Springdale Mason Pediatrics

Lyme Disease


  • Lyme Disease is a bacterial infection spread from a deer tick bite

Call or Return If

  • New rashes occur
  • Joint pain or swelling occurs
  • Stiff neck or severe headache occurs
  • Crooked smile or face muscle weakness occurs
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic


  • Most Lyme disease infections (80%) start with a bull's eye rash.
  • The bull's eye rash looks like a a large red circle or target. Usually it's solid red. Central clearing is present in 30%. It is flat, not raised.
  • The ring gets larger quickly. It becomes greater than 2 inches (5 cm). It can be as large as 12 inches (30 cm).
  • It occurs at the site of the tick bite
  • The bull's eye rash starts 7 to 14 days after the tick bite.
  • The medical name for this rash is erythema migrans.
  • The rash may be itchy. It is not painful.
  • May also have fever, headache and muscle pains while rash is growing.


  • A bacteria called Borrelia borgdurferi. It's found it the secretions of an infected deer tick
  • The deer tick is about the size of a poppy seed (pinhead). They are hard to see.
  • After feeding on blood, they become 3 times larger and are easier to see.
  • The longer the tick is attached, the greater the risk for Lyme disease. Some experts say at least 36 hours.
  • The main risk factor is being outdoors in an area with Lyme disease. Most cases occur in New England states, Minnesota, Wisconsin and California.

Prevention of Tick Bites

  • When hiking in tick-prone areas, wear long clothing. Tuck the ends of pants into socks.
  • Do tick checks at the end of each day. Early removal of ticks within 36 hours can prevent Lyme disease.

Tick Repellent for Clothing - Permethrin

  • Permethrin products (such Duranon or Permanone Tick Spray) are very good tick repellents.
  • An advantage over DEET is that permethrin is used on clothing. Put it on clothes, especially pants cuffs, socks and shoes. You can also put it on other outdoor items (mosquito screen, sleeping bags).
  • Do not put Permethrin on skin. Reason: It loses its ability to work once in contact with skin.

Tick Repellent for Skin - DEET

  • DEET is a good tick repellent. It can be used on the skin not covered by clothing.
  • Use 30% DEET for children and teens (AAP). Note: 30% DEET protects for 6 hours.
  • DEET is approved for use in children over 2 months of age. (AAP)

After Care Advice

  • Lyme disease is the most common disease caused by tick bites.
  • The risk of Lyme disease after a deer tick bite is low.
  • Even in a high risk area, the risk is about 2%.
  • Here is some care advice that should help.
Antibiotic by Mouth for Bull's Eye Rash:
  • Almost all infections start with a bull's eye rash.
  • Treatment for these patients is advised by the CDC and AAP.
  • Lyme Disease needs a prescription for an antibiotic.
  • The antibiotic will kill the bacteria that are causing Lyme disease.
  • Give the antibiotic as directed.
  • Try not to forget any of the doses.
  • Usually, 14 days of antibiotic are advised.
  • Treating with antibiotics will prevent future complications of Lyme disease.
Antibiotics and Prevention:
  • Giving an antibiotic after a deer tick bite to prevent Lyme disease depends on the risk. The risk is low with brief attachment. An antibiotic is not needed.
  • The risk is high if the deer tick was attached for longer than 36 hours. It's also high if the tick is swollen, not flat. An antibiotic may be needed. Your doctor will help you decide.
  • Giving antibiotics after all deer tick bites is not advised. Reason: Only 2% will get Lyme disease. (CDC and AAP)
Pain Medicine:
  • Muscle pains and headache may also be present.
  • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen.
  • Use as needed.
Lyme Disease Websites:
  • Helpful websites are www.lyme.org or www.cdc.gov/lyme
What to Expect:
  • With antibiotic treatment, your child should feel normal in less than 1 week.
  • The rash may last 1 - 2 weeks
  • With early treatment, antibiotics can cure Lyme disease.
  • Later complications like arthritis or muscle weakness are unlikely.
Return to School:
  • Lyme disease cannot be spread to other children
  • Your child can go back to school after the fever is gone.
  • Your child should also feel well enough to join in normal activities.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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