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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, for the typical rash and early symptoms after a tick bite; facial weakness, joint or heart problems need in-person care.
- What it is: a bacterial infection passed on by the bite of an infected tick. Most tick bites do not cause it.
- The rash: a red or pink patch that slowly spreads out from the bite, usually 1 to 4 weeks later, and sometimes up to 3 months later.
- Treatment: a course of antibiotics, usually for 3 weeks. Treatment works best when it starts early.
- Emergency: call 112 for a severe headache with a stiff neck, new confusion or weakness, fainting, chest pain or breathlessness.
Do not book a video appointment if you have a severe headache with a stiff neck or a dislike of bright light, new confusion, weakness or a seizure, fainting, chest pain or breathlessness. Call 112 or go to an emergency department. A face that suddenly droops on one side needs urgent in-person assessment, because a stroke has to be ruled out first.
Can an online doctor treat Lyme disease?
Yes, for most people. The typical Lyme disease rash, called erythema migrans, is diagnosed from how it looks and when it appeared, without a blood test, which works well on camera. A doctor by video can confirm it, prescribe antibiotics and follow it up. Lyme disease without a rash usually needs blood tests, and facial weakness, a swollen joint or heart symptoms need an in-person assessment.
How an online consultation helps with Lyme disease
- The rash, not just the bite: The doctor tells the slowly spreading Lyme rash apart from the itchy bump of a normal bite reaction, a skin infection or ringworm.
- Your timeline checked: When and where you were outdoors, and when the rash appeared, because the timing points to the diagnosis.
- Antibiotics when they help: A full course for a typical rash, chosen after the doctor checks pregnancy, allergies and your other medicines.
- A plan for the weeks ahead: What to expect while the rash fades, which symptoms to report, and when blood tests are needed.
What the doctor checks in an online Lyme disease consultation
The consultation starts with the signs that need urgent care, then the rash and your timeline. The doctor asks about:
- Warning signs: a severe headache, a stiff neck, facial weakness, numbness or shooting pains, palpitations, fainting, chest pain or breathlessness.
- The rash: where it is, when it appeared, whether it is spreading, and whether there is more than one patch.
- The tick bite: when and where you spent time in woods, parks or long grass, whether you saw a tick, and how long it may have been attached.
- Other symptoms: a high temperature, tiredness, headache, and aching muscles or joints.
- Your health: pregnancy, allergies, long-term conditions and the medicines you take.
Before the call, take photos of the rash a day or two apart with a coin next to it, so the doctor can see whether it is spreading, and note the dates you spent time outdoors.
What are the symptoms of Lyme disease?
Lyme disease usually starts with a rash around the tick bite. Some people also get flu-like symptoms a few days or weeks after the bite: a high temperature, headache, muscle and joint pain, and tiredness. Not everyone gets a rash, or notices one.
Untreated, the infection can spread. Doctors describe three stages, which can overlap, and the later problems are more likely when treatment is delayed:
Swipe sideways to compare →
| Stage | When it usually appears | What you may notice | Care |
|---|---|---|---|
| Stage 1: the skin | 1 to 4 weeks after the bite, sometimes up to 3 months | A red or pink patch spreading slowly from the bite | Antibiotics, usually online |
| Stage 2: spreading | About 3 to 10 weeks after the bite | Flu-like illness, more than one patch of rash | Antibiotics, sometimes blood tests |
| Stage 2: nerves | Weeks to months after the bite | Facial weakness, shooting nerve pains, numbness, a severe headache | Urgent in-person care |
| Stage 2: heart | Weeks to months after the bite | Palpitations, dizziness, fainting, breathlessness | Urgent in-person care, or 112 |
| Stage 3: joints | About 2 to 12 months after the bite | A swollen, painful joint, often the knee | Blood tests and antibiotics |
| Stage 3: skin | Months to years after the bite | Discoloured, swollen skin on the hands, feet, elbows or knees | In-person assessment |
Nerve problems affect about 1 in 10 people with Lyme disease in Europe. The late skin form, acrodermatitis chronica atrophicans, is seen mainly in Europe, many months or years after the bite.
What does the Lyme disease rash look like?
The rash, called erythema migrans, is a circular or oval patch around the bite. It usually appears 1 to 4 weeks after the bite, can appear up to 3 months later, and gradually spreads over days to weeks. It can last several weeks.
- It may have a darker or lighter centre, the bullseye look, but many Lyme rashes are evenly coloured all over.
- It is flat or slightly raised, and not usually hot or itchy.
- On white skin it looks pink, red or purple. On brown and black skin it can be harder to see and may look like a bruise.
