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The Stages of Lyme Disease

Lyme disease occurs in three stages: early localized, early disseminated, and late disseminated. However, the stages can overlap, and not all patients go through all three. A bulls-eye rash is usually considered one of the first signs of infection, but many people develop a different kind of rash or none at all. In most cases, Lyme symptoms can start with a flu-like illness. Untreated Lyme disease symptoms can continue to worsen and turn into a long-lived debilitating illness affecting the neurological, cardiac, and immune systems of patients. Understanding the progression of Lyme disease and its potential complications is crucial in order to emphasize the importance of early detection and treatment.

Understanding Lyme Disease Stages and When Symptoms of Lyme Disease Appear

Stage 1 Lyme Disease: Early Localized Disease

Early symptoms with localized (or acute) Lyme disease may begin hours, a few days, or even weeks after a deer tick bite. At the point of initial infection, the Lyme disease bacterium has not yet spread throughout the body. Lyme is the easiest to cure at this stage with help from your health care provider, a blood test, and antibiotic treatment (available as both oral antibiotics or intravenous antibiotics).

Early Stage Symptoms may include:

Early Stages of Lyme Disease
  • Erythema Migrans skin rash (EM rash), which may or may not look like a bull’s eye
  • flu-like illness, including chills and fever
  • fatigue
  • headache and stiff neck
  • muscle soreness and joint pain
  • swollen lymph nodes
  • sore throat
Stage 2 Lyme Disease: Early Disseminated Lyme

Early disseminated Lyme may occur several weeks or months after the black-legged tick bite. The bacterium Borrelia burgdorferi is beginning to spread throughout the body. In addition to flu-like symptoms, this stage is often characterized by an increase in typical symptoms such as:

  • chills
  • fever
  • headaches
  • fatigue
  • pain, weakness or numbness in the arms, legs
  • vision changes
  • Lyme carditis, heart problems, such as palpitations, chest pain
  • rash may appear on body
  • facial paralysis (Bell’s palsy)
Stage 3 Lyme Disease: Late Disseminated Lyme Disease

Many have asked, do you ever get rid of Lyme disease or other tick-borne illnesses? Do I have chronic Lyme disease? Can Lyme disease return? If Lyme disease isn’t promptly or effectively treated in the first two stages, late disseminated (post-treatment, chronic, or neurological) Lyme occurs weeks, months, or even years after the infected tick bite. The bacterial infection has spread throughout the body and nervous system, and many untreated patients develop chronic Lyme arthritis as well as an increase in neurological and cardiac symptoms. In later stages of infection, more severe Lyme disease symptoms may include:

  • arthritis in large joints or near the point of infection
  • severe headaches or migraines
  • vertigo, dizziness
  • migrating pains that come and go in joints/tendons
  • stiff, aching neck
  • chronic fatigue syndrome
  • sleep disturbances, insomnia
  • disturbances in heart rhythm
  • mental fogginess, concentration issues
  • numbness in the arms, legs, hands or feet
  • problems following conversations and processing information
  • severe fatigue

Lyme disease presents itself in three stages, with symptoms varying in severity. However, the best approach to Lyme disease should focus on prevention rather than treatment. To minimize the risk of infection, especially in wooded areas or during outdoor activities, it is essential to prioritize protective measures. This includes wearing long-sleeved shirts and light-colored clothing and using insect repellent to deter ticks. By focusing on disease control through awareness and prevention, we can effectively reduce the chances of Lyme disease and its debilitating consequences.

Learn more

Lyme Disease Symptoms  

Find a Doctor

Lyme Disease Treatment

Lyme Symptom Tracker App
About Lyme Disease Testing

All About Ticks
How to Prevent Lyme Disease

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