No. A certain kind of rash, called erythema migrans, is a telltale symptom of Lyme disease, and if you have it call your doctor immediately.  But not everyone who has Lyme exhibits a rash, much less the “bullseye” rash so often associated with Lyme disease.

The chart below illustrates several of the forms these rashes might take.

Lyme Disease Bullseye Rash

The Centers for Disease Control and Prevention report that as many as 70% may exhibit the erythema migrans, but this can vary by region. For example, a 2010 study showed that in the state of Maine only 43% of Lyme patients exhibited this particular type of rash.

There are many symptoms of Lyme disease and it is critical that you are alert to all of them. See Lyme Disease Symptoms for more information.

Don’t Be Fooled

Lyme disease is often referred to as the great imitator because so many of its symptoms resemble those of other diseases. Without a telltale skin rash, it can be very hard to diagnose Lyme disease.  Many people never recall being bitten.

Below is a list of just some of diseases that many people have initially been diagnosed with, only to receive a Lyme diagnosis later:

  • Arthritis: typically manifesting as joint pain, swelling, redness, heat, and limitation of movement
  • Juvenile idiopathic arthritis: a childhood disease that causes joint inflammation and swelling
  • Fibromyalgia: especially widespread muscle and soft tissue pain
  • Chronic fatigue syndrome: severe and debilitating fatigue
  • Multiple sclerosis: leading to problems with muscle control and strength, vision, balance, sensation, and mental functioning
  • Lupus: joint pain, swelling, may affect kidneys, brain and other organs

If you suspect Lyme, even if you do not recall being bitten, try to recall where and when you might have been exposed to infected ticks, and discuss the situation and symptoms with you doctor.

Image courtesy of Emily M. Eng

142 Comments on “Does Everyone Get the Telltale Bullseye Rash?

  1. How small can a bullseye rash be? We noticed what looked like a mosquito bite yesterday. It is now a bullseye, but about an inch diameter. It’s on his forearm — we check regularly and have never seen a tick. However, he had a fever for five days (now gone). We are making an appointment, but in our experience the doctors where we live in Quebec don’t know much about Lyme. Thank you!

    1. We would encourage you to photograph the rash and to carefully document any and all symptoms, especially flu-like symptoms which can occur from Lyme, and then to speak with your doctor. The US CDC website has several images of Lyme rashes that you may want to consult for reference. There are many variations of rash that can occur (and it is also true that in many cases there is no rash at all) but it is also true that other insect bites, eg spider bites, can also cause skin irritation. Should you need more help (unfortunately with Lyme disease, you often have to be your own advocate), you may want to visit the International Lyme and Associated Diseases Society (ILADS) site which offers referrals to physicians familiar with Lyme and other tick-borne illnesses. You can search by geography. Best wishes.

  2. I was diagnosed with Lyme disease in 2014. I was bitten by a tick. About a month later, during my self breast exam, I found a lump under my arm, had no bullseye rash. I went to my doctor with this discovery. My doctor orderED blood test and a mammogram since breast cancer runs in my family. It turned out I test positive for Lyme disease. I was treated with antibiotics (doxycycline). It came back 2 years later, with flu-like symptoms, night sweats, fatigue (falling asleep at work), pain in my hands and wrists, and blurred vision. Again treated with antibiotics.

  3. My daughter, 11 years old, just diagnosed with Lyme disease yesterday. She was not bitten and no rush at all, but she has knee pain. She can not bend it. The doctor ordered blood test and came positive. She gave her antibiotics for 28 days. I hope it cures disease. I heard it is chronic.

  4. My daughter, 11 years old just diagnosed with Lyme disease today. She doesn’t have any rash, and wasn’t bitten but she has knees pain. Her doctor ordered X-ray which was totally fine and blood test, it shows Lyme-positive. She gave her antibiotics for 28 days. Hopefully will be treated.

    1. Jason, Lyme can be past through the placenta to the fetus, so in fact she would have NOT needed to be bitten to have Lyme disease.

  5. I have no rash, but I have been experiencing pain in my wrist and ankle. I didn’t fall or bang into anything! The pain has been getting worst plus I’m experiencing muscle weakness. Getting kind of nervous. Do you think it’s Lyme?

  6. I just returned from Mexico were I believe I was bit by some kind of insect/tick. My inner thigh was itchy and a bright red circular welt was present. It was very itchy and burning. The doctor that looked at the photo of my leg said it was a bruise but to me it looks identical to a red-blue lesion. I’m not experiencing any Lyme disease symptoms currently.The doctor prescribed antibiotics and told me to return in two weeks if it was still present. If it’s a bruise why would I take antibiotics? Is there anyone out there with any experience with tick bites and Lyme disease?

