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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. The pattern of the rash is easy to recognise on camera, and a doctor can treat the itch and rule out look-alikes.
- What it is: a common, mild rash that starts with one larger scaly patch, followed by smaller patches on the chest and back.
- Not contagious: pityriasis rosea cannot spread from person to person; the cause is not known, but it may be a virus.
- Usual course: it clears by itself, usually in 6 to 10 weeks, and rarely comes back.
- Emergency: call 112 for blistering or peeling skin with sores in the mouth or eyes, or a rash that does not fade when you press a glass against it.
If you are pregnant and get a new rash, contact your midwife, maternity unit or doctor straight away rather than waiting. Blistering or peeling skin with sores in the mouth, eyes or genitals, or a rash that does not fade when you press a glass against it, needs 112.
Can an online doctor treat pityriasis rosea?
Yes. Pityriasis rosea is recognised by its pattern: one larger patch first, then smaller oval patches on the chest and back, which shows well on camera. It clears by itself, so care is about confirming the diagnosis, ruling out conditions that look similar and need treatment, and easing the itch. The doctor may suggest a blood test when another cause, such as syphilis, needs ruling out.
How an online consultation helps with pityriasis rosea
- A clear diagnosis: Pityriasis rosea, ringworm, psoriasis or eczema: the doctor tells them apart from the pattern.
- Look-alikes ruled out: When a rash needs a blood test, for example to rule out syphilis, and how to arrange it.
- Relief from the itch: Moisturisers, antihistamines and, when needed, a steroid cream or a short course of antiviral tablets.
- Pregnancy advice: What a new rash in pregnancy means, and who to contact without delay.
What the doctor checks in an online consultation
The doctor asks about:
- How it started: a single larger patch first, and when the smaller patches followed.
- Where it is: the chest, back, tummy, upper arms and thighs, and whether the palms, soles, face or mouth are affected.
- Symptoms: itching, and feeling unwell with tiredness, a sore throat, a high temperature or headache before the rash.
- Pregnancy: whether you are or could be pregnant.
- Medicines and vaccines: anything new in the weeks before the rash.
- Sexual health: a recent new partner, or a sore on the genitals or mouth in the past few months.
Before the call, find good light, and take a photo of the first patch if you can find it, as it helps confirm the diagnosis.
Pityriasis rosea symptoms
Some people feel unwell for a few days before the rash, with tiredness, a sore throat, a high temperature or a headache. The rash then appears in two stages:
Swipe sideways to compare →
| Stage | What you notice | Where |
|---|---|---|
| 1. Herald patch | A single pink or red oval patch, usually 2 to 5 cm across and sometimes up to 10 cm, slightly raised with a scaly edge | Usually the chest, tummy, back, thigh, upper arm or neck |
| 2. Widespread rash | Smaller oval scaly patches, appearing about 5 to 15 days later, often itchy | The chest and back, on both sides, often in a pattern like the branches of a Christmas tree |
The rash may get worse before it clears, and a second wave of patches can appear. On black or brown skin, the patches can be grey, dark brown or black, and the herald patch may be darker with a lighter border. It is unusual for the rash to affect the hands, feet or face. In a less common pattern, called inverse pityriasis rosea, it mainly affects the skin folds of the armpits and groin.
How pityriasis rosea is diagnosed
There is no test for pityriasis rosea. It is diagnosed from the story of a herald patch followed by the wider rash, which is why a photo of the first patch helps. When the diagnosis is in doubt, or the rash lasts longer than 2 months, a skin scraping to rule out ringworm, blood tests or a small skin sample may be suggested.
Pityriasis rosea or something else?
Several conditions can look like pityriasis rosea, and some of them need treatment:
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| Condition | What points to it |
|---|---|
| Pityriasis rosea | One larger patch first, then many smaller oval patches on the chest and back |
| Ringworm | One or a few ring-shaped patches that slowly grow, with a scaly edge |
| Psoriasis | Thicker, well-defined scaly plaques, or many small drop-shaped spots after a sore throat |
| Discoid eczema | Round, very itchy, sometimes weeping patches, often on the legs |
| Pityriasis versicolor | Pale, pink or brown patches with fine scale on the chest and back |
| Syphilis | A rash that can include the palms of the hands and soles of the feet |
A rash on the palms of the hands or soles of the feet is not typical of pityriasis rosea, and the doctor may suggest a blood test.
