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Insect bites
Swelling
Itchy skin
Red spots on skin
Skin rashes
Itchy bumps on skin
Skin painful to touch
Sudden sting on skin
Unexplained burning sensation on skin
Bug bites that blister
Itchy skin at night
Erythema
Not seeing your symptoms? No worries!
Irritation and inflammation of the skin caused by mosquito bites, bee stings, and other insects.
Your doctor may ask these questions to check for this disease:
This condition is typically mild and improves on its own. However, medications may help relieve pain and itching. Rarely, some patients may develop a severe allergy, requiring emergency medical care.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Yukiko Ueda, MD (Dermatology)
Dr. Ueda graduated from the Niigata University School of Medicine and trained at the University of Tokyo Medical School. She is currently a clinical assistant professor at the Department of Dermatology, Jichi Medical University, and holds several posts in the dermatology departments at Kyoto Prefectural University of Medicine, Komagome Hospital, University of Tokyo, and the Medical Center of Japan Red Cross Society.
Content updated on Mar 27, 2025
Following the Medical Content Editorial Policy
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Q.
Can Lyme disease be misdiagnosed as depression?
A.
Lyme disease can sometimes be misdiagnosed as depression because they share similar symptoms, like fatigue and mood changes.
References:
Kobayashi T, Higgins Y, Melia MT, & Auwaerter PG. (2022). Many Diagnoses are Frequently Misattributed to Lyme .... The American journal of medicine, 34861197.
https://pubmed.ncbi.nlm.nih.gov/34861197/
Rebman AW, Bechtold KT, Yang T, Mihm EA, Soloski MJ, Novak CB, & Aucott JN. (2017). The Clinical, Symptom, and Quality-of-Life Characterization .... Frontiers in medicine, 29312942.
https://pubmed.ncbi.nlm.nih.gov/29312942/
Di Battista ME, Dell'Acqua C, Baroni L, Fenoglio C, Galimberti D, & Gallucci M. (2018). Frontotemporal Dementia Misdiagnosed for Post- .... Journal of Alzheimer's disease : JAD, 30282363.
Q.
Can Lyme disease cause chronic fatigue and vertigo?
A.
Lyme disease can cause symptoms like chronic fatigue and vertigo, especially if it affects the brain.
References:
Verma V, Roman M, Shah D, Zaretskaya M, & Yassin MH. (2014). A case of chronic progressive lyme encephalitis as .... Infectious disease reports, 25568755.
https://pubmed.ncbi.nlm.nih.gov/25568755/
Novak P. (2020). Post COVID-19 syndrome associated with orthostatic .... eNeurologicalSci, 32984564.
Q.
Do doctors agree on the diagnosis and treatment of chronic Lyme disease?
A.
Doctors do not fully agree on the diagnosis and treatment of chronic Lyme disease due to differing views on its persistence and the effectiveness of tests.
References:
Cameron DJ. (2009). Clinical trials validate the severity of persistent Lyme disease .... Medical hypotheses, 19013025.
https://pubmed.ncbi.nlm.nih.gov/19013025/
Best SJ, Tschaepe MI, & Wilson KM. (2019). Investigation of the performance of serological assays used .... PloS one, 31034492.
https://pubmed.ncbi.nlm.nih.gov/31034492/
Patrick DM, Miller RR, Gardy JL, Parker SM, Morshed MG, Steiner TS, et al. (2015). A Phenotype Similar to That of Chronic Fatigue Syndrome. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 26082507.
Q.
Does delayed diagnosis and treatment of Lyme disease increase the risk of chronic symptoms?
A.
Delayed diagnosis and treatment of Lyme disease can lead to chronic symptoms, making it harder for patients to recover fully.
