Pityriasis Rosea: The “Mysterious Rash” Explained

By Dr. Tahani Williams M.D.

If you’ve ever noticed a pink, scaly rash suddenly appear on your chest, back, or stomach — only to see it spread within days — you may have experienced pityriasis rosea (pit-uh-RYE-uh-sis RO-zee-uh).

It can look dramatic and feel itchy, but there’s good news: pityriasis rosea is harmless, non-contagious, and usually clears up on its own.

Below, we’ll answer common questions about pityriasis rosea, from what causes it to how to care for sensitive skin while it heals.

What is Pityriasis Rosea?

Pityriasis rosea is a mild, temporary skin condition that most often affects teens and young adults. It typically starts with a single large spot, known as the “herald patch,” followed by many smaller patches that spread across the torso in a “Christmas tree” pattern. (1)

This rash usually lasts 6–8 weeks and fades naturally without scarring.

Sensitive Skin Tip: Keep your skin routine minimal while the rash heals. Use fragrance-free products, like Cleure’s Gentle Body Wash, to avoid irritation.

What causes Pityriasis Rosea?

Doctors don’t fully understand what triggers pityriasis rosea, but research suggests it’s likely linked to a reactivation of common human herpes viruses (HHV-6 or HHV-7). (2)

These are not the same as herpes simplex — the virus that causes cold sores. Instead, they’re part of a family of viruses that can lie dormant and reactivate during times of mild immune stress or illness.

Is Pityriasis Rosea contagious?

No, pityriasis rosea is not contagious. You can’t catch it from someone else or spread it through skin contact.

It’s thought to be a self-limited reaction of your immune system, not an infection that spreads between people.

What are the symptoms of Pityriasis Rosea?

Pityriasis rosea typically appears in stages:

1. The Herald Patch
A single, round or oval patch (2–4 inches) appears first, often on the chest or back. It may look scaly or slightly raised.

2. Smaller Spots Develop
After one to two weeks, smaller oval patches appear on the torso, following the lines of your ribs.

3. The “Christmas Tree” Pattern
The rash may form a tree-like pattern across your back or chest.

4. Itching or Mild Irritation
Some people experience mild itching, while others have no discomfort at all.

5. Flu-Like Symptoms (Occasionally)
Before the rash, a few people notice fatigue, sore throat, or mild fever — similar to a short viral illness.

Check out our Guide to Common Skin Rashes to learn more about how to identify a rash, treat it, and preventative care.

How long does Pityriasis Rosea last?

Most cases resolve naturally in 6–8 weeks, though mild cases may clear in as little as 2–4 weeks. Occasionally, the rash can persist up to 12 weeks. Once it’s gone, recurrence is rare.

How to Soothe and Treat Pityriasis Rosea at Home

While there’s no cure, gentle self-care can ease discomfort and support faster healing.

1. Cleanse Gently
Avoid harsh or fragranced soaps. Instead, use a soap-free, pH-balanced cleanser formulated for sensitive skin. Try a fragrance-free body wash that is sulfate-free and dermatologist-approved.

2. Moisturize Frequently
Apply a hypoallergenic moisturizer after bathing to lock in hydration and reduce flaking. Look for ingredients like colloidal oatmeal, shea butter, or aloe vera — found in Cleure moisturizers.

3. Relieve Itching
Cool compresses or an over-the-counter 1% hydrocortisone cream can calm irritation. If itching is severe, ask your doctor about antihistamines like loratadine.

4. Avoid Common Triggers

• Skip hot showers
• Avoid exfoliating scrubs or perfumed products
• Wear loose, breathable fabrics

5. Get Gentle Sun Exposure
Short, daily exposure (10–15 minutes) to natural sunlight may help the rash fade faster. Dermatologists sometimes recommend UVB light therapy in persistent cases.

Explore Cleure’s Sensitive Skin Collection for dermatologist-recommended care and sensitive skin support.

What should you avoid?

• Over-scrubbing or using loofahs
• Applying heavy petroleum-based ointments
• Stressing — pityriasis rosea always clears on its own

What can be mistaken for Pityriasis Rosea?

This rash can resemble other skin conditions, such as:

Condition	Key Features	Distinguishing Clue
Ringworm	Circular rash with raised border	Usually just one patch; fungal test confirms
Eczema	Dry, itchy skin	Chronic or recurring
Psoriasis	Silvery plaques on scalp, knees, or elbows	Chronic and thicker
Drug Rash	Red rash after new medication	Often widespread
Secondary Syphilis	Rash on palms, soles, trunk	Requires blood test

If you’re unsure, see a dermatologist for confirmation. They can identify pityriasis rosea by appearance or a simple biopsy if needed.

Can children or pregnant women get Pityriasis Rosea?

Yes, but it’s less common. During pregnancy, the rash may look different. It rarely causes problems, but always notify your healthcare provider to be safe.

When to See a Doctor

Consult a healthcare provider if:

• The rash lasts longer than 3 months
• It spreads to your face, palms, or soles
• Itching is severe
• You’re pregnant
• You notice fever, pain, or infection signs

Your doctor may suggest topical corticosteroids, antiviral medication (acyclovir), or light therapy for faster recovery.

Recovery and Aftercare

As the rash heals, some people develop temporary post-inflammatory hyperpigmentation — darker or lighter spots that fade over time.

Keep skin moisturized and wear sunscreen for sensitive skin to prevent irritation.

Living Comfortably While It Heals

Pityriasis rosea can be frustrating, especially when visible or itchy. Remember, it’s not caused by hygiene, diet, or allergies — just a temporary skin reaction.

Support recovery with:

• Adequate rest and hydration
• Stress management
• A simple, fragrance-free skincare routine

Explore Cleure’s full line of moisturizers for sensitive skin to find a gentle solution for your vulnerable skin.

References:

1. Chuh AAT, et al. Pityriasis rosea — An Update. Am J Clin Dermatol. 2009;10(3):167-177.
2. Drago F, et al. Human Herpesvirus 6 and 7 in Pityriasis Rosea. J Am Acad Dermatol. 2014;70(3):501-507.