What causes pityriasis rosea?
The exact cause is not known. It may be caused by a virus, and the strongest link is with herpes viruses 6 and 7, although this is not confirmed. These are not the herpes virus that causes cold sores. Some medicines and vaccines have also been linked to rashes like it.
It is most common between the ages of about 10 and 35, and slightly more common in women. Estimates suggest it affects about 0.5 to 2% of people. It is more common in the cooler months of the year, can occur in clusters in families and schools, and having a family member who has had it raises your chance. It is not considered contagious: the risk of passing it on is very low, so there is no need to stay away from work or other people.
How to treat pityriasis rosea at home
Pityriasis rosea is mild and usually goes away on its own. To ease the itch while it clears:
- Use an emollient (a moisturising treatment) on the rash.
- Avoid soaps and body washes; use the emollient as a soap substitute.
- Ask a pharmacist about antihistamine tablets to help with the itching.
See a doctor if the rash is still itchy after emollients or antihistamines, if it has not gone after 3 months, or if you are not sure what it is. If you are pregnant, contact your midwife, maternity unit or doctor straight away about any new rash.
Which pityriasis rosea treatment might the doctor recommend?
Treatment aims to ease the itch while the rash clears. This is the framework the doctors use, in line with NHS and dermatology guidance.
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| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Typical rash, little itch | Emollients and soap substitutes | Yes | Not usually needed |
| Itchy rash | Antihistamines and a steroid cream | Yes | Not usually needed |
| Severe or widespread rash | A short course of antiviral tablets may speed clearing | Yes | Not usually needed |
| Unusual rash, or palms and soles affected | Blood tests to rule out other causes | Yes, to assess | For the blood test |
| New rash in pregnancy | Contact with your maternity team without delay | Yes, to advise | As your maternity team advises |
| Still there after 3 months | A review of the diagnosis | Yes, to assess | Referral to a dermatologist may be needed |
Not sure what your rash is? A doctor can look at it on camera and tell you what helps in one consultation.
See available times →Treatment options for pityriasis rosea
What you can do yourself
- Moisturise the rash with an emollient, and use it instead of soap.
- Wash gently, and pat the skin dry rather than rubbing.
- Take an antihistamine for the itch, following the leaflet.
Prescription treatment
A prescription is never issued without a consultation. When the itch is troublesome, the doctor may prescribe a steroid cream. In some people, a 7-day course of the antiviral aciclovir may help the rash clear faster. Antibiotics do not help, and steroid tablets are not routinely used, because the rash can come back when they stop. For extensive rashes that last, narrowband ultraviolet B light treatment may be offered by a dermatologist in person. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Antifungal creams do not treat pityriasis rosea, and perfumed products, soaps and scrubbing can irritate the rash and make the itch worse.
How long does pityriasis rosea last?
The rash usually clears by itself in about 6 to 10 weeks, and within a few months for most people. It may get worse before it gets better. It rarely comes back: only about 1 to 3 in 100 people get it again.
As it clears, it can leave lighter or darker patches, especially on brown and black skin. These are not scars: pityriasis rosea does not scar, and the patches fade over weeks to months, sometimes longer.
You do not need to treat the rash or change your usual activities if it is not bothering you. See a doctor if it is getting worse, or has not gone after 3 months.
Special situations
Pregnancy
Pityriasis rosea in the first 15 weeks of pregnancy has been linked with miscarriage and premature birth. If you are pregnant and get a new rash, contact your midwife, maternity unit or doctor straight away.
A rash after a new medicine or vaccine
Some medicines and vaccines can cause a similar rash, including some blood pressure medicines (ACE inhibitors and hydrochlorothiazide), anti-inflammatory painkillers, omeprazole, isotretinoin, terbinafine and some antipsychotics. Tell the doctor about anything new you started in the weeks before, and do not stop a prescribed medicine without advice.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When pityriasis rosea is treated online, and when you need in-person care
Treated online: diagnosis of a typical rash, advice on how long it lasts, emollients, antihistamines, steroid creams, antiviral tablets when they may help, and arranging blood tests when another cause needs ruling out.
In-person care: blood tests, light treatment for a rash that lasts, a rash in pregnancy as your maternity team advises, and an unusual rash that needs a dermatologist.
