Pityriasis rosea: Diagnosis and treatment
Pityriasis rosea causes a rash that will clear on its own, so most people don’t need treatment. See a board-certified dermatologist if:
You’re pregnant or think you could be. You’ll need a diagnosis, so you can tell your obstetrician.
Symptoms are interfering with your everyday life. If itching or another symptom makes your everyday tasks uncomfortable or difficult, treatment can help.
A symptom like itch is the same or worsening after 2 months.
The rash lasts longer than 3 months.
How to relieve symptoms at home
Most people don’t need treatment and can get relief with at-home self-care. See what board-certified dermatologists recommend that can help you or your child feel more comfortable: Pityriasis rosea: How to treat it at home.
How do dermatologists diagnose pityriasis rosea?
A dermatologist will look at your rash and ask questions about your health. If you have the classic pityriasis rosea rash, a dermatologist can often diagnose you right away. To the trained eye, this rash is obvious.
During your appointment, it’s important to tell your dermatologist if you:
Are (or could be) pregnant
Have had an organ transplant
Take any medications or had a vaccine recently
Some medications and vaccines can cause a rash that looks like pityriasis rosea. It’s important to rule these out, so tell your dermatologist about vaccines you recently had and all medications you take.
Sometimes, testing is necessary to rule out another condition, such as an infection. When testing is necessary, your dermatologist may remove a bit of skin or order a blood test.
How do dermatologists treat pityriasis rosea?
If you have pityriasis rosea, the rash will go away without treatment.
In children, the rash usually clears in 16 days.
Teens and adults tend to have the rash for 6 to 8 weeks, but it can take longer for your skin to clear.
Most people do not need treatment, but sometimes, it can be helpful. Your dermatologist may recommend treatment if your symptoms or the rash:
Causes discomfort that interferes with everyday life
Has lasted longer than 3 months
Worsens instead of showing signs of easing up
Here’s what a treatment plan may include for the:
Itch (mild): Sometimes, pityriasis rosea causes itchy skin. If you’re bothered by itch, your dermatologist may include one or more of the following in your treatment plan:
An emollient: When you apply this to itchy skin, it relieves the itch and discomfort by moisturizing, softening, and soothing your skin. An emollient can be a lotion, cream, ointment, or gel.
Anti-itch medication: To treat mild itch, your dermatologist may recommend that you buy a non-prescription medication like calamine lotion and apply it to your itchy skin. Other options for relieving itch are medications that contain either pramoxine or menthol. Be sure to use the one that your dermatologist recommends.
Corticosteroid you apply to the skin: A corticosteroid, such as triamcinolone ointment or hydrocortisone cream, can relieve mild itching, inflammation, and discomfort. You apply this medication to your itchy skin 2 or 3 times a day for as long as your dermatologist recommends.
Rash (widespread or long-lasting) or itch (severe): If you have a long-lasting rash that’s causing discomfort, severe itch, or both, your dermatologist can develop a treatment plan.
The following are only prescribed when symptoms are severe and causing great discomfort:
Oral (take by mouth) antihistamine: This medication can relieve severe itching. Your dermatologist will tell you which antihistamine to take and how often to take it.
Phototherapy: In studies, phototherapy has been found to relieve both the itch and severity of pityriasis rosea in 4 weeks. If phototherapy is an option for you, you’ll need to go to a dermatologist’s office or phototherapy treatment center a few times a week for about 3 to 4 weeks. If this isn’t possible, tell your dermatologist. For phototherapy to be effective, you need to keep all phototherapy appointments. Treatment involves standing in a booth called a phototherapy unit while your skin that needs treatment is exposed to a prescribed amount of ultraviolet (UV) light. When writing your prescription for phototherapy, your dermatologist will carefully calibrate the amount of light required to treat you.
Acyclovir: This medication is used to treat viral infections. Research shows that this medication can also reduce a severe rash caused by pityriasis rosea. In studies, researchers have found that acyclovir effectively reduced the rash when patients took acyclovir 5 times a day for 1 week. Patients typically saw noticeable improvement in 1 to 2 weeks.
- Brand names:
Discomfort in your mouth or throat: While rare, pityriasis roseacan cause patches, spots, and other lesions inside the mouth or throat. These clear at about the same time that the rash clears.
If you’re experiencing discomfort in your mouth, your dermatologist can prescribe:
A dental paste that contains a corticosteroid: This can bring relief.
Dark (or light) spots: Once the rash clears, some people see dark or light spots on their skin where the rash once was. This is more common in people who have deeply pigmented skin. Like the rash, these spots will go away on their own. Clearing can take 6 to 12 months. If the spots bother you, your dermatologist may help them clear more quickly.
Can you get pityriasis rosea again?
Many people develop pityriasis rosea once and never get it again. However, it’s possible to develop the rash more than once. In studies, between 2% and 3% of people develop the disease again. While unusual, one patient developed pityriasis rosea once a year for 5 years in a row. Keep in mind that this happened to one patient.
How to feel more comfortable while you have pityriasis rosea
While you have the rash, taking some precautions can help you feel better. To see what dermatologists recommend until the rash goes away, go to Pityriasis rosea: How to treat it at home.
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References
Ciccarese G, Broccolo F, et al. “Oropharyngeal lesions in pityriasis rosea.” J Am Acad Dermatol. 2017 Nov;77(5):833-837.e4.
Clark M, Gudjonsson JE. “Pityriasis rosea.” In: Kang S, Amagai M, et al. Fitzpatrick’s Dermatology (ninth edition). McGraw Hill Education, New York, 2019: 518-26.
Goldstein AO, Goldstein BG. (section editors: Dellavalle RP, Levy ML). “Pityriasis rosea.” UpToDate. Last reviewed: 8/2024. Last accessed: 9/2024.
Heymann WR. “Probing pityriasis rosea in pregnancy.” J Am Acad Dermatol. 2021 Dec;85(6):1413.
Litchman G, Nair PA, et al. “Pityriasis rosea.” StatPearls. Last updated 3/1/2024. Last accessed 9/2024.
Méndez A, Stevens C, et al. “From the Cochrane Library: Interventions for pityriasis rosea.” JMIR Dermatol. 2023 Jun 5;6:e45388.
Wood GS, Reizner GT. “Other papulosquamous disorders.” In: Bolognia JL, et al. Dermatology. (fourth edition). Mosby Elsevier, China, 2018:170-2.
Written by:
Paula Ludmann, MS
Reviewed by:
Brendan Camp, MD, FAAD
William Warren Kwan, MD, FAAD
Ata Moshiri, MD, FAAD
Carla Torres-Zegarra, MD, FAAD
Last updated: 10/24/24