When left untreated, Lyme disease can lead to long-term side effects like chronic weakness and even facial paralysis.
Editor’s note: This article has been updated from an earlier version posted in July 2021.
If you’re a fan of spending time in the great outdoors, you’re probably familiar with the routine of checking yourself for ticks during and after a hike or camping trip. But do you know why it’s so important to catch tick bites early to prevent Lyme disease?
“When a tick bites you, they can transfer harmful bacteria they’re carrying to your body,” says emergency medicine physician Dr. Lara Phillips. For those living in the northeastern region of the United States specifically, where deer ticks are common, tick bites are associated with Lyme disease.
Symptoms of Lyme Disease
Before you start panicking about the tick you found latched onto your skin last weekend, it’s important to know if you’re at risk for Lyme disease. “A tick needs to be attached to your skin for at least 36 to 48 hours to transfer Lyme disease to your system,” says Dr. Phillips. “And we generally see spikes in cases of Lyme diseases in the late spring and early fall, when ticks are in the nymph stage of their life cycles.”
In the early stages—a few days to a month—after a prolonged tick bite, Lyme disease can manifest with flu-like symptoms including weakness, headaches, joint pain and muscle aches—in addition to the telltale bullseye-shaped rash around the bite. “Lyme disease is easy to treat, but if it’s left untreated it can lead to further complications including heart block, joint pain, chronic weakness, arthritis and other neurological symptoms,” says Dr. Phillips.
Lyme Disease and Facial Paralysis
One potential long-term side effect of Lyme disease is facial paralysis. “Many people don’t know this, but Lyme disease-associated facial palsy appears in about 5% of patients diagnosed with Lyme disease,” says Stacey Baer, facial nerve rehabilitation specialist at Jefferson’s Facial Nerve Center.
Lyme disease-associated facial palsy can show up one to three weeks after the onset of the disease and is often bilateral—meaning it affects both sides of the face. This is one symptom that distinguishes it from Bell’s palsy, the most common cause of facial paralysis. These two types of facial paralysis are treated differently: Bell’s palsy is believed to be caused by a virus and is typically treated with antivirals, but Lyme disease is a bacterial infection—it requires antibiotic therapy instead.
While medical treatment for Lyme disease involves antibiotics, Jefferson’s Facial Nerve Center focuses on getting patients with Lyme disease-associated facial palsy back to normal functionality. “In the beginning stages of facial paralysis, we focus on educating patients about the facial nerve recovery process. We introduce compensatory strategies that can be helpful to use when everyday tasks, such as drinking from an open cup and brushing teeth without spilling, are now challenging and frustrating. And we teach patients how to perform soft tissue massages to their facial muscles and make sure they are receiving proper eye care if they are having trouble with eye closure.” says Baer.
“The good news is, all patients with Lyme disease-associated facial paralysis should recover facial movement,” says facial plastic and reconstructive surgeon Dr. Ryan Heffelfinger. “However, some may develop permanent facial muscle tightness, involuntary facial movements or an abnormal smile. At the Facial Nerve Center, we can treat these long-term side effects through facial nerve rehabilitation, Botox® injections or surgical procedures.”
Preventing Lyme Disease
While deer ticks may be lurking where you are hiking, there are ways to protect yourself from Lyme disease. Dr. Phillips advises people to avoid grassy or bushy areas, wear boots or tall socks to cover your skin, use insect repellent and treat hiking or camping gear with permethrin—an insect repellent that can last for weeks at a time.
“When coming back from a hike or time outside, have someone check your back, behind your ears, along your hairline and your clothes,” says Dr. Phillips. “If possible, take a shower within two hours of coming inside—it’s been shown to reduce your risk of getting Lyme disease.”
If you find a tick on your body, remove it as soon as possible. Use tweezers to grab the tick at the mouthparts and pull. “Clean the area once you’ve removed the tick, and be sure to monitor for any flu-like symptoms or rashes,” says Dr. Phillips. Some states also offer free tick testing—you can send the body of the tick to be tested for Lyme disease and get results within about 72 hours.
If you’re concerned about a tick bite, reach out to your healthcare provider for next steps on testing and treatment for Lyme disease.