    1. I had Lyme disease 2 years ago. I never had any itching at bite site. Was told by a doctor that tick bites don’t itch. I think your doctor just wants to cover all bases by giving you the antibiotics.

    2. I’ve had Lyme disease in the past. I recently found a deer tick on me. I’m worried it’s Lyme only bc the bite area burns & stings, just like in the past. I’ve had bullseye in the past. This time the rash is blue/purple with center being bite mark. I’ll wait to see what happens by tomorrow.

    3. Hi Rene,
      Two days ago I developed a red circular area with a bluish middle behind my left knee. I also came down with a fever, joint aches, a headache, and light red rash on my chest and arms. I went to the nearest urgi-care and was told it was classic Lyme disease. I started on Doxycyline immediately. Today, the area has expanded which is typical of Lyme, however, it is warm to touch and itchy (which all the searches I have done state there is no pain or itchiness just warmth and the area can spread up to 12 inches). My blood work came back negative for Lyme but the MD also stated it may have been too early to test since my body didn’t have time for the antibodies to adhere to the disease and to go back in 30 days. Since I am very concerned about cellulitis and the antibiotic I’m on for Lyme is not the antibiotic for cellulitis, I’m going to give it another day.

  7. About 5 1/2 years ago I had a bullseye rash on my inner arm. I mistakenly brushed it off. I’m always outdoors kayaking and at the time I was a dog groomer. I am generally healthy, but feel tired all the time, have aches and pains, and my brain feels like it stopped working most days. I eat very well (I am a registered nutritionist). I had my doctor run a blood test for Lyme (I’m in Ontario) and it came back negative. I’m concerned that if I do have it and I don’t control it, I may pay for it in the future. So my question is, If I had a bullseye do I definitely have Lyme?

    1. Unfortunately, there is not a simple answer and your best bet is to consult with a knowledgeable doctor familiar with Lyme and related illnesses. [The International Lyme and Associated Diseases Society (ILADS) offers a physician directory that can help you find a provider in your geography if need.]

      Not all Erythema Migrans Lesions (bullseye rashes) are indicative of Lyme disease (e.g,. see this 2017 story in the American Journal of Medicine). In particular, STARI (or Southern Tick-Associated Rash Illness) often presents a very similar rash though generally has less severe symptoms. And as we all know, many patients infected by Lyme never present any rash at all. The Center for Diseases Control (CDC) does have images of typical Lyme-caused EM rashes as well as images of skin conditions that are not EM.

      If you believe you have been exposed to a tick and are experiencing symptoms, you should certainly continue to seek the care of a doctor.

    2. From everything I’ve been told, if you have a bullseye you have Lyme. I was bitten by a tick, went to the doctor, had 2 Lyme tests — which both came back negative — and, a few days later, I got the bullseye. Sounds to me like you have Lyme disease. Find a doctor that has experience with Lyme disease.

    3. You had a western blot test? The ELISA and Western blot are the most common tests used to diagnose Lyme disease. Both tests measure antibodies (proteins made by the immune system to fight infection) to Bb, the bacterium that causes Lyme disease. … The ELISA and Western blot can only detect whether a person has been exposed to Bb.

    4. Canada is notorious for false negatives because we only have one kind of test that often doesn’t detect it. If you had the bullseye rash, chances are high you actually do have Lyme. You can pay for a private test in California but it costs like $5000. This happened to a family in Kamloops,BC and their four kids. Canadian tests all came back negative but all four kids have now tested positive on the American test. So sad that Canada is lagging so far behind with Lyme.

    5. I had Lyme symptoms five days after being in a tick prone area and then discovered an attached tick. About 85 hours possible exposure. No rash but Doc started me on Doxycycline. I’m almost a week in and don’t feel any better. I haven’t found anything online about whether that is typical. Does anyone know how long it takes to see improvement?

  8. This looks and sounds like… I broke out with this rash last year in October. I’ve been on /off prednisone for about a year. I’ve been off now for about 3 weeks. I’m bright red – sun burn rash and peeling. Very dry and itchy. My homeopath has me on supplements and elimination diet.. Seeing small improvements, but this rash is stubborn and painful. Warm bath actually feels great… I’m using avocado oil too – which gives me some comfort during the day, but it’s always weeping. Any suggestions? I’ve been seen by dermatology (3), allergist and now homeopath.

  9. Hi everyone! I heard it’s a thing now. I just wanted to ask if any of you have tried cannabis for medication purposes? There are a lot of benefits for medical cannabis especially for skin disease. Scientists believe that CBD, an anti-inflammatory compound in the drug that doesn’t cause a ‘high,’ could help improve common skin conditions. I’ve been reading some articles about cannabis and its medical properties here in I can’t find any solid conclusive evidence that speaks to its efficacy. Any personal experience or testimonial would be highly appreciated. Thanks.

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