Roseola-Viral Rash

Is this your child’s symptom?

• 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.

Care Advice for Roseola

1. 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.
2. Treatment:
   • No treatment is needed.
   • Creams or medicines are not helpful.
3. 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).
4. Fever Medicine:
   • For fevers above 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.
5. What to Expect:
   • Roseola rash goes away in 2-3 days.
   • Some children with Roseola just have 3 days of fever without a rash.
6. 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.
7. 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

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.