Media Centre: Lyme disease symptoms

Lyme disease symptoms develop 3 days to 3 months after being infected.

The first symptoms are often similar to flu – fevers, night sweats, extreme tiredness, swollen glands, muscle and joint pain, nausea, a stiff neck and headaches.

A flat, reddish rash known as erythema migrans is thought to occur in two thirds of patients. At least a third of patients never have any rash at all. Erythema migrans is not usually itchy and not painful, it spreads out and may develop a central clearing or rings like a target. In some people it becomes large but in others it can remain just a few centimetres across. On dark skin it resembles a bruise.

Non-specific symptoms are very common in Lyme disease, including:

  • Flu-like symptoms such as fever, swollen glands, night sweats and tiredness; these can be mild or very severe;
  • Joint or muscle pain; joint pain can be noticed in one joint and then switch to different joints in a short space of time; over time, joint infection can lead to arthritis in one or more joints; muscle pain typically affects all large muscle sets and is particularly noticed in the arms and legs;
  • Neck pain or stiffness;
  • Memory problems or trouble concentrating; this is different from general absent-mindedness and can involve forgetting entire skill sets, people, or periods of time;
  • Headache; this can take the form of cluster headaches which are present for days, weeks or longer;
  • Other neurological symptoms; what the patient feels can include pain, numbness or paralysis, often on one side or sometimes in one random part of the body;  tingling or pins and needles; twitching; some people become abnormally sensitive to light, sounds or even smells; some people develop intermittent eyesight problems.

Unusual symptoms occur in a small percentage of Lyme disease patients, such as:

  • Facial paralysis, usually only on one side, called Bell’s Palsy;
  • Heart arrhythmia, which means irregular heartbeat, which can be life threatening. The commonest known type of arrhythmia associated with Lyme disease is called “heart block” but Lyme disease can cause other types of arrhythmia too;
  • Encephalitis, which means a swollen brain; this requires treatment in hospital in its acute form, but it can also occur in a milder form which causes very severe headache but is difficult to diagnose;
  • Psychosis, or other acute mental symptoms;
  • Lymphocytoma is a symptom of Lyme disease on the skin, which occurs typically on the earlobe, scrotum or nipple, but can appear elsewhere on the body.

Acrodermatitis Chronica Atrophicans (ACA), is unique to Lyme disease and can occur in people who have been infected with Lyme disease for many years. It occurs particularly on the palms of the hands and soles of the feet; it begins with painful inflammation of the skin (called “acrodermatitis”) which lasts months or years, often with bluish red discolouration, and ultimately leads to thinning of the skin ‘like tissue paper’ (called skin “atrophy”).

Some patients experience a delayed recovery from Lyme disease symptoms, after their antibiotic treatment has ended. Sometimes symptoms do not resolve.


DISCLAIMER: Caudwell LymeCo charity shares public domain  information, which it believes to be reliable, in good faith. It should never replace the advice of a qualified physician with a license to practise medicine. If you believe any information on this website to be incorrect, you are invited to contact the charity using the Contact page.