Lyme Disease Doctor

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Lyme Disease Rash

Written by Dr. Diane Mueller

The Lyme Disease Rash is classically in a bullseye type of pattern. This often times looks like a red dot in the center with concentric rings around it. Lesions can also occasionally have a puss filled center. Common places where people find this rash include the trunk, legs and arms. It is important to realize that the rash can be on the scalp, hidden beneath the hair where it can easily be missed. It can show up in as little as 3-day post an insect bite but may be as many as 30 days. Some reports even show that the rash can show up within 24 hours of infections. (Lyme Disease is basically a bacterial infection caused by the bacteria Borrelia Burgdorferi) Lyme Disease Rash may occasionally look purplish.

There often are multiple rashes present with Lyme Disease. The rash could present in one place or in many.  For more information on Lyme Disease and to get help, visit our main page HERE.

Lyme Disease Rash

The dissemination of multiple rashes throughout the body may be due to Borrelia’s ability to move throughout the body very easily. This microorganism is in the shape of a corkscrew and has a flagella (tail), which allows it to travel easily through body tissue. Occasionally it is not in target lesion formation and may just be a flat red rash. It tends to be fairly large. The rash can be painful, but generally the pain is minor if it is present at all. The rash may be itchy.

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Ringworm and allergic types of reactions can look similar to the Lyme Disease rash. Also many type of insects will leave bite marks in the middle of a rash. You can certainly sometimes find this with the Lyme Disease rash, but other insects can cause a similar appearance. This is why if you see a rash it is important not to jump to conclusions, but instead get proper testing done in order to determine if it is indeed Lyme Disease. You can see our page on Lyme Disease Testing for more information on this topic. Testing is horribly unreliable and there are some tests on the market that are substantially better for diagnosis than others. This is super important information to consider as if you do some of the standard preliminary tests for Lyme Disease, there is a really high chance of a false negative. If you are considering testing for Lyme Disease, definitely read our article on proper testing.
While some preliminary studies on the classic Lyme Disease Rash (known medically as erythema migrans) illustrated that the rash was present in almost all cases of Lyme Disease, later studies have shown this not to be true. It may be as low as even 25% of those infected with Lyme Disease truly develop the Lyme Disease rash. Most commonly, early symptoms also present with fever and achiness. Because of the symptomatic similarity, in some people, this may initially look like the flu. When missed in its early stages, it can go dormant and months or years later, lead to the development of neurological symptoms, cardiac symptoms, pain, fatigue, fibromyalgia and more. Cognitive decline is also associated with long term Lyme Disease.

At our medical clinic, most of the people that we find positive for Lyme Disease through testing do not remember a tick bit or ever having the classic Lyme Disease Rash. 

If you see a target lesion looking type of rash, it is worth getting checked out. However, if you have neurological, cardiac, cognitive or other systemic health problems without a known origin, it is important to consider Lyme Disease as part of the diagnosis.

It is also important to realize that Lyme Disease is classically caused by the bacteria borrelia burgdorferi, but that there are many other species of borrelia. While borrelia burgdorferi may cause this rash, some other species of borrelia may not. These other types of borrelia are also spread by ticks as well as other insect bites. The Lyme Disease rash is non-contagious. You do not need to be concerned about contracting Lyme (or spreading) through skin to skin contact. Lyme is also not spread through saliva or kissing.

For more information on the topic of Lyme Disease Rash, see our other blogs:

And always remember to be an advocate for yourself. The medical community is really just beginning to understand Lyme Disease and there is a lot of inaccurate information out there. Many people are told that they do not have Lyme Disease because of improper tests being ordered. Working with a Lyme Literate Doctor is essential for your proper diagnosis and recovery.

Murray TS, Shapiro ED. Lyme disease. Clin Lab Med. 2010 Mar;30(1):311-28. doi: 10.1016/j.cll.2010.01.003. PMID: 20513553; PMCID: PMC3652387.

Skar GL, Simonsen KA. Lyme Disease. [Updated 2022 May 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:

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