When to get in-person care
Call 112 or go to an emergency department now for:
- blistering or peeling skin with sores in the mouth, eyes or genitals
- a rash that does not fade when you press a glass against it, especially with a fever
- a rash with swelling of the lips, tongue or throat, or difficulty breathing
Get medical advice the same day for:
- a new rash in pregnancy: contact your midwife, maternity unit or doctor
- a rash with a high temperature and feeling very unwell
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about the rash: show the first patch and the rest of the rash on camera in good light, and say if you are or could be pregnant.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s pityriasis rosea? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Ringworm can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about pityriasis rosea
What is pityriasis rosea?
Pityriasis rosea is a common, mild rash. It starts with one larger scaly patch, called a herald patch, followed days later by smaller oval patches on the chest and back. It goes away on its own.
What does a herald patch look like?
The herald patch of pityriasis rosea is a single pink or red oval patch, 2 to 5 cm across, slightly raised with a scaly edge, usually on the chest, tummy, back, neck, upper arm or thigh. On darker skin it may be darker with a lighter border.
Is pityriasis rosea contagious?
No. Pityriasis rosea cannot spread from person to person, even though a virus is the likely trigger, because the rash is thought to be the body’s reaction to a virus most people already carry rather than a fresh infection; you can carry on with work, school, swimming and normal contact, and partners and children do not need to keep away.
How long does pityriasis rosea last?
Pityriasis rosea usually lasts about 6 to 10 weeks, and within a few months for most people. See a doctor if it has not gone after 3 months.
How did I get pityriasis rosea?
Usually no one can say. Pityriasis rosea may be triggered by a virus, most likely herpes viruses 6 or 7, which are different from the cold sore virus. Some medicines and vaccines cause a similar rash, and it sometimes runs in families. The risk of passing it on is very low.
Can pityriasis rosea be prevented?
No. Pityriasis rosea cannot be prevented, because there is no vaccine and no known way to avoid the trigger, which is probably a reactivation of herpes viruses 6 or 7 that most adults already carry; it is not caught from other people, so isolation, special hygiene or avoiding someone with the rash make no difference. What you can prevent is the irritation: emollients, cool showers, loose cotton and keeping out of hot baths stop the rash itching and flaking.
What can be mistaken for pityriasis rosea?
Ringworm, psoriasis, especially the drop-shaped guttate type, pityriasis versicolor, lichen planus, seborrhoeic dermatitis, rashes from medicines, and secondary syphilis, which can affect the palms and soles. A doctor tells them apart from the pattern.
How do you get rid of pityriasis rosea?
Pityriasis rosea goes away on its own, usually in 6 to 10 weeks. Use an emollient on the rash and instead of soap, and try antihistamine tablets for the itch. A doctor can prescribe a steroid cream, and sometimes an antiviral that may help it clear faster.
Is pityriasis rosea dangerous?
No. Pityriasis rosea is a mild rash that clears by itself and does not scar. The exception is early pregnancy, when it has been linked with miscarriage, so contact your maternity team about any new rash.
Is pityriasis rosea dangerous in pregnancy?
In the first 15 weeks of pregnancy pityriasis rosea has been linked with miscarriage and premature birth. Contact your midwife, maternity unit or doctor straight away about any new rash in pregnancy.
Can pityriasis rosea come back?
Rarely. Only about 1 to 3 in 100 people get pityriasis rosea again, sometimes years later, because one episode usually leaves lasting immunity; a rash that keeps returning, lasts more than 3 months or does not follow the usual herald-patch pattern is more likely to be something else, such as a drug rash, guttate psoriasis or secondary syphilis, and is worth a consultation.
Can an online doctor treat pityriasis rosea?
Yes, usually. A doctor can recognise pityriasis rosea on camera, rule out look-alikes, treat the itch, and arrange a blood test if another cause needs ruling out.
- Pityriasis rosea, NHS, National Health Service (UK), reviewed 7 September 2023.
- Pityriasis rosea, DermNet, New Zealand, reviewed December 2021.
- Pityriasis rosea: patient information leaflet, British Association of Dermatologists, updated June 2023.
- Pityriasis rosea: symptoms and causes, Mayo Clinic, 12 July 2024.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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