References:
Hirsch AG, Herman RJ, Rebman A, Moon KA, Aucott J, Heaney C, & Schwartz BS. (2018). Obstacles to diagnosis and treatment of Lyme disease in .... BMJ open, 29895655.
https://pubmed.ncbi.nlm.nih.gov/29895655/
Bransfield RC, Goud Gadila SK, Kursawe LJ, Dwork AJ, Rosoklija G, Horn EJ, et al. (2024). Late-stage borreliosis and substance abuse. Heliyon, 38779029.
https://pubmed.ncbi.nlm.nih.gov/38779029/
Bonoldi VLN, Yoshinari NH, Trevisan G, & Bonin S. (2024). Baggio-Yoshinari Syndrome: A Report of Five Cases. Microorganisms, 39458417.
Q.
How can I prevent Lyme disease tick bites?
A.
To prevent Lyme disease tick bites, wear long sleeves and pants, use tick repellent, and check for ticks after being outdoors.
References:
Schwartz AM, Mackeprang JM, Mead PS, & Hinckley AF. (2022). A review of epidemiologic studies from the United States. Zoonoses and public health, 35791092.
https://pubmed.ncbi.nlm.nih.gov/35791092/
Richardson M, Khouja C, & Sutcliffe K. (2019). Interventions to prevent Lyme disease in humans. Preventive medicine reports, 30456054.
https://pubmed.ncbi.nlm.nih.gov/30456054/
Eisen L. (2022). Personal protection measures to prevent tick bites in the .... Ticks and tick-borne diseases, 35364518.
Q.
Is chronic Lyme disease accepted by doctors?
A.
Chronic Lyme disease is a controversial topic among doctors, with some accepting it and others questioning its validity.
References:
Koedel U, Fingerle V, & Pfister HW. (2015). Lyme neuroborreliosis-epidemiology, diagnosis and .... Nature reviews. Neurology, 26215621.
https://pubmed.ncbi.nlm.nih.gov/26215621/
Maloney EL. (2016). Controversies in Persistent (Chronic) Lyme Disease. Journal of infusion nursing : the official publication of the Infusion Nurses Society, 27755213.
https://pubmed.ncbi.nlm.nih.gov/27755213/
Lantos PM. (2015). Chronic Lyme disease. Infectious disease clinics of North America, 25999227.
Q.
Is there new research funding for chronic Lyme disease treatments?
A.
New research is focusing on improving how we classify and treat chronic Lyme disease, which could lead to better treatment options in the future.
References:
Fallon BA, Kuvaldina M, Zubcevik N, DeBiasi R, Mulkey SB, Chiu C, et al. (2025). Proposed research classification criteria for Lyme disease .... Frontiers in medicine, 40070652.
https://pubmed.ncbi.nlm.nih.gov/40070652/
Adkison H, & Embers ME. (2023). Lyme disease and the pursuit of a clinical cure. Frontiers in medicine, 37293310.
https://pubmed.ncbi.nlm.nih.gov/37293310/
Bobe JR, Jutras BL, Horn EJ, Embers ME, Bailey A, Moritz RL, et al. (2021). Recent Progress in Lyme Disease and Remaining .... Frontiers in medicine, 34485323.
Q.
What are some unproven treatments for chronic Lyme disease?
A.
Some unproven treatments for chronic Lyme disease include long-term antibiotics, herbal supplements, and hyperbaric oxygen therapy. These treatments lack scientific support and may not be safe.
References:
Lantos PM, Shapiro ED, Auwaerter PG, Baker PJ, Halperin JJ, McSweegan E, & Wormser GP. (2015). Unorthodox alternative therapies marketed to treat Lyme .... Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 25852124.
https://pubmed.ncbi.nlm.nih.gov/25852124/
Auwaerter PG, Bakken JS, Dattwyler RJ, Dumler JS, Halperin JJ, McSweegan E, et al. (2011). Antiscience and ethical concerns associated with advocacy .... The Lancet. Infectious diseases, 21867956.
https://pubmed.ncbi.nlm.nih.gov/21867956/
Sakizadeh JR, Rothenberger MK, & Alpern JD. (2025). Characteristics of Clinics Offering Nontraditional Lyme .... Open forum infectious diseases, 40103734.
