Tick Bullseye Rash: What You Need to Know About Lyme Disease

A tick bullseye rash can signal Lyme disease. But not always. Here’s what you need to know.

Why Diagnosing Lyme Disease Is So Complicated — And Why It Matters

For years, the U.S. Centers for Disease Control and Prevention (CDC) estimated that between 30,000 and 40,000 people were diagnosed with Lyme disease each year. However, that figure didn’t tell the full story. After reassessing the data, the CDC now believes the actual number is closer to 476,000 cases per year—more than 10 times the previously reported estimate. This startling update points to a much larger public health issue than many people realize.

So why is Lyme disease so underreported? And why is it notoriously difficult to diagnose, even for people with access to quality medical care?

The Problem with Testing
The current gold standard for diagnosing Lyme disease relies on blood tests that measure your body’s immune response to Borrelia burgdorferi, the bacterium transmitted by infected ticks. But here’s the catch: these tests don’t look for the bacteria itself—they look for antibodies your body produces in response to the infection. That means:

• You might test negative early in the infection before your immune system has had time to mount a response.
• You might test negative later if your immune system is weakened or doesn’t produce a strong antibody response.
• And even if you do test positive, the results can be ambiguous or dismissed if your symptoms don’t fit the typical Lyme pattern.

This means many people with Lyme disease—especially those in the early or late stages—can be misdiagnosed, delayed in getting treatment, or overlooked entirely.

Symptoms That Mimic Other Diseases
Lyme disease is known as “the great imitator” for a reason. Its symptoms—fatigue, joint pain, headaches, brain fog, nerve pain, and more—can look like dozens of other chronic illnesses, including fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis, lupus, and even multiple sclerosis.

This overlap makes diagnosis even harder, especially if a patient doesn’t remember a tick bite or didn’t develop the hallmark tick bullseye rash (erythema migrans). While often cited as a telltale sign of Lyme disease, this rash:

• Only appears in about 75% of those infected.
• Can be missed entirely, especially in people with darker skin tones.
• Takes an average of 7 days to appear—and may never appear at all.

Missed Early Detection, Long-term Consequences
If Lyme disease isn’t diagnosed and treated early with antibiotics, it can progress to later stages and cause more severe problems—neurological symptoms, arthritis, cognitive dysfunction, and heart complications, to name a few. But by the time those symptoms arise, lab tests may no longer reliably detect the infection, and treatment becomes much more difficult.

To complicate matters, antibiotics don’t always fully resolve symptoms, especially if treatment is delayed. Some people experience persistent or recurring symptoms long after the infection is supposedly cleared, a condition often referred to as Post-Treatment Lyme Disease Syndrome (PTLDS) or chronic Lyme disease—a topic of ongoing debate and research.

A Costly, Confusing Journey for Many Patients
The road to a Lyme diagnosis can be long, frustrating, and expensive. Patients often visit multiple doctors, undergo a wide range of tests, and face skepticism from healthcare providers. Misdiagnosis not only delays appropriate care—it can lead to unnecessary treatments, increased anxiety, and mounting healthcare costs.

The Takeaway for Health-Conscious People
If you spend time outdoors—especially in wooded, grassy, or coastal areas—be vigilant about tick prevention and tick checks. And if you develop unexplained symptoms, even months after a tick exposure, don’t dismiss the possibility of Lyme disease—especially if your health concerns don’t respond to conventional treatments.

The earlier Lyme is caught, the more likely it is to be treated effectively. But understanding the diagnostic challenges is a crucial first step toward advocating for yourself and getting the care you need.

Lyme Disease Symptoms — Whether or Not You Have a Tick Bullseye Rash

Lyme disease can be easy to miss and hard to pin down—especially if you don’t spot the classic tick bullseye rash that many people associate with tick bites. But here’s the truth: not everyone gets that rash, and even when they do, it may show up late or be easily overlooked.

That’s why it’s critical to understand the full spectrum of Lyme disease symptoms. Whether you spend a lot of time outdoors, live in a high-risk area, or just want to stay informed, knowing what to look for can make all the difference in catching Lyme disease early—and getting the treatment you need.

Early Signs: What to Watch For After a Tick Bite
Even if you never saw a tick on your body, Lyme disease may still be a possibility—ticks can be tiny, and bites are often painless. If you’ve been outdoors in wooded or grassy areas, pay close attention to how you feel in the days and weeks afterward.

