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Can Lyme Disease Cause or Trigger Psoriasis?

Medically reviewed by Zeba Faroqui, M.D.
Written by Emily Wagner, M.S.
Posted on May 10, 2023

If you’re living with psoriasis or psoriatic arthritis (PsA), you may wonder whether infections can cause psoriatic disease or trigger your flares. Studies show that Lyme disease may lead to PsA and make symptoms worse for some people.

Lyme disease is a topic among members of MyPsoriasisTeam. “Did anyone else have Lyme disease and get worse symptoms afterward?” asked one member. “My PsA was very mild and undiagnosed (had Sjögren’s and RA diagnosis only) until a few months after Lyme.”

In this article, we’ll cover what Lyme disease is and how it’s related to psoriasis and PsA. Knowing the signs of Lyme disease and how it may affect your condition can help you recognize the signs and get treatment as soon as possible.

What Is Lyme Disease?

Lyme disease is the most common vector-borne disease in the United States — that is, infections spread by blood-feeding arthropods such as fleas, mosquitos, and ticks. Lyme is caused by the Borrelia burgdorferi and Borrelia mayonii bacteria, which are transmitted through tick bites.

Ticks, a type of parasitic arachnid, can transmit Lyme disease to humans through bites. (CC BY-NC-ND 3.0 NZ/DermNet)

Symptoms of Early-Stage Lyme Disease

Lyme disease develops in three stages. Stage 1 symptoms can begin between three and 30 days after a tick bite. The symptoms differ from person to person and can change depending on what stage of infection you’re in. Most people have heard that Lyme disease causes a “bull’s-eye” rash to form around the site of a tick bite. This is known as erythema migrans, and it’s seen in up to 80 percent of people with Lyme disease.

In around 80 percent of people infected with Lyme disease, a bull’s-eye rash develops around one week after a tick bite. The color of the rash varies, depending on skin tone. (CC BY-NC-ND 3.0 NZ/DermNet)

If a rash develops, it usually does so around one week after a tick bite. The color of the rash varies depending on skin tone. On dark skin, it may appear purple or brown, and on light skin, it may appear pink or red.

Over the course of several days, the circle will continue to expand, sometimes growing as large as 12 inches or more. The rash typically doesn’t itch and isn’t painful, but it may feel warm to the touch.

Whether or not a rash develops, you may develop flu-like symptoms during the early stage of Lyme disease, including:

  • Headache
  • Fatigue
  • Fever
  • Chills
  • Swollen lymph nodes
  • Achy joints and muscles

If you’ve had a tick bite and begin experiencing any of these symptoms, you should seek medical attention immediately, according to the Centers for Disease Control and Prevention (CDC). The sooner you begin treatment, the more likely you are to cure Lyme disease before it can progress.

Symptoms of Late-Stage Lyme Disease

Left untreated, Lyme disease will continue to progress and begin affecting other organs. Stage 2 Lyme disease — also known as early disseminated disease — develops within three to 10 weeks after a tick bite. Symptoms can include:

  • Neck stiffness or pain
  • Rashes on other areas of your body
  • Nerve pain
  • Facial palsy (muscle weakness in your face)

Stage 3 Lyme disease — also known as late disseminated disease — eventually causes Lyme arthritis. The most common symptom is pain and swelling in your body’s large joints, especially in the knees. This may begin between two months and one year after a tick bite.

​​

In late-stage Lyme disease, inflammation can occur, causing swelling and discoloration. Skin can start to thin and tear easily. (CC BY-NC-ND 3.0 NZ/DermNet)

Diagnosing and Treating Lyme Disease

If your doctor thinks you may have Lyme disease, they’ll typically first perform a physical exam to look for the telltale bull’s-eye rash. However, not everyone develops this rash, so it can sometimes be difficult to make a diagnosis. Researchers have found that Black people are diagnosed with Lyme disease later than white people, according to the Journal of General Internal Medicine. This may be because of a lack of research on how to recognize early stage Lyme skin symptoms on darker skin.

