Can African Americans Get Lyme Disease? Why It May Be Missed or Diagnosed Late
IS LYME DISEASE LESS COMMON IN BLACK PATIENTS?
OR IS IT
MISSED OR DIAGNOSED LATE?
Yes—African Americans can get Lyme disease. However, reported cases are lower in this population, and some evidence suggests diagnosis may be delayed or missed.
Differences in exposure, access to care, and recognition of symptoms—especially skin findings—may all contribute.
For a broader overview, see the Lyme disease symptoms guide.
What Did the Study Find?
Using electronic medical records from Geisinger, researchers identified 9,657 Lyme disease cases diagnosed between 2006 and 2014 in central and northeastern Pennsylvania.
More than 97% of patients were white non-Hispanic. Only 0.9% were Hispanic and 1.4% were Black non-Hispanic.
However, these findings do not necessarily reflect true infection rates and may be influenced by differences in diagnosis, reporting, or access to care.
Why Might Lyme Disease Be Under-Recognized?
The authors suggest that Lyme disease risk may be higher in communities located near wooded or grassy areas, which in this region tend to be more affluent and predominantly white.
However, other factors may also contribute, including:
- Differences in access to healthcare
- Awareness of Lyme disease
- Patterns of outdoor exposure
- Recognition of symptoms
Delayed Diagnosis May Occur
Some studies suggest that African Americans may be at higher risk for delayed diagnosis and treatment of Lyme disease.
Delayed diagnosis can allow symptoms to progress and may increase the risk of complications.
Why Rash Recognition Matters
Erythema migrans rashes do not always look like a classic bull’s-eye—and may appear differently on darker skin, making them harder to recognize.
This variability can contribute to missed or delayed diagnosis in the early stage of Lyme disease.
For more on rash variation, see what an erythema migrans rash really looks like.
Clinical Perspective
In clinical practice, variability in rash appearance and symptom recognition remains a key challenge across all populations.
Improving awareness of how Lyme disease presents across different skin tones and populations is essential for timely diagnosis.
FAQ: Lyme Disease and Race
Is Lyme disease less common in African Americans?
Reported cases are lower, but this may reflect differences in diagnosis, exposure, or recognition rather than true absence of disease.
Can Lyme disease be missed in darker skin?
Yes. Rashes may appear differently and may not show the classic bull’s-eye pattern, increasing the risk of missed diagnosis.
Clinical Takeaway
Lyme disease can affect anyone—including African Americans—but may be under-recognized or diagnosed later in some populations.
Greater awareness of symptom variability and diagnostic challenges is key to improving early recognition and treatment.
Related Articles:
Lyme disease diagnosis almost missed in patient with Babesia
Lyme disease in children rising in Pennsylvania: An inside look
References:
- Moon KA, Pollak J, Hirsch AG, et al. Epidemiology of Lyme disease in Pennsylvania 2006–2014 using electronic health records. Ticks Tick Borne Dis. 2018.
- Fix AD, Pena CA, Strickland GT. Racial differences in reported Lyme disease incidence. Am J Epidemiol. 2000.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
Could being a Southerner affect the diagnosis and treatment of Lyme and other tick-borne diseases?
Yes.
Interesting, however in my case, white female undiagnosed for 20+ years with access to endless doctors who had no clue and treated me horribly, so …
Thanks for sharing your frustration.
I’m african american suffering from Lyme Borreliosis and Candida for a few years. I’ve gone from physician to physician without treatment. I’m tired and weary. I see the disparity of treatment with regards to demographic info. My mother died from the same symptoms I’m experiencing. I just want help. I’ve spent my life savings on life sustaining treatments for my mother and I. In Alabama but willing to travel but require a physician who accepts Medicare/ Medicaid and Igenex results!
Hello sir.
Did you ever get help or diagnosed?
MX Hayes,
You should join the Facebook Lyme groups! I got so much information. The Lyme Support and Wellness is the most helpful, but I’m in about 5-6 groups. I learn something new everyday. I’m so sorry you are going thru this. It took 17 years of misdiagnosis to finally get a Lyme diagnosis for myself. You need a Lyme Literate Dr(LLMD). There is a directory online, if you Google that phrase! I wish you so much luck!
I have met many with darker complexions who couldn’t see the rashes or ticks in their scalps, etc.