Dear Alice,

What is pitoriasis rosea?

Dear Reader,

Pityriasis rosea, often misspelled (you were very close!) and mispronounced, is a generally mild skin disease more common in (but not limited to) individuals 10 to 35 years of age. Females may be slightly more likely to have pityriasis rosea than males.

The symptoms of pityriasis rosea can last anywhere from several weeks to several months. The first symptom usually is a characteristic skin rash, or lesion, on the chest or back region known as a "herald" or "mother" patch. This appears as a single, large, pinkish, reddish, or brownish-colored patch that is round to oval in shape and slightly raised. There is usually a scaly circular center as well.

One to two weeks later, more smaller, but similar, patches will appear on the trunk, arms, and legs. The face, hands, and feet are rarely affected. Another characteristic of pityriasis rosea is the distinctive pattern of an evergreen, or Christmas, tree that the patches form over the back. Other symptoms may include some itching (usually mild), fatigue, and/or aches. As of yet, the cause is unknown, but some experts think that it may be associated with certain strains of the herpes virus (not the same strains that cause oral and genital herpes, however). While pityriasis rosea may occur in clusters of people, it is not considered highly contagious and usually does not recur.

Pityriasis rosea normally clears up on its own within six to eight weeks, although occasionally some lesions may persist for several months. If you have darker skin, the pigmentation from the rash may take longer to fade; however, know that it will eventually disappear, with or without treatment. If your case is severe, a dermatologist may prescribe medication to relieve itching and inflammation, and possibly suggest ultraviolet (UV) light treatments or moderate exposure to sunlight to help promote healing and reduce itchiness. While you wait for the rash to fade, you can help keep symptoms under control by:

  • Avoiding any situation where you might get overheated
  • Not taking hot showers or baths
  • Taking an oatmeal bath in lukewarm water
  • Using calamine lotion or zinc oxide cream (to help with itching)

Symptoms of pityriasis rosea can be easily confused with those of several other conditions (including ringworm, secondary syphilis, eczema, and psoriasis), so it's important to get a proper diagnosis from your health care provider or a dermatologist. Once you're sure what you have, you can take the right steps to quash the rash.


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