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Roseola-Viral Rash

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Definition

  • Widespread fine pink rash caused by Roseola 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
  • A doctor has told you that your child probably has Roseola or
  • Rash occurs after several days of fever. Fever gone now and your child feels fine.

Symptoms of Roseola

  • Most children get Roseola between 6 months and 3 years of age.
  • Rash: Pink, small, flat 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.

Cause of Roseola

  • Human herpes virus 6 (HHV6)

Viral Rashes and Drug Rashes

  • Prescription drugs sometimes cause widespread rashes.
  • Non-prescription (OTC) drugs rarely cause any rashes.
  • Most rashes that occur while taking an OTC drug 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 med when the rash starts. But, the fever med 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.
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When To Call

Call 911 Now

  • Rash becomes purple or blood-colored with fever
  • You think your child has a life-threatening emergency

Go to ER Now

  • Rash becomes purple or blood-colored without fever

Call Doctor or Seek Care Now

  • Large blisters on skin
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Fever comes back
  • Rash becomes worse
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Rash lasts more than 4 days
  • You have other questions or concerns

Self Care at Home

  • Roseola rash
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Care Advice

What You Should Know About Roseola:

  • 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 (such as Eucerin) once or twice daily.
  • 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 Medicine:

  • For fevers higher than 102° F (39° C), give an acetaminophen product (such as Tylenol).
  • Another choice is an ibuprofen product (such as Advil).
  • Note: fevers less than 102° F (39° C) are important for fighting infections.
  • For all fevers: keep your child well hydrated. Give lots of cold fluids.
  • Note: by the time the rash occurs, the fever should be gone. If your child has both, see Rash or Redness - Widespread care guide.

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 (AAP).
  • Your child can return to child care or school, even if the rash is still present.
  • Children exposed to your child earlier may come down with Roseola in 9-10 days.

Call Your Doctor If:

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

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Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2024. Schmitt Pediatric Guidelines LLC.
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