The early symptoms of Lyme disease can be mild and easily overlooked. The first symptom is usually a rash called erythema migrans which occurs in 60-80 percent of all Lyme disease cases. The rash is usually reddish and may appear as an expanding rash, blotch, or a central spot surrounded by clear skin that is ringed with the red rash. This is where the term “bull’s eye” rash comes from. Rashes appearing within the first week are usually 2½ inches across. Those untreated and noticed later (two to four weeks) may be six or more inches across. More than one rash may appear and may occur at sites other than that of the tick bite. The red patch(es) may be warm, but they are usually not painful or itchy.
Flu-like symptoms, chills, fever, stiff neck, headache, and fatigue, are often experienced, but they may not seem serious enough to require medical attention. If left untreated, more severe symptoms may appear weeks, months or even years after a tick bite. These may include severe headaches, arthritis, weakness of facial muscles and nervous system abnormalities. Swelling and pain in the large joints may recur over many years.