Rash after a tick bite


If from Ticks is spoken, the fear of the diseases they transmit always resonates. In principle, there are a number of so-called "Zoonoses", that is, transferred to humans via animals Infectious diseasesspread by ticks. In Central Europe, however, the Early summer meningoencephalitis (TBE) and the Lyme disease.

TBE, a disease caused by viruses, initially manifests itself through flu-like symptoms. One follows later Inflammation of various organs, including the heart and brain. A skin rash is not caused by the TBE virus.

In contrast, the rash represents a special form of rash Key symptom of Lyme disease in the early stages. This is the so-called "Erythema chronicum migrans", in German: the"Wandering rednessIn the following article you will learn how to recognize and treat this rash and the other accompanying symptoms of Lyme disease.


The cause of Lyme borreliosis and its wandering reddening is mostly the bacterium Borrelia burgdorferi or a type of bacteria related to it. This globally occurring bacterium is practically only transmitted via the common wood tick, but in rare cases also by mosquitoes or horseflies. The rash it causes is merely an expression of the first of the three Lyme disease stages. It is caused by the immune cells of the body's own defenses. These follow the bacterium, which spreads around 3 mm per day, and cause a visible reddening by increasing the blood flow to the skin.

Symptoms / appearance of the rash

The so-called Wandering redness is the main symptom that enables the doctor to recognize Lyme disease early on. As "Erythema chronicum migrans" will the circular, non-scaly reddening of the skin refers to, which on average 1.5 weeks, but often within the first week, after the tick bite around the puncture site forms. The rash is typical painless, does not itch and is sharply demarcated from its surroundings. If left untreated, the rash will expand in a ring over the surrounding skin in the weeks that follow. The larger its diameter, the paler the ring usually becomes. In the center of this, the skin is usually noticeably paler. There can often be a solid nodule or a slight blistering to be watched.

This unique shape of the rash (and she alone!) is an indication of active disease as a result of a tick bite, as it occurs only as a result of Lyme disease. Other tick-borne diseases, however, do not cause a rash. In the course of removing the tick, it is not uncommon for small skin injuries to occur, which then lead to a Reddening of the skin directly at the injection site to lead. However, this is meaningless and shouldn't be alarming.

It can also allergic reactions get on the tick's saliva - this creates a flat skin rash with blistering, which does not speak for Lyme disease.

The rash occurs the whole body on, this is an indication that the cause is not the tick bite, since the wandering redness is always severe locally limited is. Of course, such a rash should still be examined by a doctor.

Symptoms accompanying the rash

In addition to the characteristic rash and the increased antibodies in the blood a few weeks after the tick bite, a number of other symptoms confirm the diagnosis of Lyme disease. These accompanying symptoms are overall rather unspecific, so that they are only indicative of Lyme disease in combination with the symptoms mentioned above. They occur primarily in stage I of lime borreliosis, when the bacteria attach to a lymphatic or blood vessel and can thus spread in the body. These unspecific general phenomena include above all:

  • fever
  • a headache
  • Muscle and limb pain
  • Conjunctivitis (Conjunctivitis)
  • Lymph node swelling

The so-called lymphocytomas, however, are a little more specific. These are soft, lump-like swellings that discolor the skin blue-red. They mainly appear on the earlobes, nipples, and genital areas. Even if they are a common side effect of Lyme disease, they can still occur in the context of viral diseases.

If the disease is not discovered and treated early, stages II and III of the disease follow. Weeks to months after the actual tick bite, neurological symptoms appear here, such as paralysis of the mimic Facial muscles and (neuropathic) Nerve pain. In addition, inflammation of various organs, especially the heart, as well as the skin and joints, can occur. However, the rash has already subsided by these advanced stages.

For more information read also Lyme disease symptoms

Itchy rash

The Erythema migrans, the characteristic rash of Lyme disease, is in many cases accompanied by neither pain nor itching, which is why it is not taken seriously by many patients. However, in some cases, it may actually be itchy.

Patients with chronic Lyme disease in particular have reported that the central nodule at the point where the tick stung it begins to itch at regular intervals. However, it should be noted that many people are allergic to the ticks' saliva. Like other allergic reactions, the one that follows is often accompanied by a flat rash, which differs significantly from the wandering red in its blistering. It is usually accompanied by itching.

Apart from that, it should be noted that the stitches of the Black fly are often incorrectly interpreted as the result of a tick bite. In contrast to this, black flies bites are accompanied by severe itching, pain and significant overheating of the skin.

Ultimately, this means that itching is only rarely due to an infectious disease that is transmitted by ticks. Other causes are more likely with itchy rashes. Nonetheless, if you have any concerns or doubts about the rash, it is always advisable to see a doctor.

Read on for more information too Itchy rash, tick bite itches - is this normal?

What can a rash all over your body indicate?

A rash after a tick bite is typically local to the tick bite and spreads from there.A rash all over the body, on the other hand, is rather unusual, but can indicate a general allergic reaction. This leads to the formation of wheals all over the body.

However, since you often get a tick bite outdoors, it is not always clear whether the tick is the origin of the rash. Various grasses can also cause a rash all over the body. Especially when a lot of sunlight can act on the body at the same time. The combination occasionally leads to a rash all over the body.

Also read the article on the topic: Allergic reaction


A early removal the tick within the first 24 hours after the tick bite protects against infection in the vast majority of cases. It should anyway one to two weeks after a tick bite for characteristic rash or flu-like symptoms should come one Antibiotic therapy to be started. This can usually ensure that the pathogen is killed before the disease has serious consequences or becomes a chronic stage.

in the first stage the borreliosis, in which the wandering redness occurs, is typically the antibiotics for this Doxycycline or Amoxicillin administered. The length of time the selected antibiotic is administered depends on the patient's individual risk factors. Among other things, it takes into account whether the patient is under a allergy against antibiotics or on one Renal failure suffers. On average, however, the therapy is carried out over a period of two to four weeks.

Further information can also be found at B.orreliosis treatment

What can be the consequences of an untreated rash after a tick bite?

The typical rash after a tick bite is so-called wandering redness. This indicates an infection from the tick bite with the Borrelia bacteria. Borrelia in most cases only cause local symptoms, but can also attack nerves and organs, especially the brain. Usually general symptoms such as fever and malaise appear first.

Read more on the subject at: Fever after a tick bite

Then there is a long period with no symptoms. The infection usually heals in time. Occasionally, however, the serious complications associated with brain involvement arise. Early antibiotic treatment when the rash occurs after the tick bite, together with removing the tick, can prevent this disease (advanced borreliosis). Without therapy, the disease can progress.

Further diagnostics

The diagnosis of Lyme disease can typically be made on the basis of its characteristic rash. Detection of the bacteria in a blood culture is problematic in the early stages of the disease, which is why direct evidence of Lyme borreliosis can initially only take place via serological detection of antibodies. To do this, blood must be drawn from the patient, which is then sent to a laboratory. However, the antibodies can only be detected from about the 3rd week since the infection. Further tests for the disease exist, but are not very informative and are therefore rarely used.

Further information can also be found at Lyme disease test

Duration of the rash

The wandering red usually shows itself within a few days to about two weeks the first time after the tick bite. In the following weeks it will migrate in a ring over the surrounding skin. How long this rash lasts depends primarily on how quickly Lyme disease was recognized and a eAppropriate antibiotic therapy was initiated. However, within a few days to a few weeks of starting this treatment, the rash should have resolved.