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.

When to Call for Roseola-Viral Rash

Call 911 Now

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

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

Care Advice for Roseola

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

Remember! Contact your doctor if you or your child develop any "Contact 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.

Last Reviewed: 05/01/2025

Last Revised: 01/25/2025

Copyright 2000-2025 Schmitt Pediatric Guidelines LLC.