Recognizing Lyme disease after a tick bite: migratory redness, skin rashes & more

Tick bite and now? Typical symptoms of Lyme disease 

It can happen so quickly. While hiking in the forest or walking in tall grass - and a tick has attached itself unnoticed. A single bite is enough to transmit pathogens such as Borrelia bacteria.

That's why you need to pay attention: from removing the tick correctly to carefully observing the site of the bite in the following days. If a so-called migratory redness, a ring-shaped, spreading rash with a pale center (the so-called bull's-eye pattern) appears around the bite site or if other symptoms occur, medical advice should be sought immediately.

Symptoms of Lyme disease:

• Migratory redness
• Fever
• Headache
• Muscle & joint pain
• Fatigue
• Sweating
• Gastrointestinal complaints
• Swelling of the lymph nodes

Treatment of Lyme disease

Lyme disease is usually treated with antibiotics and the infections mostly heal without consequences. However, it can also occur that an initial antibiotic treatment does not work properly, in which case a different antibiotic must be used.

Lyme disease symptoms can also subside without antibiotics, but the risk of a severe course is higher. If the pathogen spreads further in the body, burning pain occurs at the site of the bite. The bacteria infect the nervous system, which can lead to paralysis, especially in the face, neuritis or meningitis. A few months to years after a tick bite with infection, joint inflammation and swelling may also occur. These can lead to chronic inflammation of the skin and heart problems.

When the risk of infection is particularly high 

Lyme disease is the most common tick-borne infection and is usually diagnosed in spring or early summer. The risk of contracting Lyme disease depends primarily on the age and size of the tick and how long the tick has been attached to the skin. The longer the tick has been sucking blood, the higher the risk of infection. According to the BMSGPK, however, in over 85% of all patients the only reaction to a tick bite is the appearance of redness.

Recognizing Lyme disease without erythema

In individual cases, Lyme disease can also occur without migratory erythema. If flu-like symptoms occur within six weeks of an infection from a tick bite, as is the case with migratory erythema, it may also be a Borrelia infection. 

In any case, such symptoms should be taken seriously even without visible redness and a doctor should be consulted. Early diagnosis is crucial to prevent serious long-term consequences, such as chronic inflammation of the skin.

Which skin rashes are similar to migratory erythema?

In addition to tick bites, there are other causes of similar skin rashes. Some rashes have comparable characteristics to erysipelas: 

• Ringworm (tinea corporis) 
  Trigger: fungal infection of the skin
  Transmission: Fungus is transmitted from the skin of animals or humans via moist or injured skin layers in direct contact or via contaminated objects
  Rash: ring-shaped rash with scaly edges, paler in the center, itchy
  Difference: scaly

• Other insect bites (gadfly or horsefly bites) 
  Trigger: horsefly or gadfly bite
  Transmission: saliva of the gadfly or horsefly is released into the skin via the bite 
  Rash: reddened, swollen and itchy area 
  Difference: localized redness, not ring-shaped around the bite

• Hives (urticaria) 
  Trigger: can occur acutely or chronically, allergic reaction (pollen), infections, medication or physical stimuli (UV light, heat, cold) 
  Rash: itchy pale to reddish wheals, coin-sized swellings
  Difference: rash over a large area, wheals

If you are still unsure about the cause of sudden reddening of the skin, consult your doctor or obtain information from pharmacies in your area. On APO24 you will find the opening hours and on-call services of Austrian pharmacies.

Your APO24 team