Pityriasis Rosea

What is pityriasis rosea?

Pityriasis rosea (pih-tuh-RY-uh-sis ROH-zee-uh) is a common skin condition that causes patches of your skin to develop raised, scaly rashes. It may appear on any part of your body, but it usually appears on the trunk (torso), arms and legs. “Pityriasis” means “scaly,” and “rosea” means “pink,” but the rashes may look red, gray, brown or purple.

Pityriasis rosea is also known as Christmas tree rash.

Who does pityriasis rosea affect?

Anyone can get pityriasis rosea. You may be more likely to develop it if you’re:

• Between the ages of 10 and 35.
• A woman. Women are 50% more likely to develop pityriasis rosea.

In some cases, people with pityriasis rosea report that they had significant or long-term stress before developing a rash. However, there isn’t enough research to determine that stress may cause pityriasis rosea.

Pityriasis rosea doesn’t usually affect people over the age of 60. However, if it does, the symptoms may last for a longer period.

How does pityriasis rosea affect my body?

Pityriasis rosea commonly affects the skin on your trunk, arms or legs. A variant called inverse pityriasis rosea can affect the skin on your neck, face, armpits (axillae) and groin, though it isn’t common.

Your skin may develop discolored patches (lesions) that look like scales or dry, crinkly paper. The patches may itch.

What are the symptoms of pityriasis rosea?

The symptoms of pityriasis rosea usually develop in stages:

• You may initially develop a fever, headache or upper respiratory infection.
• You may develop a raised, discolored, circular or oval-shaped patch that ranges from 1 to 6 centimeters (cm). This patch is the “herald” or “mother” patch.
• About one to two weeks later, discolored circular or oval-shaped patches appear in groups near the herald patch. These patches are smaller than the herald patch — they range from 1 to 2 cm — and are often called “daughter” patches. They develop in a pattern that resembles sagging Christmas tree branches.
• In approximately 50% of people with pityriasis rosea, the patches itch.
• In darker-skinned or Black people, the patches may be more raised (papular), and the centers of the patches may look like the tissue is dying (necrotic).

Pityriasis rosea doesn’t hurt. However, if you scratch your patches, you may break your skin, leading to an infection that can cause pain.

How do you get pityriasis rosea?

Healthcare experts believe herpesvirus 6 (HHV-6), HHV-7 and/or HHV-8 cause pityriasis rosea, but there aren’t any conclusive studies. These strains of the herpes virus aren’t related to the strains that cause cold sores or genital herpes.

Does COVID-19 cause pityriasis rosea?

Studies show that some skin conditions may appear with COVID-19, including pityriasis rosea. However, the studies don’t conclusively prove that COVID-19 causes pityriasis rosea.

What is the difference between pityriasis rosea and ringworm?

Pityriasis rosea and ringworm look similar. They’re both papulosquamous (pap-you-lo-skway-miss) disorders, which is a term used to characterize skin disorders according to the presence of raised, discolored, scaly patches of skin.

However, a fungus causes ringworm. No one knows what causes pityriasis rosea, though healthcare experts think a virus might be responsible.

Is pityriasis rosea a sexually transmitted disease?

Pityriasis rosea isn’t a sexually transmitted disease or infection (STD or STI). You can’t spread pityriasis rosea to another person through unprotected sex or skin-to-skin contact.

What if I develop pityriasis rosea while pregnant?

If you develop symptoms of pityriasis rosea while pregnant, contact your healthcare provider right away. Studies show that the development of pityriasis rosea during pregnancy may cause birth complications, including miscarriage and poor muscle tone and development once the baby is born (neonatal hypotonia).

How is pityriasis rosea diagnosed?

Your healthcare provider can typically diagnose pityriasis rosea after a physical exam. However, pityriasis rosea can look similar to other skin conditions, including:

• Eczema (atopic dermatitis).
• Psoriasis, including guttate psoriasis.
• Ringworm.
• Tinea versicolor.

If there’s any doubt, your healthcare provider may perform the following tests:

• Allergy test.
• Biopsy.
• Blood tests to check for causes of a rash that aren’t related to pityriasis rosea.

