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Pityriasis rosea

Key points about pityriasis rosea

Pityriasis rosea is a skin rash which looks like ringworm.
Usually one patch appears on your upper body, then 1–2 weeks later many smaller patches appear.
It most often affects teenagers and young adults (rangitahi)
It often follows a viral illness that can include a cough, sore throat, runny nose and body aches and may be caused by your body’s reaction to the virus.
It lasts 6–10 weeks and goes away completely.
Pityriasis rosea can't be spread from person-to-person, so there's no need to keep children away from school.

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Pityriasis rosea is a common skin rash. You usually get it between the ages of 10 and 35 years, and it most often happens in winter. It lasts 6 to 10 weeks then goes away without needing treatment.

Pityriasis rosea usually starts with a single pink or red round or oval patch on your chest, back or tummy. This is called a herald patch. It’s about 2 to 5cm across. The centre of the patch might be scaly, and it might have a red rim.

The image below shows a person with pityriasis rosea and the herald patch can be seen as an oval patch under the collarbone on the right of the image.

Image credit: DermNet NZ

About 7 to 14 days later, lots of pink or red flaky patches appear all at once. The rash occurs mostly on your upper body and arms. The patches can follow the lines of your ribs, so this is sometimes called a Christmas tree pattern. You can sometimes get patches on your legs too. You don’t usually get it on the palms of your hands or the soles of your feet. If you’re pregnant, have dark skin or are younger the rash can be bumpier or even look like blisters. As the rash clears up, the patches of skin can look lighter or darker than usual, but this usually disappears over a few more months. It doesn't leave scars.

Video: Pityriasis rosea

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(Family Doctor, Australia, 2015)

Symptoms

Many people will have a cold, with a sore throat, cough or runny nose, but this is getting better by the time the rash appears.
About 1 in 4 people get itching along with the rash.

Cause

The exact cause is not known. The rash may be your body’s reaction to:

a virus (most common) which is why you can feel cold symptoms before the rash appears
some medicines
a vaccine.

Diagnosis

It’s hard to tell the difference between pityriasis rosea and other skin rashes, so if you’re not sure make an appointment to see your healthcare provider.

Your healthcare provider will likely diagnose pityrasis rosea clinically, based on how it developed and what it looks and feels like. If they are unsure they may take a small sample of skin called a skin biopsy.

Treatment

Pityriasis rosea goes away by itself so medicine isn't needed. You can get pityriasis rosea again, but that’s uncommon.

Shower and bathe with plain water and bath oil, aqueous cream, or other soap substitutes. Normal soap can irritate the rash. Use lukewarm water – avoid taking hot baths or showers as this can also irritate your skin.
Use moisturising creams for dry skin. Read more about emollients and moisturisers.
If the rash is itchy, it’s important not to scratch, as sometimes a scratch-itch cycle can develop. This happens when you itch more because you scratch, so you scratch more because you itch and so on.
See your pharmacist to talk about an antihistamine or 1% hydrocortisone cream if your skin is itchy.
Direct sunlight may heal the rash more quickly, but it’s important not to get sunburnt, so only expose your skin for a few minutes in the early morning or evening.