What does pityriasis rosea look like?

The rash often begins with a single oval patch called a herald patch. It may develop on the chest, back, abdomen or another area.

Several days to two weeks later, smaller patches may appear across the trunk, upper arms or thighs. These patches often follow the natural lines of the skin and can create a pattern resembling drooping branches.

Depending on skin tone, the rash may appear:

Pink or red
Tan
Brown
Gray
Purple
Darker or lighter than the surrounding skin

The patches usually have a fine, wrinkled scale near their edges.

Does pityriasis rosea cause symptoms?

Some patients have no symptoms other than the rash. Others develop mild to severe itching.

Before the rash appears, a patient may briefly experience:

Fatigue
Headache
Sore throat
Mild fever
Reduced appetite

Not everyone develops a herald patch or the classic distribution.

What causes pityriasis rosea?

The exact cause remains uncertain. Research suggests that reactivation of certain viruses may be involved, but pityriasis rosea is not generally considered contagious.

You do not need to avoid school, work or close contact solely because of this diagnosis.

The rash is not caused by fungus, and over-the-counter ringworm medication will not clear it.

How is pityriasis rosea diagnosed?

A dermatologist may diagnose the condition by examining the pattern and scale.

Testing may be performed when the rash is unusual. A skin scraping can exclude fungus, while blood testing may help rule out another illness. A biopsy is occasionally needed.

Tell your provider about all medications and supplements because some drug reactions can resemble pityriasis rosea.

How is pityriasis rosea treated?

The rash generally clears on its own, often within several weeks, although some cases last longer.

Treatment may be recommended for discomfort and can include:

A topical corticosteroid
Oral antihistamine
Fragrance-free moisturizer
Phototherapy for extensive symptoms
Antiviral medication in selected severe cases

Cool or lukewarm bathing and loose clothing may reduce itching.

Patients who are pregnant or may be pregnant should inform their healthcare provider, particularly when the rash develops early in pregnancy.

Schedule a pityriasis rosea consultation

Pityriasis rosea can be difficult to distinguish from fungal infection and other rashes. The Dermatology Clinic can confirm the cause and recommend treatment when itching or widespread inflammation becomes uncomfortable. Contact us today to get scheduled.