Wandering redness after tick bite • Often an indication of Lyme disease

Wandering redness is the reddening of the skin that spreads around the puncture site days or weeks after a tick bite. It is a typical indication of an infection with Lyme borreliosis, which absolutely requires treatment with antibiotics. Read everything about appearance, possible causes, diagnosis and therapy options here.

At a glance:

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What is wandering red?

The typical wandering redness (Erythema migrans) spreads in a ring around a tick bite and has a diameter of more than five centimeters. It usually occurs 3 to 30 days after the tick bites and often appears as a non-raised reddening on the edge with a clearly visible puncture point in the center. Their occurrence is a serious indication of a borreliosis infection transmitted by the tick bite: 60 to 90 percent of those infected with Lyme borreliosis show wandering redness. Wandering redness is therefore the main symptom of Lyme borreliosis and should definitely be clarified by a doctor.

Atypical wandering redness

The wandering redness does not always express itself as the typical circle around the puncture site – in this case one speaks of an atypical wandering redness. It manifests itself, for example, as a flat reddening, the color of which can vary from an easily overlooked pink to an intense purple. This does not always migrate, sometimes several rednesses appear over the body.

However, this must be differentiated from the normal inflammatory reaction at the puncture site, which usually disappears within a few days after removing the animal.

Diagnosis: This is how the wandering redness is examined by a doctor

If a definable red patch of skin spreads around the puncture site a few days or weeks after a tick bite, this can indicate Lyme disease. In this case, a visit to the doctor’s office is urgently recommended. Here the diagnosis begins with a detailed discussion (anamnesis), in which, among other things, questions about a tick bite or a stay in a tick area are asked.

This is followed by a detailed examination of the reddened area; Experts often recognize at first glance whether the problem is wandering redness. There are also other symptoms such as

added, the suspicion of borreliosis is confirmed. In this case – before any further diagnosis – treatment with antibiotics is started in order to prevent a serious course of the disease. Borreliosis antibodies can be detected in the blood two weeks after infection at the earliest – a blood sample is taken and examined in the laboratory. In the case of atypical courses, a skin sample is taken from the reddened area (biopsy) in order to detect the pathogen directly.

Differential diagnostics: what looks like wandering red?

Since numerous diseases are accompanied by reddening of the skin, it is important to differentiate between reddening and other forms of skin reaction (differential diagnosis).

The following other causes can be behind a reddening of the skin, among others:

  • Reactions to insect bites

  • Tinea corporis (a fungal disease of the skin)

  • Erysipelas (an infection of the skin caused by streptococci)

  • Drug eruption (hypersensitivity to certain drugs)

  • Erythema annulare centrifugum (irregular, ring- or arch-shaped skin lesions of unknown origin, often associated with autoimmune diseases, infections, or allergic reactions)

  • Erythema infectiosum acutum (also called rubella, infectious childhood disease that begins with a rash on the face and spreads to the extremities)

Therapy: what helps against wandering redness?

Antibiotic therapy shortens the course of the disease and prevents complications. Doxycycline and amoxicillin have proven to be particularly effective; cefuroximaxetil and azithromycin are also used less frequently. The duration of the therapy depends on the severity of the symptoms: If there is only one wandering redness without any further symptoms, 10 to 14 days of treatment are usually sufficient. In more severe cases, the duration of therapy is up to 30 days.

Course and prognosis

With timely therapy, the cure rates of wandering redness are 95 to 100 percent – in the vast majority of cases Lyme borreliosis heals with antibiotic treatment without consequences. If the disease remains untreated for a long time, the pathogen spreads in the body and triggers what is known as neuroborreliosis in around 3 out of 100 cases: the bacteria attack the brain and nerves, which can lead to paralysis, nerve and meningitis.

In about 2 out of 100 cases, months or years after a borreliosis infection, Lyme arthritis develops: The pathogens infect the joints, which is accompanied by painful joint inflammation and swelling. Both neuroborreliosis and Lyme arthritis can be effectively treated with antibiotics.


Prevention of wandering redness

So far, there is no vaccine against Lyme disease – the only effective prevention is therefore to avoid tick bites by covering them with clothing and by searching the skin after being outdoors.

If a tick bite does occur, it is important to remove the animal as quickly and as carefully as possible – preferably within the first twelve hours. The risk of Borrelia transmission increases with the tick’s suckling time, but transmission within the first twelve hours has rarely been observed. After removing the tick, the bite site should be observed for up to six weeks in order to detect any reddening at an early stage.

Ticks: the most important facts!

Source: Lifeline | Das Gesundheitsportal by www.lifeline.de.

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