Justin Bieber has revealed he is battling Lyme disease.
Taking to Instagram, the Canadian pop sensation told his 124m followers he “recently” discovered he had the bacterial infection after a “rough couple years”.
In a post that has been liked more than 2.2m times, the “Sorry” hitmaker dismissed claims he “looks like s***” because he is “on meth”.
Bieber, 25, added he has “chronic mono” - or glandular fever - which has affected his “skin, brain function, energy and overall health”.
Now on the “right treatment”, the singer reassured fans he will be “back better than ever”, with more details being revealed in an upcoming “docu series” on YouTube.
Bieber is not the only familiar face to battle Lyme disease, with Shania Twain, Avril Lavigne and Bella Hadid all overcoming the infection.
What is Lyme disease? What are its symptoms?
Lyme disease is a bacterial infection that can spread to humans via the bite of an infected tick, the NHS reports.
It is “not common in the UK”, affecting 2,000 to 3,000 people every year in England and Wales, government statistics show.
In the US, around 30,000 cases are reported to the Centers for Disease Control and Prevention annually.
Symptoms tend to be vague and flu-like, including fatigue, fever, headaches, and muscle and joint pain.
Many - but not all - develop the tell-tale bull’s eye rash around the bite, which can appear up to three months after coming into contact with a tick.
The rash, which usually fades after several weeks, may feel slightly raised at the border.
How is Lyme disease treated? How can you avoid infection?
Lyme disease can be more effectively treated if caught early, according to the NHS.
Most ticks are harmless, however, Lyme-carrying critters are found all over the UK, even in London parks.
Grassy and woodland areas are most risky, like the Scottish Highlands.
It is important to remove a tick as soon as you spot one.
Using fine-tipped tweezers or a special removal tool, grasp the tick as close to the skin as possible.
Slowly pull upwards, trying not to squeeze or crush the tick.
Clean the area with antiseptic or soap and water.
For most this will be the end of it, however, see your GP if you have been bitten by a tick and go on to develop flu-like symptoms or a bull’s eye rash.
Two blood tests are required to confirm the infection, which are not always accurate early on.
When it comes to overcoming Lyme disease, spotting it early seems to be critical.
A delay in diagnosis can allow the bacteria to “infiltrate nerve cells, the brain, other organs, collagen and connective tissue, making it hard to purge from the body”, Dr Paul Taylor, of Sunnybrook Hospital in California, wrote on YourHealthMatters.
If diagnosed, your GP will prescribe antibiotics, usually taken for several weeks.
Dr Taylor describes the pathogen as “tenacious”, often developing resistance to antibiotics.
Nonetheless, most patients make a full recovery, even if it takes months, according to the NHS.
Some continue to have symptoms despite treatment, with low energy and aches lasting years. Many compare this to chronic pain or fatigue.
Why this occurs is often disputed, with experts being muddled as to how best to treat it.
If your symptoms return, your GP may refer you to specialist care.
In his Instagram post, Bieber referred to Lyme disease as “incurable”.
According to the CDC, there is no test that “proves” a patient has been cured.
The proteins that fight the infection can persist after the bacteria have been killed off. With blood tests detecting these proteins, it can give the impression the patient is still ill.
DNA fragments from “dead” bacteria can also linger, but that does not mean the pathogen is still viable.
Whether Lyme disease can be life-threatening is a controversial subject.
CDC scientists called it a “rare cause of death in the US”, Reuters reported.
Between 1999 and 2003, 114 US records listed Lyme disease as behind the fatality.
One died of respiratory failure, linked to the infection’s affect on the central nervous system.
Others cite suicide, or even the infection triggering dementia or multiple sclerosis. This is unconfirmed, however.
When it comes to Lyme disease, prevention is better than cure.
With no vaccine, Public Health England (PHE) claims the best way to avoid infection is to dodge ticks.
It recommends walking on clearly defined paths and avoiding brushing against vegetation when possible.
PHE also advises wearing light clothing to help spot any crawling ticks.
An insect repellent may help discourage ticks, while long trousers and sleeves can reduce the amount of exposed skin the ticks could attach to.
Dr Josh Berkowitz, from the Lyme Disease Clinic, also recommends checking your pets for ticks after they have been outside.
Find out more information at Lyme Disease Action.