Q.
What are the initial treatments for Lyme disease?
A.
The initial treatment for Lyme disease usually involves antibiotics like doxycycline, amoxicillin, or cefuroxime, which are effective in early stages.
References:
Sigal LH. (1992). Current recommendations for the treatment of Lyme disease. Drugs, 1379147.
https://pubmed.ncbi.nlm.nih.gov/1379147/
Bratton RL, Whiteside JW, Hovan MJ, Engle RL, & Edwards FD. (2008). Diagnosis and treatment of Lyme disease. Mayo Clinic proceedings, 18452688.
https://pubmed.ncbi.nlm.nih.gov/18452688/
Hansmann Y. (2009). Treatment and prevention of Lyme disease. Current problems in dermatology, 19367098.
Q.
What are the symptoms of Post-Treatment Lyme Disease Syndrome (PTLDS)?
A.
Post-Treatment Lyme Disease Syndrome (PTLDS) can cause tiredness, joint and muscle pain, and trouble thinking clearly, even after Lyme disease treatment.
References:
Wester KE, Nwokeabia BC, Hassan R, Dunphy T, Osondu M, Wonders C, & Khaja M. (2024). Exploring the Mechanisms of Post-treatment Lyme Disease .... Cureus, 39161484.
https://pubmed.ncbi.nlm.nih.gov/39161484/
Aucott JN. (2015). Posttreatment Lyme disease syndrome. Infectious disease clinics of North America, 25999226.
https://pubmed.ncbi.nlm.nih.gov/25999226/
Bai NA, & Richardson CS. (2023). Posttreatment Lyme disease syndrome and myalgic .... Chronic diseases and translational medicine, 37711861.
Q.
What bacteria causes Lyme disease?
A.
Lyme disease is caused by bacteria called Borrelia, mainly Borrelia burgdorferi in the United States.
References:
Chomel B. (2015). Lyme disease. Revue scientifique et technique (International Office of Epizootics), 26601457.
https://pubmed.ncbi.nlm.nih.gov/26601457/
Marques AR, Strle F, & Wormser GP. (2021). Comparison of Lyme Disease in the United States and .... Emerging infectious diseases, 34286689.
https://pubmed.ncbi.nlm.nih.gov/34286689/
Steere AC, Strle F, Wormser GP, Hu LT, Branda JA, Hovius JW, et al. (2016). Lyme borreliosis. Nature reviews. Disease primers, 27976670.
Q.
What does a Lyme disease rash look like?
A.
The Lyme disease rash, often called erythema migrans, usually looks like a red, circular patch that can expand and sometimes resembles a bull's-eye.
References:
Berger BW. (1989). Dermatologic manifestations of Lyme disease. Reviews of infectious diseases, 2814169.
https://pubmed.ncbi.nlm.nih.gov/2814169/
Müllegger RR, & Glatz M. (2008). Skin manifestations of lyme borreliosis: diagnosis and .... American journal of clinical dermatology, 18973402.
https://pubmed.ncbi.nlm.nih.gov/18973402/
Strle F, & Wormser GP. (2022). Early Lyme Disease (Erythema Migrans) and Its Mimics .... Infectious disease clinics of North America, 36116832.
Q.
What happens if Lyme disease is left untreated?
A.
If Lyme disease is left untreated, it can lead to serious health problems affecting the joints, heart, and nerves.
References:
Chodynicka B, Flisiak I, Lukaszuk C, & Bułhak V. (1997). [Late consequences of untreated lyme borreliosis]. Przeglad epidemiologiczny, 9562794.
https://pubmed.ncbi.nlm.nih.gov/9562794/
Szer IS, Taylor E, & Steere AC. (1991). The long-term course of Lyme arthritis in children. The New England journal of medicine, 2052061.
https://pubmed.ncbi.nlm.nih.gov/2052061/
Steere AC. (1995). Musculoskeletal manifestations of Lyme disease. The American journal of medicine, 7726191.
