Pityriasis rosea – how to ease it

Have you noticed a slightly raised, circular or oval-shaped rash appear on your skin? Did it become more widespread over time? This might be pityriasis rosea – a common but non-contagious skin rash.

Although similar in name, it’s different to pityriasis versicolor – a common fungal skin infection caused by a yeast.

Pityriasis rosea is mild and usually clears up on its own within a couple of months (without leaving any scarring), but if yours is causing discomfort, self-care can help you manage the symptoms.

Signs of pityriasis rosea

The condition starts with a rash, known as a herald patch. This patch may be:

• slightly raised
• scaly
• oval-shaped or round
• look pink with a red border on white skin, or dark with a light border on brown or black skin.

You might also have had flu-like symptoms a few days before the rash, such as:

• tiredness
• a sore throat
• a high temperature
• a headache.

Pityriasis rosea usually appears in 2 stages. These are:

• stage 1 – when a scaly, oval, or round patch appears on the body, commonly on the chest, thigh, upper arm, or neck, but it can develop anywhere. It’s usually between 2cm to 5cm wide
• stage 2 – this can develop into a widespread itchy rash of smaller, scaly spots 5 to 15 days later, most commonly on the chest or back. It usually appears in the same place on both sides of the body.

Getting urgent help

Seek emergency care for pityriasis rosea if you’re pregnant and a new rash develops – having pityriasis rosea in the first 15 weeks of pregnancy has been linked with premature birth and miscarriage.

What is the cause?

The root cause of pityriasis rosea isn’t fully known, but it is thought that it may be caused by certain viruses in the herpes family.

You might also be more likely to get it if:

• it runs in your family
• you’re under the age of 35
• it’s spring or fall time
• you take specific medicines, such as isotretinoin and terbinafine (skin condition treatments).

Self-care tips

Pityriasis rosea may get worse before it gets better, but it often clears up on its own within a few months. If your rash is itchy and causing you discomfort, try these tips:

• showering or bathing in lukewarm water to avoid further irritation
• avoiding using harsh soaps and body washes
• using calamine lotion to soothe the rash
• protecting your skin from the sun with sunscreen – use one with at least SPF 30.

Pharmacy care

If managing pityriasis rosea symptoms at home doesn’t help, a pharmacist may be able to ease the itchiness of pityriasis rosea with further treatments. These may include:

• an emollient (moisturizer)
• antihistamine tablets.

When to see a doctor and getting diagnosed

See your doctor if you're not sure what your rash is, you’ve tried pharmacy treatments and the pityriasis rosea rash is still itchy, has gotten worse, you’re worried about it, or it’s not gone away after 3 months.

In most cases, your doctor can tell if your rash is caused by pityriasis rosea just by looking at it, and by asking questions.

But sometimes it can be difficult to distinguish between the type of rash caused by pityriasis rosea and other conditions like psoriasis, ringworm, or eczema.

So you might need to have some blood tests, a biopsy or skin scraping – where a section of your skin is examined under a microscope.

What’s the treatment?

If your itchiness is severe, or other treatments haven’t helped, your doctor might prescribe you a steroid cream.

They might also refer you to a dermatologist, who can help you with other treatments such as:

• UVB phototherapy (light treatments)
• specific ointments and creams.

When will the condition go away?

Pityriasis rosea usually disappears on its own between 4 and 10 weeks.

Once the rash has cleared, you might notice dark spots, or lighter areas of skin (more noticeable on brown or black skin). Your skin should return to normal within a few months, although it can take longer in some people.

The condition usually doesn’t return.