Pityriasis Rosea

• A common, harmless skin rash that goes away on its own.

• Most common in children, teens, and young adults (ages 6–35).

• May be slightly more common in spring and fall.

• Most people only get it once.

What causes it?

• The exact cause is not known, but it is probably caused by a virus.

• It is NOT caused by a fungus, bacteria, or an allergy.

• It is not caused by anything your child did or didn't do.

Is it contagious?

• No — pityriasis rosea is NOT considered contagious.

• Your child does NOT need to miss school, gym, or any activities.

What does the rash look like?

The rash usually happens in two stages:

• Stage 1 — The "herald patch":

  • A single, round or oval spot appears first.

  • Usually on the chest, belly, or back

  • About 1 to 3 inches across with a raised, scaly edge.

  • Can look a lot like ringworm.

• Stage 2 — The spreading rash (1–2 weeks later):

  • Many smaller oval spots appear on the chest, back, belly, upper arms, and legs.

  • Spots are about ¼ to ½ inch across and may have fine scales (crinkled look).

  • May also appear in the groin and armpits.

  • On the back, spots often line up in a "Christmas tree" pattern.

  • Usually does NOT appear on the face.

• Color varies by skin tone:

  • Lighter skin: pink, red, or salmon-colored

  • Darker skin: purplish, dark brown, gray, or harder to see

Does it itch or hurt?

• Some children feel itchy, especially during the first 1–2 weeks.

• Up to 1 in 4 children may have more noticeable itching.

• The rash is not painful.

Are there other symptoms?

Before or during the rash, some children may have mild symptoms such as:

• Feeling tired or not quite like themselves.

• Sore throat or cough.

• Mild headache or slight fever.

• Decreased appetite.

Most children with pityriasis rosea feel normal otherwise.

How is it diagnosed?

• A healthcare provider can usually diagnose it just by looking at the rash.

• No special tests are needed in most cases.

How long does it last?

• The rash goes away on its own in 6 to 10 weeks (sometimes up to 3 months).

• New spots may keep appearing during the first 2–6 weeks, but all spots will clear up.

• Skin may look slightly lighter or darker where spots were. This is temporary and fades over time, though it may take a few extra weeks to months (more noticeable on darker skin tones). This rash does not leave scars.

How is it treated?

Most children do not need any medicine.

Here are things that can help if your child is uncomfortable:

• Moisturizing cream:

  • Use a fragrance-free cream on dry or itchy areas 3 times a day

  • After a lukewarm bath, apply within 3 minutes to lock in moisture

• Avoid soap during bathing:

  • Soap dries out the skin and makes itching worse

  • Use plain water, a soap substitute, or gentle bath oil instead

• Lukewarm baths only:

  • Hot water makes itching worse

• Steroid cream (for very itchy spots):

  • Use 1% hydrocortisone cream (no prescription needed) up to 3 times a day

  • As the rash improves, moisturizing cream alone should be enough

• Antihistamines:

  • Cetirizine (Zyrtec) or diphenhydramine (Benadryl) may help with itching

  • Click here for a dosing guide.

• Sunlight exposure (one time only):

  • About 30 minutes of sunlight on the rash (enough to make skin slightly pink)

  • May help reduce itching and shorten the rash

  • Do NOT sunburn — talk to your pediatrician first

• Soft, loose-fitting clothing to reduce irritation

When to call CPCMG

• The rash becomes very itchy and home care is not helping

• The rash looks different from what is described here (blisters, rash on palms/soles, or mouth sores)

• The rash looks infected (pus, oozing, or crusted sores)

• The rash lasts longer than 3 months

• Your child has a high fever or seems very unwell

• Your child seems to be getting worse