Q.
What is Post-Treatment Lyme Disease Syndrome (PTLDS)?
A.
Post-Treatment Lyme Disease Syndrome (PTLDS) happens when people still feel sick after getting treated for Lyme disease, even though the infection is gone.
References:
Aucott JN. (2015). Posttreatment Lyme disease syndrome. Infectious disease clinics of North America, 25999226.
https://pubmed.ncbi.nlm.nih.gov/25999226/
Wester KE, Nwokeabia BC, Hassan R, Dunphy T, Osondu M, Wonders C, & Khaja M. (2024). Exploring the Mechanisms of Post-treatment Lyme Disease .... Cureus, 39161484.
https://pubmed.ncbi.nlm.nih.gov/39161484/
Ścieszka J, Dąbek J, & Cieślik P. (2015). Post-Lyme disease syndrome. Reumatologia, 27407225.
Q.
What other diseases have symptoms similar to chronic Lyme disease?
A.
Chronic Lyme disease symptoms can be similar to those of chronic fatigue syndrome, fibromyalgia, and certain autoimmune diseases, making it challenging to diagnose.
References:
Bai NA, & Richardson CS. (2023). Posttreatment Lyme disease syndrome and myalgic .... Chronic diseases and translational medicine, 37711861.
https://pubmed.ncbi.nlm.nih.gov/37711861/
Seidel MF, Domene AB, & Vetter H. (2007). Differential diagnoses of suspected Lyme borreliosis or .... European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 17605053.
https://pubmed.ncbi.nlm.nih.gov/17605053/
Gaudino EA, Coyle PK, & Krupp LB. (1997). Post-Lyme syndrome and chronic fatigue .... Archives of neurology, 9362985.
Q.
What type of tick transmits Lyme disease?
A.
The black-legged tick, also known as the deer tick, is the type of tick that transmits Lyme disease.
References:
Bush LM, & Vazquez-Pertejo MT. (2018). Tick borne illness-Lyme disease. Disease-a-month : DM, 29402399.
https://pubmed.ncbi.nlm.nih.gov/29402399/
Lo Re V 3rd, Occi JL, & MacGregor RR. (2004). Identifying the vector of Lyme disease. American family physician, 15117014.
https://pubmed.ncbi.nlm.nih.gov/15117014/
Mead P. (2022). Epidemiology of Lyme Disease. Infectious disease clinics of North America, 36116831.
Q.
When are Lyme disease ticks most active?
A.
Lyme disease ticks are most active during the warmer months, especially in spring and summer.
References:
Burtis JC, Bjork J, Johnson TL, Schiffman E, Neitzel D, & Eisen RJ. (2023). Seasonal activity patterns of host-seeking Ixodes .... Journal of medical entomology, 37075475.
https://pubmed.ncbi.nlm.nih.gov/37075475/
Salkeld DJ, Castro MB, Bonilla D, Kjemtrup A, Kramer VL, Lane RS, & Padgett KA. (2014). Seasonal activity patterns of the western black-legged tick, .... Ticks and tick-borne diseases, 25113980.
https://pubmed.ncbi.nlm.nih.gov/25113980/
Piesman J, Mather TN, Dammin GJ, Telford SR 3rd, Lastavica CC, & Spielman A. (1987). Seasonal variation of transmission risk of Lyme disease .... American journal of epidemiology, 3687924.
Q.
Where are Lyme disease ticks found in the US?
A.
Lyme disease ticks, known as blacklegged ticks, are mainly found in the northeastern, north-central, and Pacific Coast areas of the United States.