- A small red, itchy bump that appears within a day or two of the bite is a normal reaction to the bite, not Lyme disease.
Lyme disease rash or something else?
Swipe sideways to compare →
| Rash | When it appears | How it behaves | What it usually means |
|---|---|---|---|
| Normal bite reaction | Within hours to a day or two | A small, itchy bump that settles within days | No treatment needed |
| Lyme disease rash | 1 to 4 weeks after the bite, sometimes later | Spreads slowly over days to weeks; not usually itchy or painful | See a doctor: antibiotics |
| Infected bite | Within the first few days | Red, hot, swollen and increasingly painful, sometimes with pus | See a doctor |
| Ringworm | Any time | An itchy ring with a raised, scaly edge | Antifungal cream |
What is Lyme disease, and how do you catch it?
Lyme disease, also called Lyme borreliosis, is an infection with bacteria called Borrelia, passed on when an infected tick bites and feeds. It is the most common tick-borne infection in Europe. Ticks live in woodland, long grass and parks, and climb onto people and animals as they brush past. Tick bites are often painless, so many people never notice the tick.
- Most ticks do not carry it: about 12% of ticks in Europe, roughly 1 in 8, carry the bacteria. The share is thought to be about 5% in Ireland, and is highest in central Europe, over 20% of adult ticks, including Austria, Czechia, southern Germany, Switzerland, Slovakia and Slovenia.
- In the UK: higher-risk areas include grassy and wooded areas in southern England and the Scottish Highlands.
- When: most infections probably happen in late spring and early summer, but ticks can be active whenever the temperature is above freezing.
- Time attached: infected ticks are unlikely to pass on the bacteria in the first hours of feeding, and Lyme disease can be prevented if an infected tick is removed within 36 hours, so remove ticks as soon as you find them.
- Not contagious: there is no evidence that Lyme disease spreads through touching, kissing or sex. Pets do not pass it on directly, but they can bring ticks into the home.
How common is Lyme disease?
In England and Wales, 1,000 to 1,500 cases are confirmed by laboratory tests each year, and an estimated 1,000 to 2,000 more are diagnosed without a laboratory test. In a study of blood donors in England, about 0.5% had antibodies to the bacteria.
How to remove a tick safely, and what to do after a bite, is covered step by step on the tick bites page.
How is Lyme disease diagnosed?
The typical spreading rash after a tick bite is enough: doctors diagnose and treat it without a blood test. Without the rash, blood tests look for antibodies to the bacteria, and they can be negative in the first weeks of the illness:
Swipe sideways to compare →
| Situation | Test | What to know |
|---|---|---|
| A typical spreading rash after a tick bite | No test | Antibiotics start on the diagnosis alone |
| Symptoms that suggest Lyme disease, without the rash | An antibody blood test (ELISA) | Can be negative early on |
| A negative test within 4 weeks of the first symptoms, and Lyme disease still suspected | A repeat ELISA | Taken 4 to 6 weeks after the first test |
| A positive or uncertain ELISA | A confirming test (immunoblot) | Lyme disease is diagnosed when the symptoms fit and this test is positive |
| Symptoms for 12 weeks or more, and a negative ELISA | An immunoblot | Used when Lyme disease is still suspected |
A tick bite without symptoms is not diagnosed as Lyme disease: watch for a rash or illness over the next 3 months instead.
Is Lyme disease curable, and can it kill you?
Yes, it is curable. Diagnosed early, Lyme disease can be cured with antibiotics, and most people recover quickly and completely. People treated later also respond well, although some are left with long-term damage to the joints or the nerves. Without treatment, the infection can spread, and the stage 2 and 3 problems become more likely.
Can Lyme disease kill you?
Very rarely. Deaths have been reported from Lyme carditis, when the infection disturbs the heart’s electrical rhythm, but they are rare: serious heart block occurs in about 0.8% of the Lyme disease cases reported in the United States, and a 2013 CDC report described three sudden deaths there, adding to four reported before.
Which Lyme disease treatment might the doctor recommend?
Treatment depends on your symptoms, not on the bite alone. This is the framework the doctors use, in line with NICE and NHS guidance:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| A tick bite, no rash, feeling well | Remove the tick, and watch for a rash or illness for up to 3 months | Yes | Not needed |
| A red rash spreading from a tick bite | A course of antibiotics, without a blood test | Yes | Not usually needed |
| Flu-like illness after a tick bite, without a rash | Blood tests, and antibiotics if Lyme disease is likely | Yes, to assess | For blood tests |
| Facial weakness, shooting nerve pains or numbness | Urgent assessment and antibiotics | No | Urgent in-person care |
| A swollen, painful joint months after a bite | Blood tests, then a longer antibiotic course | Yes, to assess | For examination and tests |
| Palpitations, dizziness, fainting or breathlessness | Heart tests and antibiotics | No | Call 112 for fainting or chest pain |
Not sure whether your rash is Lyme disease? A doctor can look at it on camera in one consultation.
