, Schriefer M.Current Guidelines, Common Clinical Pitfalls, and Future Directions for Laboratory Diagnosis of Lyme Disease, United States. Emerg Infect Dis. 2016 Jul;22(7):1169–77. doi: 10.3201/eid2207.151694Centers for Disease Control and Prevention.Treatment of Lyme disease.Centers for Disease Control and Prevention.How many people get Lyme disease?.Sanchez E, Vannier E, Wormser GP, Hu LT.Diagnosis, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: a review.JAMA. 2016;315(16):1767-1777. doi:10.1001/jama.2016.2884American Academy of Pediatrics.When can doxycycline be used in young children?Shapiro ED.Borrelia burgdorferi (Lyme disease).Pediatr Rev. 2014;35(12):500-9. doi:10.1542/pir.35-12-500Hofhuis A, van de Kassteele J, Sprong H, et al.Predicting the risk of Lyme borreliosis after a tick bite, using a structural equation model.PLoS One. 2017;12(7):e0181807. Published 2017 Jul 24. doi:10.1371/journal.pone.0181807National Institute of Neurological Disorders and Stroke.Neurological complications of Lyme disease information page.National Institute of Allergy and Infectious Diseases.Chronic Lyme Disease.Ścieszka J, Dąbek J, Cieślik P.Post-Lyme disease syndrome.Reumatologia. 2015;53(1):46-48. doi:10.5114/reum.2015.50557Centers for Disease Control and Prevention.Post-treatment Lyme disease syndrome.Centers for Disease Control and Prevention.Lyme carditis.John Hopkins Medicine.Ticks and Lyme disease.Centers for Disease Control and Prevention.Preventing tick bites on people.Centers for Disease Control and Prevention.Lyme disease: transmission.Centers for Disease Control and Prevention.Tick removal and testing.Centers for Disease Control and Prevention.Lyme disease prophylaxis after tick bite.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Moore A, Nelson C, Molins C, Mead P, Schriefer M.Current Guidelines, Common Clinical Pitfalls, and Future Directions for Laboratory Diagnosis of Lyme Disease, United States. Emerg Infect Dis. 2016 Jul;22(7):1169–77. doi: 10.3201/eid2207.151694Centers for Disease Control and Prevention.Treatment of Lyme disease.Centers for Disease Control and Prevention.How many people get Lyme disease?.Sanchez E, Vannier E, Wormser GP, Hu LT.Diagnosis, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: a review.JAMA. 2016;315(16):1767-1777. doi:10.1001/jama.2016.2884American Academy of Pediatrics.When can doxycycline be used in young children?Shapiro ED.Borrelia burgdorferi (Lyme disease).Pediatr Rev. 2014;35(12):500-9. doi:10.1542/pir.35-12-500Hofhuis A, van de Kassteele J, Sprong H, et al.Predicting the risk of Lyme borreliosis after a tick bite, using a structural equation model.PLoS One. 2017;12(7):e0181807. Published 2017 Jul 24. doi:10.1371/journal.pone.0181807National Institute of Neurological Disorders and Stroke.Neurological complications of Lyme disease information page.National Institute of Allergy and Infectious Diseases.Chronic Lyme Disease.Ścieszka J, Dąbek J, Cieślik P.Post-Lyme disease syndrome.Reumatologia. 2015;53(1):46-48. doi:10.5114/reum.2015.50557Centers for Disease Control and Prevention.Post-treatment Lyme disease syndrome.Centers for Disease Control and Prevention.Lyme carditis.John Hopkins Medicine.Ticks and Lyme disease.Centers for Disease Control and Prevention.Preventing tick bites on people.Centers for Disease Control and Prevention.Lyme disease: transmission.Centers for Disease Control and Prevention.Tick removal and testing.Centers for Disease Control and Prevention.Lyme disease prophylaxis after tick bite.
Moore A, Nelson C, Molins C, Mead P, Schriefer M.Current Guidelines, Common Clinical Pitfalls, and Future Directions for Laboratory Diagnosis of Lyme Disease, United States. Emerg Infect Dis. 2016 Jul;22(7):1169–77. doi: 10.3201/eid2207.151694
Centers for Disease Control and Prevention.Treatment of Lyme disease.
Centers for Disease Control and Prevention.How many people get Lyme disease?.
Sanchez E, Vannier E, Wormser GP, Hu LT.Diagnosis, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: a review.JAMA. 2016;315(16):1767-1777. doi:10.1001/jama.2016.2884
American Academy of Pediatrics.When can doxycycline be used in young children?
Shapiro ED.Borrelia burgdorferi (Lyme disease).Pediatr Rev. 2014;35(12):500-9. doi:10.1542/pir.35-12-500
Hofhuis A, van de Kassteele J, Sprong H, et al.Predicting the risk of Lyme borreliosis after a tick bite, using a structural equation model.PLoS One. 2017;12(7):e0181807. Published 2017 Jul 24. doi:10.1371/journal.pone.0181807
National Institute of Neurological Disorders and Stroke.Neurological complications of Lyme disease information page.
National Institute of Allergy and Infectious Diseases.Chronic Lyme Disease.
Ścieszka J, Dąbek J, Cieślik P.Post-Lyme disease syndrome.Reumatologia. 2015;53(1):46-48. doi:10.5114/reum.2015.50557
Centers for Disease Control and Prevention.Post-treatment Lyme disease syndrome.
Centers for Disease Control and Prevention.Lyme carditis.
John Hopkins Medicine.Ticks and Lyme disease.
Centers for Disease Control and Prevention.Preventing tick bites on people.
Centers for Disease Control and Prevention.Lyme disease: transmission.
Centers for Disease Control and Prevention.Tick removal and testing.
Centers for Disease Control and Prevention.Lyme disease prophylaxis after tick bite.
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