Weiss Pediatric Care

Roseola

Definition

  • Roseola is widespread fine pink rash that's caused by a specific virus
  • Classic feature is that the rash is preceded by 3 to 5 days of high fever
  • The fever goes away before the rash starts

Call or Return If

  • Fever comes back
  • Rash lasts more than 4 days
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • Most children get Roseola between 6 months and 3 years of age.
  • Rash: Pink, small, flat or slightly raised spots on the chest and stomach. Rash is the same on both sides of the body. Then may spread to the face and arms.
  • Classic feature: 3 to 5 days of high fever without a rash or other symptoms.
  • The rash starts 12 to 24 hours after the fever goes away.
  • The rash lasts 1 to 3 days.
  • By the time the rash appears, the child feels fine.

Causes

  • Human herpes virus 6 (HHV6)

Viral Rashes and Drug Rashes

  • Prescription medicines sometimes cause widespread rashes.
  • Non-prescription (OTC) medicines rarely cause any rashes.
  • Most rashes that occur while taking an OTC medicine are viral rashes.
  • Fever medicines (acetaminophen and ibuprofen) cause the most confusion. Reason: Most viral rashes start with a fever. Hence, the child is taking a fever medicine when the rash starts. But the fever medicine had nothing to do with the rash.
  • Drug rashes can't be diagnosed over the phone.

Prevention

  • Good hand washing can prevent spread of infection.

After Care Advice

Overview:
  • Most children get Roseola between 6 months and 3 years of age.
  • It's the most common rash in this age group.
  • By the time they get the rash, the fever is gone. The child feels fine.
  • The rash is harmless and goes away on its own.
  • Here is some care advice that should help.
Treatment:
  • No treatment is needed.
  • Creams or medicines are not helpful.
Moisturizing Cream for Itch:
  • Roseola usually is not itchy. If your child's rash is itchy, here are some tips.
  • Use a moisturizing cream once or twice daily. Examples are Eucerin or Cetaphil creams.
  • Apply the cream after a 5 or 10-minute bath. (Reason: Water-soaked skin feels less itchy).
  • Avoid all soaps. (Reason: Soaps, especially bubble bath, make the skin dry and itchy).
Fever:
  • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
  • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
What to Expect:
  • Roseola rash goes away in 2-3 days.
  • Some children with Roseola just have 3 days of fever without a rash.
Return to Child Care:
  • Once the fever is gone for 24 hours, the disease is no longer contagious.
  • Even if the rash is still present, your child can return to child care or school.
  • Children exposed to your child earlier may come down with Roseola in 9-10 days.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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