See available times →Treatment options for Lyme disease
What you can do yourself
- Remove any attached tick straight away with fine-tipped tweezers or a tick-removal tool, then clean the bite.
- Photograph the bite site, and the rash if one appears, every few days.
- Take paracetamol for aches and a high temperature, and rest.
- If you are prescribed antibiotics, finish the course even when the rash fades.
Prescription treatment
A prescription is never issued without a consultation. For a typical Lyme disease rash, the doctor may prescribe a course of antibiotics, usually for 3 weeks. Doxycycline is the usual first choice for adults, and amoxicillin or azithromycin are alternatives. In pregnancy, the doctor chooses an antibiotic suitable for the stage of pregnancy. Lyme arthritis is treated for longer, usually 4 weeks, and severe forms are treated in hospital with antibiotics into a vein. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
A tick bite without symptoms is not treated as Lyme disease: watch for a rash or illness instead. Private tests that have not been validated can give unreliable results, and treatments sold online without a medical assessment can be unproven, so speak to a doctor first.
What if symptoms continue after treatment?
Most people recover fully, although improvement can take months. Some people, an estimated 10 to 20%, still have symptoms such as tiredness, aches and a lack of energy more than 6 months after treatment. This is called post-treatment Lyme disease syndrome. The cause is not clear, there is no agreed treatment, and further antibiotics do not help it.
If symptoms come back or do not improve, see a doctor. The doctor looks for other causes, a new tick bite, or treatment that did not work, which may need a second course with a different antibiotic. After two complete courses, more antibiotics are not routinely recommended, and a specialist referral may help.
How to prevent Lyme disease
There is no vaccine against Lyme disease, so preventing tick bites, and removing ticks quickly, is what protects you:
- Cover your skin outdoors, and tuck your trousers into your socks.
- Use an insect repellent on your skin and clothes: DEET-based products work best.
- Stay on clear paths when you walk through woods or long grass.
- Wear light-coloured clothing, so ticks are easier to see and brush off.
- Check your skin, your clothes and your pets after time outdoors, including the hairline, armpits, groin and backs of the knees.
Special situations
Pregnancy
Lyme disease in pregnancy is treated with an antibiotic suitable in pregnancy. Passing the infection to the baby is extremely rare, and with the right treatment there is no increased risk of problems at birth. Tell the doctor if you are pregnant or breastfeeding.
Living or walking in high-risk areas
If you often spend time in woodland in central Europe, check for ticks every day, and keep photos of any bite. Tick-borne encephalitis, a different infection spread by ticks in parts of Europe, is covered on the tick bites page.
A weakened immune system
If your immune system is weakened by illness or medicines, see a doctor promptly about any rash or illness after a tick bite.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When Lyme disease is treated online, and when you need in-person care
Treated online: the typical spreading rash after a tick bite, early flu-like symptoms with a clear history, advice after a tick bite, and follow-up during and after treatment.
In-person care: blood tests when there is no rash, facial weakness, nerve pains or numbness, a swollen joint, heart symptoms, and treatment with antibiotics into a vein.
When to get in-person care
Call 112 or go to an emergency department now for:
- a severe headache with a stiff neck or a dislike of bright light
- new confusion, weakness of an arm or leg, or a seizure
- fainting, chest pain or breathlessness
- a face that suddenly droops on one side
Get medical advice the same day for:
- a spreading red rash after a tick bite, with a high temperature or feeling unwell
- shooting nerve pains, numbness or tingling after a tick bite
- a fast, slow or irregular heartbeat after a tick bite
- a rash or flu-like illness after a tick bite if you are pregnant
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about the rash: show it on camera in good light, share photos of how it has changed, and say when and where a tick may have bitten you.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s Lyme disease? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Tick bites can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about Lyme disease
What is Lyme disease?
Lyme disease is a bacterial infection passed on by the bite of an infected tick. It is the most common tick-borne infection in Europe. It usually starts with a spreading rash around the bite, and it is treated with antibiotics.
What does a Lyme disease rash look like?
The Lyme disease rash is a circular or oval red, pink or purple patch around a tick bite that slowly spreads over days to weeks, sometimes with a bullseye centre. It is not usually hot or itchy, and on brown and black skin it can look like a bruise.
Is it the Lyme disease rash or something else?
