Definition

• Pityriasis Rosea (PR) is a widespread skin rash
• Special finding: a large "herald patch" that precedes the rash by 1 to 2 weeks

Health Information

Symptoms

• The rash begins with a large, scaly, pink patch on the chest or back. This is called a "herald" or "mother" patch. It looks like a large ringworm and is 1 to 3 inches across.
• A widespread rash of smaller matching spots on both sides of the body. This occurs 7 to 14 days after the herald patch first appears.
• This rash consists of pink, oval-shaped spots that are 1/4 to 1/2 inch across. The spots are covered with fine scales. This gives the rash a crinkled appearance.
• The rash appears mainly on the chest, stomach, and back. Often, it is worse in the groin and armpits. Usually, the rash does not occur on the face.
• The rash can be itchy during the first one or two weeks.
• Age Range. Usually affects people between the ages of 6 and 35 years.

Cause

• The cause is unknown. It’s probably caused by a virus.
• Fungus, bacteria, and allergy have been proven not to be the cause.

Care Advice

1. Overview:
   • Pityriasis Rosea (PR) is a harmless rash that will go away on its own.
   • It lasts 6–10 weeks. During this time your child will feel fine except for some itching
   • Here is some care advice that should help.
2. Moisturizing Cream:
   • Buy a large bottle of moisturizing cream (avoid those with fragrances).
   • Put the cream on any dry or itchy area 3 times per day.
   • After warm water baths or showers, trap the moisture in the skin. Do this by putting on the cream everywhere after bathing. Use the cream within 3 minutes of completing the bath.
   • Avoid soap during bathing. Reason: soap makes the skin dry and more itchy.
3. Steroid Cream:
   • For very itchy spots, use 1% hydrocortisone cream. No prescription is needed.
   • Use up to 3 times per day as needed until the itching is better.
   • Eventually, the moisturizing cream will be all that you need.
4. Sunlight Exposure:
   • One dose of ultraviolet light can stop itching and shorten the course of PR.
   • Have your youngster sunbathe for 30 minutes (enough to make the skin pink). Do this only once.
   • If this is not possible, consider a tanning salon once. Caution: Avoid sunburn.
5. What to Expect:
   • Itching usually lasts 1–2 weeks
   • The rash goes away on its own in 6 to 10 weeks.
6. Return to School:
   • Your child does not need to miss any school or gym.
   • Pityriasis rosea does not spread to others.

Call Your Doctor If

• Rash becomes very itchy
• Rash becomes infected with pus or draining scabs
• Rash lasts longer than 3 months
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

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