Tick Bites: How to Recognize the Signs of a Tick Bite Rash (With Pictures)

Tick bites are common nuisances, especially for people who hike, garden, or spend time outdoors. Fortunately, most tick bites aren’t serious. But about 500,000 tick bites result in illness every year in the U.S. — and the number of new illnesses is rising. About 80% of those illnesses are due to Lyme disease. 

The best way to know if you’ve been bitten by a tick is to do a “tick check” after being in a tick-prone area. To do a tick check, carefully scan your entire body for ticks. This is important because quick removal of a tick can prevent disease. In fact, your risk of Lyme disease is much lower if the tick is removed in fewer than 36 hours.

Even if you don’t see the actual tick on your body, you should know what a tick bite looks like and be on the lookout for symptoms. Early treatment of tick bites can prevent illness or reduce the risk of serious complications. 

What do tick bites on humans look like?

Tick bite marks on humans can vary in appearance and can change over time. The first signs of a tick bite are skin changes related to the actual bite. These include things like: 

• A small pinprick or a black dot

• A small nodule (lump) that’s skin-colored, brown, or reddish

• A blistered area

• A small bruise

• Changes in skin color (red, brown, or dark purple)

• Swelling or a sore on the skin

• Bull’s-eye rash 

• Small pink, violet, or brown skin patches, especially on the hands, arms, and feet 

• A tick head stuck in the skin

• An allergy to meat and dairy (called alpha-gal syndrome)

Most tick bites are harmless, and these skin changes usually go away on their own in about a week. But some tick bites can cause serious illness, including the most common one, Lyme disease. 

Is it Lyme disease or a normal tick bite?

Not all tick bites lead to Lyme disease. One of the first signs of Lyme disease is the bull’s-eye rash, which happens in about 3 in 4 people. This round rash develops within 30 days of the tick bite.

It starts as a round spot and then slowly grows into a larger circle. Sometimes, it forms a ring (which makes it look like a bull’s-eye). In fair skin, the rash is usually red. But in darker skin, it may appear brown or purple, or it can even look like a bruise.

Here are some Lyme disease rash pictures on different skin tones.

Close-up of a bulls-eye rash.

Lyme disease rash can be faint and doesn’t always form a bulls-eye pattern.

In darker skin, the rash from Lyme disease may appear as a darker brown rim with a lighter center.

The rash from Lyme disease can be faint and harder to see on darker skin.

How to check for ticks

If you’ve been in a grassy or tree-covered area, you should always do a tick check to look for ticks on your skin. You can usually identify a tick by its size, shape, and color. They’re usually brown or black, no bigger than an apple seed, and oval in shape. 

EXPERT PICKS: WHAT TO READ NEXT

• What is Lyme disease? Learn what you need to know about this tick-borne illness, including how it’s diagnosed and treated. 

• Removing a tick from your skin: Read our step-by-step guide on how to safely remove a tick from your skin. 

• Other tick-borne diseases: Other than Lyme disease, learn what other common diseases can be caused by tick bites.

Ticks like warm, moist areas, so it’s especially important to check the following parts of your body: 

• Scalp 

• Armpits 

• Around the ears 

• Around the waist 

• Inside your belly button

Are there other tick-bite symptoms to look for?

Besides a rash, other symptoms of tick-borne illnesses can develop over time. Symptoms may not show up for days to weeks after a tick bite. They can include:

• Fever

• Chills

• Muscle and joint aches

• Headache

• Rash

• Weakness that spreads up the body (very rare)

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Keep in mind that you might not know if you’ve been bitten by a tick. You might not develop a rash. And the tick may fall off before you see it. If you’ve been in an area where ticks live, you should think about the possibility of a tick bite and seek medical care if any symptoms pop up. 

Tick-borne illnesses

There are hundreds of different kinds of ticks, and most don’t cause disease. Lyme disease is the most common tick-borne disease. Other illnesses that can be caused by different ticks include: 

• Babesiosis

• Rocky Mountain spotted fever (RMSF)

• Southern tick-associated rash illness (STARI) 

• Tularemia 

• Alpha-gal syndrome 

• Ehrlichiosis 

• Anaplasmosis

• Tick-borne relapsing fever (TBRF)

Should I worry about a tick bite?

Most tick bites are harmless. But there are some serious illnesses that can happen after a tick bite. Ticks aren’t dangerous themselves, but they can harbor dangerous microorganisms. In fact, ticks carry germs that cause over 15 different illnesses in the U.S. 

Depending on where you live, you may be more likely to get certain tick-borne illnesses. Ticks live around the world and across the U.S. 

Here are some of the most common tick-borne infections and where in the U.S. they happen:

• Lyme disease: mostly in the Northeast, Upper Midwest, and the Pacific West Coast

• Rocky Mountain spotted fever: most common in North Carolina, Tennessee, and surrounding states 

• Tularemia: across the U.S.

• Ehrlichiosis: mostly in South Central and Eastern U.S.

• Anaplasmosis: mostly in the Northeast, Upper Midwest, and Pacific West Coast

• Babesiosis: mostly in the Northeast and Upper Midwest

• Tick-borne relapsing fever: rare, but has been reported mainly in the western U.S. 

What can be mistaken for a tick bite?

When a tick is still attached to the skin, it may be mistaken for an odd mole or an enlarged blood vessel. Tick bites can also be mistaken for other skin conditions, especially if you didn’t see the tick attached to your skin. 

Some conditions a tick bite can be mistaken for include:

• Insect bites

• Skin infection (cellulitis)

• A reaction to a medication

• Ringworm 

• Pityriasis rosea

• Granuloma annulare

• Hives 

When to see a doctor for a tick bite

If you’re anxious about a tick bite, it’s always a good idea to make a healthcare appointment for reassurance or guidance. If you find a tick attached to your skin, you should carefully remove it and take a picture of the tick. The picture will help a healthcare professional make a diagnosis if you develop symptoms. 

Seek medical attention if you develop any of these symptoms within 30 days of a tick bite:

• Signs of infection (redness, swelling, pain, warmth, drainage)

• Rash

• Joint or muscle pain

• Flu-like symptoms (headache, fatigue, weakness, or fever)

• Nausea, vomiting, or diarrhea

You should call 911 immediately if you experience any signs of a serious allergic reaction, like trouble breathing, nausea or vomiting, or hives.

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Why trust our experts?

Written by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

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