When you become infected with the Borrelia bacteria, your immune system creates antibodies against it to fight the infection. Doctors use antibody tests as one of the most accurate ways to diagnose Lyme disease. A western blot and an enzyme-linked immunosorbent assay (ELISA) are both used to detect antibodies in your spinal fluid or blood.

One member shared their experience with Lyme disease and testing. “I am battling Lyme and the skin from hell together now. However, I am going to urge everyone to have the Lyme test (western blot is the best one). Catching it early will prevent a lot of damage, and it is the last thing doctors ever seem to look for.”

Lyme disease is typically treated with an antibiotic taken two to three times a day for a few weeks. The most commonly prescribed antibiotic treatments are doxycycline, amoxicillin, or cefuroxime. They may be taken by mouth or given intravenously, depending on your symptoms and how severe they are.

Lyme Disease and Arthritis

Scientists know that Lyme arthritis can develop in untreated cases of Lyme disease, which typically affects the knees. In one small study, researchers found evidence that Lyme disease may be associated with the later development of autoimmune joint diseases such as PsA.

Further studies are needed to confirm whether untreated Lyme actually raises the risk for PsA, as well as details about the relationship between Lyme and autoimmune arthritis.

Lyme Disease Skin Symptoms May Look Similar to Psoriasis

MyPsoriasisTeam members have noted that skin lesions from psoriasis can be difficult to tell apart from Lyme disease skin. “I got Lyme disease in April. My rash kind of made it not so obvious to me, but it wasn’t a typical Lyme disease rash,” shared one member.

Lyme disease rashes may cause skin discoloration. They can also develop crusts that look similar to psoriasis. If you were bitten by a tick while in Europe, you’re at a higher risk of developing acrodermatitis chronica atrophicans. This condition causes swelling and skin color changes on your feet, hands, elbows, and knees.

Tips To Lower Your Risk of Lyme Disease

Blacklegged ticks, also known as deer ticks, can be found throughout the United States, but they’re more common in the Northeast, mid-Atlantic, and upper Midwest states. They tend to live in grassy or wooded areas like forests and fields. If you live in or are visiting any of these areas, be sure to take extra precautions, especially in spring and summer.

To prevent getting bitten by a tick, the CDC recommends the following:

  • Apply the insect repellent permethrin to your clothes, boots, and other gear when outdoors to prevent ticks from attaching to them.
  • Stick to trails and pathways and avoid walking through areas with high grass and brush.
  • Check your clothes after being in an area that may have ticks.
  • Perform a full-body check for ticks after being outside, then showering within two hours of going inside.

Managing Your Psoriasis and Lyme Disease

If you’re diagnosed with Lyme disease, it’s important to stick to your treatment plan to prevent it from progressing and causing other health issues. Your doctor will prescribe antibiotics to take for a few weeks — be sure to take the entire dose to ensure it’s as effective as possible.

If you develop Lyme disease while living with psoriasis or PsA, your doctor will walk you through any changes to your treatment plan. One member wondered whether their antibiotic prescription would interfere with their biologic treatment. They shared, “Seems I have Lyme disease, on doxycycline, and due for my Cosentyx. Won’t know until Monday if I can take it, too.”

If you’re newly diagnosed with PsA and have a history of Lyme disease and psoriasis, your doctor will go over your different treatment options. They may prescribe a topical corticosteroid to help treat psoriasis skin lesions.

For joint pain and inflammation from PsA, you may be given a disease-modifying antirheumatic drug (DMARD) such as methotrexate (Otrexup or Trexall) or apremilast (Otezla). Biologics that block inflammatory proteins like tumor necrosis factor (TNF), such as adalimumab (Humira) and infliximab (Remicade), are also used to treat psoriasis and PsA.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriatic arthritis and psoriasis and their loved ones. Here, more than 117,000 members come together to share their stories, ask and offer advice, and discuss life with PsA.

Do you have psoriasis or PsA and Lyme disease? How has it affected your disease? Leave a comment below, or start a conversation on your Activities page.

Posted on May 10, 2023
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Zeba Faroqui, M.D. earned her medical degree from the SUNY Downstate College of Medicine. Learn more about her here.
Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here.

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