Pityriasis Rosea: Symptoms, Causes, and Treatment

Medically Reviewed by Poonam Sachdev on October 24, 2023
7 min read

Pityriasis rosea, a rash that usually appears on the torso, upper arms, thighs, or neck, may sound worse than it really is. The condition has a name that’s hard to say: pit-ih-RIE-uh-sis ROW-zee-ah. But it’s common and fairly easy to treat. The condition is sometimes called "Christmas tree rash."

Though its exact cause is still unknown, doctors think the rash is related to a viral infection, possibly some forms of herpes. It generally affects children, teens, and adults in their 20s, though it can affect people of any age. It also may affect you if you’re pregnant.

It’s not contagious and, in most people, does not leave marks or scars after it heals.

Pityriasis rosea starts with a single patch on your back or torso. That’s called the “herald patch” or “mother patch.” It’s usually oval-shaped and about 2-10 centimeters (a little less than an inch to almost 4 inches) in diameter.

You may find it slightly raised or rough in texture. Sometimes, you may also have symptoms such as headache, fever, or sore throat .

A week or two after the herald patch appears, it is joined by “daughter patches”smaller, scaly rashes that form on your chest or back, often in the shape of a Christmas tree. In some cases, these patches may become itchy, especially when you exercise or they're exposed to heat. Some people never get daughter patches and instead only have large patches on their skin. It’s also possible to see only small bumps with no large mother patches.

The color and texture of the rash vary across skin tones too. If you have light skin, the rash will be pink and slightly raised with a fine white scale covering the center. If you have dark skin, the rash will be dusky violet to brown in color. Also, it may be more raised and look like the tissue is dying in the center.

While the cause of pityriasis rosea is unclear, it may be linked to infections with certain strains of the herpes virus. That doesn't include the kind of herpes virus that causes cold sores. Pityriasis rosea is not contagious, so there's no need to avoid or limit contact with anyone when you have rashes.

Risk factors

Though pityriasis rosea can affect anyone, you may be more likely to get it if you’re:

  • Between the ages of 10 and 35.
  • A woman, as women are 50% more likely to get pityriasis rosea.
  • Pregnant.
  • Dealing with serious or long-term stress. Though some people have gone through this, there isn’t enough research to confirm this triggers pityriasis rosea.

A dermatologist, a doctor who treats skin conditions, can usually diagnose pityriasis rosea by sight. To make sure, they may order a blood test, scraping, or biopsy. Those tests can rule out other types of skin problems, including eczema, ringworm, and psoriasis.

While the rash itself doesn't need treatment and will go away on its own, usually within 6-8 weeks, you can go to your dermatologist for treatment or pityriasis rosea medication to soothe symptoms. They may suggest:

  • Antihistamines. These allergy medicines can help ease itching and can come in the form of a cream or pill.

  • Corticosteroids. This kind of cream is made to treat skin dryness, scaling, and itching. One type your doctor may suggest is triamcinolone ointment.

  • Over-the-counter topical medications. Calamine lotion or zinc oxide may help you feel less itchy.

  • Prednisone. This is a steroid medicine taken by mouth and can help with serious itching.

  • Acyclovir. A type of antivirus medicine, acyclovir (Valtrex, Zovirax) may help the rash go away sooner in some people.

  • UVB phototherapy. Also known as light treatments, this treatment exposes your skin to natural or artificial light to lessen symptoms. Keep in mind that light therapy can leave lasting dark spots on your skin, even after the rash clears.

You should talk to your doctor before using any medication.

Along with prescribed treatments, there are some home remedies for pityriasis rosea self-care that can help stop itching and soothe and protect your skin.

Creams

  • Anti-itch lotion, such as hydrocortisone cream
  • Calamine lotion for itch relief and moisturization
  • Protect your skin from the sun by generously applying a broad-spectrum sunscreen with at least 30 SPF, even on cloudy days. Reapply every 2 hours or more often if swimming or sweating.

Natural ingredients

One of the most popular home remedies for pityriasis rosea is oatmeal because it can help soothe itching. It is finely ground to a powder and then mixed with warm water to form a paste. Apply the paste to rashes for 10 minutes, then wipe it off. You can also bathe or shower in lukewarm water and use an oatmeal-based bath product.

Other natural treatments you can use on your skin include:

  • Aloe vera
  • Coconut oil
  • Neem leaf (boiled and put in a bath)
  • Lavender oil
  • Safflower oil
  • Tea tree oil

Anti-inflammatory diet

While you don't have to avoid any food or drinks if you have pityriasis rosea, some people believe eating anti-inflammatory food can help lessen itching.

These types of food include:

  • Oily fish, such as mackerel, salmon, or sardines
  • Leafy greens, such as spinach and kale
  • Olive oil
  • Tomatoes

This diet also avoids food that can worsen inflammation, such as:

  • Fried foods, including many fast-food items.
  • Cured meats with nitrates, such as hot dogs.
  • Highly refined oils and trans fats.
  • Refined carbohydrates, such as sugar, pastries, and white bread.

There isn't any way to keep this condition from happening. But many people who get pityriasis rosea once usually never get it again.

In most cases, pityriasis rosea is harmless and doesn’t return once it goes away.

If your case lasts longer than 3 months, check in with your doctor. You may have another condition or be reacting to a medication.

If you have a darker skin tone, you may have patches of skin that are darker or lighter after your pityriasis rosea heals. This condition is called post-inflammatory hyperpigmentation or hypopigmentation, and it's temporary.

Pregnant women are one of the groups that have a higher chance of getting serious complications from this condition. If you’re pregnant and get pityriasis rosea, see your OB/GYN at once. In one small study, a majority of women who got the rash in the first 15 weeks of pregnancy had miscarriages.

 

There is no known cause, cure, or prevention method for pityriasis rosea, but it's usually nothing to worry about and will go away on its own. While there aren't any ways to get rid of the rash faster, there are things that can help you feel more comfortable as it clears up over many weeks. Talk to your dermatologist about any at-home or over-the-counter remedies that they suggest or, if you have more intense itching or dryness, ask them about any prescribed treatments they can give you.

  • What is the main cause of pityriasis rosea?

    While the cause of pityriasis rosea is unclear, it may be linked to infections with certain strains of the herpes virus. That doesn't include the kind of herpes virus that causes cold sores.

  • What gets rid of pityriasis rosea fast?

    There's no way to make rashes go away faster, so treatment choices focus on symptoms such as itching. But pityriasis rosea should clear up on its own in 6-8 weeks.

  • Is pityriasis rosea something to worry about?

    Pityriasis rosea clears up on its own in a few weeks, so it’s usually nothing to worry about. But you may need to have a follow-up visit with your dermatologist if:

    • The rash lasts longer than 3 months.
    • The itch or other symptoms remain or worsen after you’ve had the rash for 2 months.
    • You're pregnant.
  • How long does pityriasis rosea last on average?

    Some people see the rash disappear within 6-8 weeks, but it can take as little as 3 weeks or as long as 5 months or more for the skin to clear.