All About The Lone Star Tick and Lone Star Tick Disease

The lone star tick has spread from southern states all the way up to Maine. It is probably more common than the blacklegged deer tick that causes Lyme disease and cause at least three tick-borne diseases.

lone star tick disease

The lone star tick can cause tick borne illnesses like Southern Tick Associated Rash Illness and Ehrlichiosis.

© Joesboy | Getty Images

According to the Centers for Disease Control and Prevention (CDC), the lone star tick has been moving out of the south for the last 20 to 30 years. It has steadily moved up the east coast and west into central parts of the country. In fact, although the black-legged deer tick that causes Lyme disease is the tick most people fear, the lone star tick is probably more common and more aggressive. Lone star does not carry Lyme disease, but it does carry several other important diseases you should know about.

Lone Star Tick Bite Rash

Unlike the black-legged tick that just sits and waits, the lone start tick actively seeks out humans to bite. It senses your movement and the carbon dioxide from your breath. Once it gets on your skin it is an aggressive biter that burrows into your skin. This bite is irritating, and it causes redness, itching, and swelling at the site of the bite. This tick bites at any stage of development from larva to adult. You can identify the female by a white spot on its back. The male has white spots around the outer edge of its back.

The redness and swelling at the site of the bite does not mean you have lone star tick disease. If you have lone star tick disease you may get a rash that is identical to a Lyme disease rash called erythema migrans. This is a red rash that spreads outward around the bite, the so called “bulls-eye” rash. This rash can occur from 7 to 30 days after the bite.

Southern Tick Associated Rash Illness (STARI)

This is probably the most common disease caused by the lone star tick. It may cause a rash similar to Lyme disease along with symptoms that include:

  • Fever
  • Chills
  • Headache
  • Fatigue
  • Muscle ache
  • Swollen glands

The organism carried by lone star ticks that causes this disease is not known, so there is no blood test available to diagnose it. STARI is diagnosed by its signs and symptoms along with the history of a tick bite. Unlike Lyme disease there are no long-term complications like neurological disease or arthritis. Treatment for STARI is the antibiotic doxycycline.


This bacterial infection may also be carried by lone star ticks. If the bacteria – called Ehrlichia chaffeensis – gets into your system from a tick bite, symptoms of the infection may start in a few days to a few weeks. Symptoms may include:

  • Rash
  • Fever
  • Headache
  • Chills
  • Nausea
  • Vomiting
  • Weakness

This disease can occur without the rash. It is diagnosed by finding the bacteria in a blood test. Treatment is the antibiotic doxycycline.

Learn more about Ehrlichiosis – Another Tick Borne Illness on the Rise.

Alpha-Gal Syndrome

This is the strangest disease caused by the lone star tick. Alpha-gal syndrome is an allergy to red meat. It occurs because of a type of sugar molecule carried by the tick. In some people this molecule – called alpha gal – causes a person’s immune system to produce antibodies against alpha gal. These antibodies can mistake meat molecules as alpha-gal and launch an allergic response, similar to a food allergy.

Unlike a usual food allergy to peanuts or shellfish that occurs within minutes, this reaction is delayed by 3 to 6 hours. Symptoms of the allergic reaction may include:

  • Itchy rash
  • Hives
  • Wheezing
  • Nausea and vomiting
  • Stomach ache
  • Headache

A severe type of reaction called anaphylaxis may occur. Anaphylaxis causes a drop in blood pressure, swelling in the throat, and difficulty breathing. Treatment of anaphylaxis is an injection of epinephrine. Alpha-gal syndrome may be diagnosed in people who have allergic reactions to meat without any other evidence of food allergies. The only treatment is to avoid meat. People with alpha gal may also react to gelatin and the cancer drug Cetuximab.

Prevention of Lone Star Tick Bites

Avoiding lone star tick bites prevents lone star tick diseases. In addition to STARI, ehrlichiosis, an alpha-gal syndrome, lone star tick bites have been linked to tularemia, Heartland virus, and rocky mountain spotted fever. These are the tick prevention tips for lone star ticks and other ticks:

  • When outside during tick season wear long pants and socks.
  • Avoid wooded areas and grass fields.
  • Treat your skin with a tick repellant containing DEET.
  • Treat your clothing with a tick repellant called picaridin.
  • Check your body for ticks by looking and feeling.
  • Ticks may be on your skin for hours before biting, so take a shower when you get home.
  • If you find a tick, grab it as close to your skin as possible with a fine tweezer and remove it by pulling up.
  • Treat the bite area with a disinfectant or rubbing alcohol, and an antibiotic ointment if available.
  • Save the tick in case you have symptoms of disease. A health care provider may be able to identify the tick and that may help; guide treatment.
  • If you have any of the signs or symptoms of tick disease, see a health care provider.

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Chris Iliades, MD

Dr. Chris Iliades is board-certified in Ear, Nose and Throat and Head and Neck Surgery from the American Board of Otolaryngology and Head and Neck Surgery. He holds a medical … Read More

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