How Can I Treat a Lyme Disease Rash?

Clara Kedrek

The most important Lyme disease rash treatment is antibiotic medications. Skin manifestations of Lyme disease are caused by infection with a bacterial species called Borrelia burgdorferi, which is typically transmitted through the bite of a deer tick. Patients with Lyme disease can have skin findings such as erythema migrans or acrodermatitis chronica atrophicans. The initial step in treating these lesions is to administer oral antibiotics, and if this is ineffective, to try intravenous antibiotics. While there is a role for the symptomatic management of Lyme disease rashes, such as using lotions or pain relieving medications, the use of these therapies should not delay antibiotic administration.

Hydroxyzine can help the itching that can accompany Lyme disease.
Hydroxyzine can help the itching that can accompany Lyme disease.

Soon after being infected with Borrelia burgdorferi, many patients develop a characteristic bull’s eye-shaped Lyme disease rash that is known by the medical term erythema migrans. It typically develops in the weeks to months after being bitten by an infected tick, and is often the first sign that a person might be developing Lyme disease. The best treatment for this Lyme disease rash is oral antibiotic medications. Pharmaceutical agents including doxycycline, amoxicillin, and cefuroxime are all effective in treating the infection.

Amoxicillin is effective against a Lyme disease rash.
Amoxicillin is effective against a Lyme disease rash.

Many patients develop a different Lyme disease rash later in their disease courses, often months to years after they initially acquired the infection. This rash is referred to as acrodermatitis chronica atrophicans, and causes discoloration of the skin that leads to swelling and eventually thinning of the skin. As with erythema migrans, the first step in treatment of this rash is oral antibiotics. If this is ineffective, administration of intravenous antibiotics might be required.

There are a number of other types of Lyme disease rash that can affect patients more rarely compared to the other two rashes. The treatment for these rashes often depends on what stage the patients are at in terms of their Lyme disease course, and also on what types of non-cutaneous manifestations of Lyme disease they may have. Therapy in general still focuses an antibiotic administration. Other Lyme disease skin findings can include cutaneous scleroborrelioses, in which patients developed areas of skin thickening and hardening, and cutaneous atrophoborrelioses, in which the skin located on the elbows or undersides of the extremities is thinned.

Although the most important aspect of Lyme disease rash treatment is taking antibiotic medication to eradicate the infection, other medical treatments can relieve symptoms caused by the rash. For example, patients who are experiencing itching could be treated with medications such as hydroxyzine or diphenhydramine to alleviate this irritation. A number of soothing creams or lotions could be applied to relieve pain or skin dryness caused by the rash. Pain can be alleviated with a number of oral medications such as acetaminophen or ibuprofen.

Deer ticks are largely responsible for the spread of Lyme disease.
Deer ticks are largely responsible for the spread of Lyme disease.

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Discussion Comments


Patients with Lyme disease rashes should try using cortisone cream. It helps reduce inflammation and calms the urge to scratch.

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