References:
Burtis JC, Foster E, Schwartz AM, Kugeler KJ, Maes SE, Fleshman AC, & Eisen RJ. (2022). Predicting distributions of blacklegged ticks (Ixodes .... Ticks and tick-borne diseases, 35785605.
https://pubmed.ncbi.nlm.nih.gov/35785605/
Eisen L, & Eisen RJ. (2023). Changes in the geographic distribution of the blacklegged .... Ticks and tick-borne diseases, 37494882.
https://pubmed.ncbi.nlm.nih.gov/37494882/
Fleshman AC, Graham CB, Maes SE, Foster E, & Eisen RJ. (2021). Reported County-Level Distribution of Lyme Disease .... Journal of medical entomology, 33600574.
Q.
Why do some people have lingering Lyme disease symptoms?
A.
Some people have lingering symptoms after Lyme disease because their bodies react differently to the bacteria, causing ongoing issues even after treatment.
References:
Baarsma ME, & Hovius JW. (2024). Persistent Symptoms After Lyme Disease. The Journal of infectious diseases, 39140720.
https://pubmed.ncbi.nlm.nih.gov/39140720/
Wester KE, Nwokeabia BC, Hassan R, Dunphy T, Osondu M, Wonders C, & Khaja M. (2024). Exploring the Mechanisms of Post-treatment Lyme Disease .... Cureus, 39161484.
https://pubmed.ncbi.nlm.nih.gov/39161484/
Rebman AW, & Aucott JN. (2020). Post-treatment Lyme Disease as a Model for Persistent .... Frontiers in medicine, 32161761.
Q.
What do tick bites look like? Characteristics to distinguish tick bite marks.
A.
Tick bites can present with specific characteristics that help distinguish them from other insect bites. Recognizing these features is important for identifying potential tick-borne diseases, such as Lyme disease.
References:
Pearn J. The clinical features of tick bite. Med J Aust. 1977 Sep 3;2(10):313-8. doi: 10.5694/j.1326-5377.1977.tb99163.x. PMID: 927249.
Aberer E. What should one do in case of a tick bite? Curr Probl Dermatol. 2009;37:155-166. doi: 10.1159/000213073. Epub 2009 Apr 8. PMID: 19367100.
Stanek G, Strle F. Lyme borreliosis-from tick bite to diagnosis and treatment. FEMS Microbiol Rev. 2018 May 1;42(3):233-258. doi: 10.1093/femsre/fux047. PMID: 29893904.
Q.
Why do some bug bites become hard or swollen?
A.
Bug bites may get swollen, red or hardened due to an allergic reaction or infection.
References:
Gaunder BN. Insect bites and stings: managing allergic reactions. Nurse Pract. 1986 Mar;11(3):16, 19-22, 27-8. doi: 10.1097/00006205-198603000-00004. PMID: 2869463.
Bircher AJ. Systemic immediate allergic reactions to arthropod stings and bites. Dermatology. 2005;210(2):119-27. doi: 10.1159/000082567. PMID: 15724094.
Lee H, Halverson S, Mackey R. Insect Allergy. Prim Care. 2016 Sep;43(3):417-31. doi: 10.1016/j.pop.2016.04.010. PMID: 27545732.
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https://ijdvl.com/insect-bite-reactions/Moore SJ, Mordue Luntz AJ, Logan JG. Insect bite prevention. Infect Dis Clin North Am. 2012 Sep;26(3):655-73. doi: 10.1016/j.idc.2012.07.002. PMID: 22963776.
https://www.sciencedirect.com/science/article/abs/pii/S0891552012000748?via%3DihubStibich AS, Carbonaro PA, Schwartz RA. Insect bite reactions: an update. Dermatology. 2001;202(3):193-7. doi: 10.1159/000051635. PMID: 11385222.
https://www.karger.com/Article/Abstract/51635Wilcock J, Etherington C, Hawthorne K, Brown G. Insect bites. BMJ. 2020 Aug 7;370:m2856. doi: 10.1136/bmj.m2856. PMID: 32769081.
https://www.bmj.com/content/370/bmj.m2856