The Lyme disease rash grows slowly over days to weeks, is more than 5 cm across, is not itchy or hot, and appears 1 to 4 weeks after the bite. The red, itchy, swollen patch that comes up within hours of a tick bite is a reaction to the bite, not Lyme disease, and settles within days; cellulitis is hot, painful and spreads fast with fever; ringworm has a scaly, raised edge; and a spider bite reaction has a central puncture.
What are the first symptoms of Lyme disease?
Lyme disease usually starts with a spreading rash around the tick bite, 1 to 4 weeks after the bite and sometimes up to 3 months later. Some people also have flu-like symptoms: a high temperature, headache, aching muscles and joints, and tiredness.
Do all ticks carry Lyme disease?
No. About 12% of ticks in Europe, roughly 1 in 8, carry the Lyme disease bacteria, from about 5% in Ireland to more than 20% of adult ticks in parts of central Europe.
What causes Lyme disease, and how do you catch it?
Lyme disease is caused by Borrelia bacteria carried by Ixodes ticks, which live in woodland, long grass, heathland and parks and climb onto skin as you brush past; the bacteria pass into the blood while the tick feeds, usually only after it has been attached for more than 24 hours, which is why removing ticks promptly prevents most infections. Lyme disease is not passed between people, and deer, mice and birds keep the ticks infected.
Can you have Lyme disease without a rash?
Yes. Not everyone gets the rash or notices one. Flu-like symptoms after a tick bite, or later problems such as facial weakness, nerve pains or a swollen joint, can also be Lyme disease, and blood tests are then used to confirm it.
How is Lyme disease treated?
Lyme disease is treated with antibiotics, usually for 3 weeks for the rash and early symptoms. Doxycycline is usually the first choice for adults. Later forms need longer courses, and severe forms are treated in hospital.
Is Lyme disease curable?
Yes. Diagnosed early, Lyme disease can be cured with antibiotics, and most people recover completely, although it can take months. People treated later also respond well, but some are left with long-term joint or nerve damage.
Can Lyme disease kill you?
Very rarely. A few deaths have been reported from Lyme carditis, when the infection disturbs the heart’s rhythm. Palpitations, dizziness, fainting, chest pain or breathlessness after a tick bite need urgent care.
Is Lyme disease contagious?
No. Lyme disease is caught from the bite of an infected tick. There is no evidence that it spreads through touching, kissing or sex, and no reports of it spreading through breast milk.
How long does a tick need to be attached to pass on Lyme disease?
The risk rises the longer an infected tick feeds, and it is low in the first hours. Removing an infected tick within 36 hours can prevent Lyme disease, so remove any tick as soon as you find it.
What can I do at home after a tick bite to avoid Lyme disease?
Remove the tick as soon as you find it with fine tweezers or a tick tool, gripping it close to the skin and pulling steadily without twisting or squeezing, then clean the bite with antiseptic and wash your hands; note the date, photograph the bite, watch the area for 4 weeks for a spreading patch and yourself for fever or aches, and never use petroleum jelly, heat or alcohol on an attached tick. Antibiotics are given only if Lyme disease develops.
Can Lyme disease symptoms continue after treatment?
Most people recover fully from Lyme disease, although it can take months. An estimated 10 to 20% still have tiredness and aches more than 6 months later. See a doctor if symptoms come back or do not improve.
Can an online doctor treat Lyme disease?
Yes, for the typical rash. A doctor can diagnose it on camera without a blood test, prescribe antibiotics and follow it up. Lyme disease without a rash, facial weakness, joint or heart problems need tests or in-person care.
- Lyme disease, NHS, National Health Service (UK), reviewed 3 June 2025.
- Lyme disease: recommendations (NG95), NICE, National Institute for Health and Care Excellence, 2018.
- Facts about Lyme borreliosis, ECDC, European Centre for Disease Prevention and Control, updated 6 March 2016.
- Lyme disease, HSE, Health Service Executive (Ireland), reviewed 10 February 2025.
- Lyme disease, MedlinePlus, US National Library of Medicine, reviewed 1 March 2026.
- How Lyme disease spreads, CDC, US Centers for Disease Control and Prevention, reviewed 24 September 2024.
- Three sudden cardiac deaths associated with Lyme carditis, United States, November 2012 to July 2013, CDC, Morbidity and Mortality Weekly Report 62(49), 13 December 2013.
- What is Lyme disease and how is it diagnosed and treated?, UK Health Security Agency, 30 June 2026.
- Lyme borreliosis: epidemiology and surveillance, UK Health Security Agency, updated 14 April 2022.
- Lyme disease: symptoms and causes, Mayo Clinic, updated 6 May 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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