How is pityriasis rosea treated?

In most cases, pityriasis rosea goes away without any treatment in six to eight weeks.

If you have a very itchy rash, your healthcare provider may prescribe the following to help relieve your symptoms:

• Antivirals. Antiviral medications help your body fight off harmful viruses.
• Phototherapy. Phototherapy uses ultraviolet light, usually ultraviolet B (UVB), from special lamps. The ultraviolet light waves found in sunlight can help certain skin disorders, including pityriasis rosea. UVB can cause permanent dark spots (hyperpigmentation) in darker skin of color even after your rash has gone away, so it’s a good idea to check with your healthcare provider if you have darker skin.
• Prednisone tablets. Prednisone is a corticosteroid taken by mouth with a glass of water. It relieves inflammation in your skin as well as other parts of your body.

Are there any home remedies for symptoms of pityriasis rosea?

There are several over-the-counter products or home remedies that can help stop your rash from itching.

While home remedies are safe for most people, it’s a good idea to check with your healthcare provider before trying some of the following options. You may be at risk of developing an allergic reaction on your skin.

• Antihistamines. Antihistamines are a class of drugs commonly used to treat allergy symptoms, including itchy skin.
• Calamine lotion. Calamine lotion can relieve itching and discomfort as well as moisturize dry, scaly skin.
• Hydrocortisone creams or ointments. Hydrocortisone is a corticosteroid combined with an anesthetic pain reliever.
• Oatmeal: Oatmeal can soothe itchiness. The best way to use oatmeal on your pityriasis rosea rash is to grind it into a fine powder (colloidal oatmeal) in a blender or food processor. Mix the oatmeal powder with warm water until it becomes a thick, sticky paste. Apply enough of the oatmeal paste to cover your rash completely. After at least 10 minutes, wipe off the paste with a clean towel.

Should I avoid any foods or drinks I have pityriasis rosea?

If you have pityriasis rosea, you don’t have to avoid any foods or drinks. However, some people believe that eating an anti-inflammatory diet may relieve itching. Some research shows that people who follow a Mediterranean diet have lower levels of inflammation in their bodies.

Foods that have anti-inflammatory properties include:

• Oily fish, such as mackerel, salmon or sardines.
• Leafy greens, such as spinach and kale.
• Olive oil.
• Tomatoes.

Foods that may increase inflammation include:

• Fried foods, including many fast-food items.
• Cured meats with nitrates, such as hot dogs.
• Highly refined oils and trans fats.
• Refined carbohydrates, such as sugar, pastries and white bread.

How can I prevent pityriasis rosea?

There isn’t any way to prevent pityriasis rosea.

What can I expect if I have pityriasis rosea?

If you have pityriasis rosea, it can generally be well-managed without any treatment. It should clear your body in six to eight weeks. However, if you experience any symptoms, therapy can provide relief.

If you have pityriasis rosea, it’s unlikely that you’ll get it again. You also won’t have permanent scarring or other damage to your skin.

When should I see my healthcare provider?

Call your healthcare provider if:

• You develop new symptoms.
• Your symptoms don’t improve after treatment.
• Your rash lasts longer than 10 weeks.
• Your rash looks infected (red, purple, gray or white skin; irritation and swelling).
• You’re pregnant and develop a rash.

What questions should I ask my healthcare provider?

• How can you tell that I have pityriasis rosea?
• If I don’t have pityriasis rosea, what other skin condition might I have?
• How long will it take my body to clear the rash?
• What medications do you recommend?
• Do the medications have any side effects?
• What at-home treatments do you recommend?
• Is there a prescription cream or ointment that you can prescribe?
• Should I see a dermatologist or another specialist?

A note from Cleveland Clinic

Though pityriasis rosea is a common skin rash, it can still make you feel self-conscious, and it can be unpleasant if it itches. There isn’t a cure, but it isn’t contagious. Once it’s gone, you likely won’t develop it again.

It’s important to pay attention to your skin. Contact your healthcare provider as soon as you notice a rash.