GoodRx Guide
Lyme Disease: Your GoodRx Guide
Comprehensive information for you or a loved one — including treatment options and discounts on popular medications.
Definition
Lyme disease is an illness spread by ticks. The bacteria Borrelia burgdorferi usually causes it. A bite from an infected tick spreads the bacteria to humans or animals and causes Lyme disease. Lyme disease is the most common tick-borne infection in the U.S.
It’s difficult to know exactly how many Americans get Lyme disease each year because of how the information is reported. But, according to estimates from the CDC, every year about 476,000 people are diagnosed and treated for Lyme disease in the U.S.
People with Lyme disease can have different symptoms, ranging from mild to severe. The good news is antibiotics can treat Lyme disease. And you can even prevent it from happening by taking steps to avoid tick bites.
Causes
Lyme disease happens in nearly every state, but it’s more common in certain parts of the U.S. Most cases occur in Northeastern and mid-Atlantic states as well as in Wisconsin and Minnesota. Lyme disease also happens on the West Coast — in California, Washington, and Oregon.
Blacklegged ticks spread Lyme disease. Ixodes pacificus is the type of tick that spreads the disease on the West Coast. In the rest of the country, it’s Ixodes scapularis.
These ticks are very small and dark in color, so it can be hard to see them on your skin. They live in wooded, grassy, or brushy areas. So if you spend time outside — especially during warmer months — you may run into ticks.
Anyone can get Lyme disease if an infected tick bites them. Most cases happen in children between 5 to 14 years old and adults over age 40. The good news is not all ticks are infected, and not all tick bites cause Lyme disease. There are also steps you can take to prevent tick bites when you’re outdoors (more on this below).
Symptoms
There are different stages of Lyme disease based on how advanced the infection is. Each stage has different symptoms, but there can be overlap between stages.
Early localized disease
Early localized disease is the first stage of Lyme disease, and it usually starts within 1 month of a tick bite. Symptoms may include:
Fever and chills
Muscle and joint pain
Headache
Fatigue
Swollen lymph nodes
Neck stiffness
In this early stage, a red rash in the shape of a bullseye (erythema migrans) may appear on the skin at the location of the tick bite.
Early disseminated disease
Early disseminated disease occurs weeks to months after the tick bite. This stage is more serious and has symptoms that can affect the nervous system or heart. In this stage, erythema migrans can spread and cause many bullseye lesions on the skin.
Late Lyme disease
Late Lyme disease happens months to years after the tick bite. The most common problem in this stage is arthritis that causes joint pain and swelling. Lyme disease can also affect the nervous system in this late stage.
Knowing these symptoms can help to avoid the more serious, late-stage effects. Early treatment can prevent Lyme disease from progressing.
Diagnosis
It’s a good idea to see your primary healthcare provider if you get a tick bite in a region where Lyme disease is common — especially if you develop symptoms after the bite.
If you have symptoms of early localized Lyme disease, your healthcare provider can often start treatment without running any tests.
There’s testing for Lyme disease, but it doesn’t always lead to a clear diagnosis. This is because it involves looking for antibodies in the blood. Antibodies are special molecules your immune system makes to fight an infection. In early-stage Lyme disease, shortly after a tick bite, testing can be negative because the body is still making antibodies. So it’s too early for the test to detect them.
On the other hand, after you’ve had Lyme disease, you can test positive for antibodies for many years — even after the infection is gone. And because you can get Lyme disease more than once, this makes it hard to tell the difference between a prior infection and a new infection.
Scientists can test ticks to identify the species, but experts don’t recommend testing a tick for Lyme disease. This is because even if the tick is infected, it may not have spread the infection to you.
Medications
Prescription antibiotics can treat Lyme disease. Treatment for early-stage Lyme disease uses one of the following antibiotics:
Doxycycline (Monodox)
Amoxicillin (Amoxil)
Another option is azithromycin (Zithromax), but it isn’t a top choice.
These antibiotics come as a pill you take by mouth. Treatment takes 7 to 14 days depending on the medication. The choice of antibiotic (and how long you need to take it) depends on what symptoms and stage of Lyme disease you have. Other considerations include medication allergies, side effects, and cost.
Longer courses of antibiotic treatment are necessary when Lyme disease affects the heart or nervous system, or when it causes arthritis. Treatment with the above antibiotics takes 14 to 28 days in these more advanced cases. Ceftriaxone (Rocephin) is the top choice when someone needs intravenous (IV) treatment for more serious symptoms.
Prevention
To get Lyme disease, an infected tick must bite you. So the best way to prevent Lyme disease is to prevent tick bites. To do this you need to prevent ticks from getting on your skin. The good news is there are steps you can take if you know you’ll be outside where there are ticks.
Follow these tips to reduce your risk:
Stay on trails and walkways. Avoid walking in tall grass or brush where ticks live.
Wear appropriate clothing. Long sleeves, pants, and closed shoes keep ticks off your skin. Wearing light colors helps you spot ticks more easily.
Use insect repellent. You can treat your clothing with permethrin before outdoor activities. Use the U.S. Environmental Protection Agency’s search tool to find the right insect repellent for you.
Do a tick check. After being outside, check yourself, children, and pets for ticks on clothing and skin.
Take a shower. Showering within 2 hours of being outside helps remove unattached ticks from your body.
Wash clothing and equipment. Washing clothing in hot water and/or drying on high heat for at least 10 minutes kills ticks
Common concerns
If a tick bites you, remove it right away. The longer the tick is attached, the greater the chance of it transmitting Lyme disease (if it’s infected).
Once you remove the tick, put it in a sealed bag or container. After a tick bite you may be able to take a one-time dose of the oral antibiotic doxycycline monohydrate (Monodox) to prevent Lyme disease. This depends on how long the tick was attached, when you removed it, and where (geographically) you got the bite. Talk to your healthcare provider to see if this is right for you.
Is Lyme disease contagious?
No, Lyme disease is not contagious. To get Lyme disease, an infected tick must bite you. If you have Lyme disease, you can’t spread it to another person or animal (or vice versa).
Antibiotics can cure Lyme disease, and most people do well after completing treatment. Post-Treatment Lyme Disease Syndrome (PTLDS) can develop when someone has symptoms for more than 6 months after treatment. There’s no known treatment for PTLDS, and its cause is unknown. The good news is people often feel better over time, although it may take many months.
If Lyme disease goes untreated, symptoms can get worse. Diagnosing and treating Lyme disease early prevents progression to later stages. Antibiotics can still treat late-stage Lyme disease, but the symptoms are more serious and recovery may take longer.
References
Centers for Disease Control and Prevention. (2011). Tick-borne diseases.
Centers for Disease Control and Prevention. (2019). Tick bite prophylaxis.
Centers for Disease Control and Prevention. (2020). Lyme disease rashes and look-alikes.
Centers for Disease Control and Prevention. (2021). How many people get Lyme disease?
Centers for Disease Control and Prevention. (2021). Lyme arthritis.
Centers for Disease Control and Prevention. (2021). Lyme disease data tables: Most recent year.
Centers for Disease Control and Prevention. (2021). Lyme disease maps: Most recent year.
Centers for Disease Control and Prevention. (2021). Neurologic Lyme disease.
Centers for Disease Control and Prevention. (2022). Lyme carditis.
Centers for Disease Control and Prevention. (2022). Lyme disease.
Lantos, P. M., et al. (2020). Clinical practice guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 guidelines for the prevention, diagnosis and treatment of Lyme disease. Clinical Infectious Diseases.