Early symptoms may include:

• Fever and chills

• Headache

• Fatigue

• Muscle and joint aches

• Swollen lymph nodes

• Erythema migrans rash – a red, expanding rash that sometimes clears in the center, giving it a bullseye appearance

But here’s the tricky part: about 1 in 4 people don’t get the bullseye rash, and others may develop rashes that don’t look like a bullseye at all. That’s why it’s important to look beyond the skin and listen to your body.

When Lyme Disease Progresses: Serious and Systemic Symptoms
If Lyme disease goes untreated—even just for a few days in some cases—it can begin to affect the nervous system, joints, heart, and more. These more severe symptoms can begin as early as three days after the bite, or may take weeks or months to develop.

Watch for these warning signs of more advanced Lyme disease:

• Severe headaches and neck stiffness – Often a sign that the infection has reached the central nervous system

• Rashes on other parts of the body – Not just the bite site

• Pain that comes and goes in muscles, joints, bones, or tendons

• Facial paralysis (Bell’s palsy) – Sudden weakness or drooping on one or both sides of the face

• Heart palpitations or irregular heartbeat (Lyme carditis) – Can cause dizziness or even fainting

• Shortness of breath and unusual fatigue – Often mistaken for anxiety or other conditions

• Inflammation of the brain or spinal cord – May lead to more serious neurological problems

• Shooting pain, numbness, or tingling in hands or feet – Often described as a “burning” or electric sensation

• Cognitive symptoms like brain fog, confusion, and short-term memory issues

Tick Bullseye Rash and Lyme Disease Testing

When you have a tick bullseye rash, you’ll probably want to get lab tests to identify antibodies to the bacteria, which can help confirm or rule out a Lyme disease diagnosis. These tests are most reliable a few weeks after an infection. By then, your body has had time to develop antibodies. The two main tests are ELISA and Western blot:

• Enzyme-linked immunosorbent assay (ELISA) test is used most often to detect Lyme. ELISA detects antibodies to Borrelia burgdorferi, but it can provide false-positive results.
• Western blot test may be used to confirm a positive ELISA diagnosis. In this two-step approach, the Western blot detects antibodies to several proteins of Borrelia burgdorferi.

Essentially, a doctor can perform the ELISA blood test, which looks for antibodies your body produces in response to the Borrelia burgdorferi bacteria (the cause of Lyme disease). If that test is positive or borderline, it should be followed up with a Western blot test to confirm the diagnosis.

If You Have Symptoms, Don’t Wait
If you suspect you’ve been exposed to ticks, or if you’re experiencing any of the symptoms above—even without a rash—don’t brush it off. Lyme disease is most treatable in its early stages, and delayed treatment can lead to long-term complications.

Keep in mind: tests may not be reliable in the first few weeks after infection. If symptoms are strong and you have a history of tick exposure, some doctors may begin treatment based on clinical symptoms alone.

Antibiotics are used to treat Lyme disease. Recovery is usually faster and more complete the sooner treatment begins. Standard treatment for early-stage Lyme is 14-21 days of oral antibiotics such as doxycycline (for adults and children older than 8) or amoxicillin or cefuroxime (for adults, younger children, and pregnant or breast-feeding women).

If the disease involves the central nervous system, as part of your Lyme disease diagnosis your doctor might recommend an intravenous antibiotic for 14-28 days. Intravenous Lyme disease treatment often eliminates infection, but it may take you some time to recover from your symptoms. These antibiotics can cause such side effects as a lower white blood cell count, mild to severe diarrhea, or colonization or infection with other antibiotic-resistant organisms unrelated to Lyme.

Lyme Disease Support

Our company owner, Michael Van der Linden, got a tick bite (and a tick bullseye rash) and suffered from Lyme disease for almost four years. After giving up on high-powered antibiotics, he found a different path. He drank three cups of Phyllanthus niruri tea a day. Within 90 days of drinking Phyllanthus niruri tea, he was Lyme-free. While his personal story proves nothing scientifically, his personal story combined with his desire to help others is the reason he started Linden Botanicals in the first place.

Phyllanthus niruri has been used around the world for thousands of years to address kidney stones and a variety of chronic illnesses. Its antiviral, antibacterial, anti-plasmoidal qualities can help to attack the spirochete that causes syphilis. It has 100+ bioactive compounds. It’s not a hammer that pounds pathogens. Instead, it offers fantastic support to the body’s immune system. That’s why Phyllanthus niruri makes a wonderful support for Lyme disease treatment.

It is thought that Phyllanthus niruri blocks the spirochete from replicating and that it interferes with the outer surface proteins (OSPs) that are integral to the ability of Borrelia burgdorferi to evade the immune system. We believe that Phyllanthus niruri is the world’s best synergistic adaptogen and that it offers more health benefits than any other plant.

For example, Panax Ginseng, the most famous adaptogen, contains 28 types of saponins, whereas Phyllanthus niruri contains 168 different active compounds. That’s 6 times as many.

In addition, Cryptolepis sanguinolenta is a Lyme disease support superstar. In this scientific study, seven herbs showed activity against Borrelia burgdorferi, the bacterium that causes Lyme disease. Of those seven, only Cryptolepis completely eradicated B. burgdorferi.

Whether or Not You Have a Tick Bullseye Rash, Consider All-Natural-Herbal Support

If someone has a tick bullseye rash or is concerned about chronic Lyme disease, they may want to consider the Persister Desister Lyme Disease Support Kit from Linden Botanicals as part of their wellness routine because it offers all-natural herbal support that targets key concerns associated with Lyme, especially the persistent forms of the disease.

While this kit is not a substitute for professional medical treatment, it may provide valuable support for the body’s natural defenses and help manage symptoms and recovery. It may be a valuable part of a supportive protocol, especially for those with lingering symptoms or looking to strengthen their body’s resilience during and after treatment.

Here’s why the herbal components in the kit are worth considering:

1. Cryptolepis sanguinolenta

Traditionally used in West African herbal medicine, Cryptolepis has been studied for its antimicrobial and antiprotozoal properties, especially against Borrelia burgdorferi, the bacterium that causes Lyme disease.

• Research suggests Cryptolepis may help target both active and persistent forms of the bacteria, which is important for those dealing with chronic or treatment-resistant Lyme symptoms.

• It may also help manage symptoms such as fatigue, immune dysregulation, and inflammation.

2. Cistus incanus

This Mediterranean shrub has been used for centuries for its antioxidant, antibacterial, antiviral, and biofilm-busting properties.

• Lyme bacteria are known to hide in protective biofilms in the body, which makes them harder to eliminate.

• Cistus incanus may help disrupt these biofilms, allowing the immune system (and other treatments) to be more effective.

• It’s also known to support oral and gut microbiomes, which can be compromised in Lyme patients.

3. Phyllanthus niruri (“Chanca Piedra”)

Often used in South American herbal medicine, Phyllanthus is recognized for its support of liver and kidney health, making it valuable in any detox or recovery protocol.

• It supports the body’s natural detox pathways, which is key during and after Lyme treatment, especially when addressing die-off reactions (Herxheimer responses).

• It also provides anti-inflammatory and immune-modulating benefits, helpful for chronic inflammation and lingering Lyme symptoms.

Why Consider the Persister Desister Kit?

Here’s why our proprietary Persister Desister Kits provide exceptional, all-natural herbal support:

• Holistic Support: Targets multiple dimensions of Lyme disease—immune function, microbial persistence, inflammation, detoxification, and biofilms.

• Non-Pharmaceutical: Appeals to those seeking plant-based, natural alternatives or complements to antibiotic treatment.

• Synergistic Herbs: These three herbs are selected to work together in support of overall wellness, rather than treating isolated symptoms.

It’s also a good idea to arm yourself with the facts:

• Learn 5 ways to prevent Lyme disease.
• Identify Lyme symptoms and get Lyme support.
• Learn about Borrelia burgdorferi and Lyme disease.
• Recognize the 5 Lyme disease myths.
• Learn how Phyllanthus niruri may help fight Lyme.
• Learn about Helicobacter pylori (H. pylori) and Phyllanthus niruri.
• Identify 5 ways to find a trusted source for Phyllanthus niruri.
• Read our free Lessons from the Darkness e-book: insights from Linden Botanicals owner Michael Van der Linden, who suffered from Lyme for almost 4 years.

Final Thoughts for the Health-Conscious

Lyme disease is often invisible at first, but that doesn’t make it harmless. The sooner you recognize symptoms, the sooner you can get help—and avoid more serious complications down the road.

• Always do tick checks after outdoor activities.

• Don’t ignore unexplained fatigue, pain, or neurological symptoms.

• And if something feels “off,” trust your instincts and talk to a healthcare provider who understands Lyme disease.

Your health and well-being are worth the extra attention.

To learn more, another good place to start is with our Lyme Disease Resources and the Persister Desister FAQ.

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