Pityriasis rosea is a rash that commonly start off within one small area before spreading to other areas of the body. It is thought to be due to a viral infection. It usually clears within a few months. The fastest method to clear up pityriasis rosea & to decrease symptoms such as itch, is with medical phototherapy.
- This common rash often starts a week or two after flu like symptoms
- It starts off as a small patch, before spreading to the rest of your body
- P. rosea normally resolves in a few months
- Simple anti-inflammatory creams & phototherapy accelerates resolution
Pityriasis Rosea at a glance
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This common rash is due to reactivation of Human Herpesvirus 6 & 7, however it can be due
to a whole heap of other viruses including COVID. It can also occur after the COVID
Classic p.rosea start off as one patch (called a herald patch), after a few days to
weeks, it spreads to involve the body & limbs. Often, the patches are confined to the
upper body and follow the ribs in lines. Atypical variants can occur.
The rash lasts a few months before clearing up completely. If you require faster clearance, a treatment called phototherapy is under Medicare
8-12 weeks on average. Some resolve within a month, others can take up to 6 months.
Light skin patients may have residual patches of skin colour changes after the infection
The aim of treatment is to –
1. Reduce the itch associated with this infection.
2. Clear up the rash as fast as possible.
Whilst awaiting phototherapy, you can do a few things to reduce itching.
- Baths: keep cool, use Aveeno or QV Wash. Oatmeal baths if possible.
- Lotions: Aqueous cream – keep in the fridge & apply as required. Use a fan.
- Anti-inflammatory creams: can be prescribed by our team or your GP.
- Antihistamines: Phenergan 10-50 mg at night. It will bomb you out.
This can be done with cream or narrowband phototherapy or both. Remember that most
cases will settle within 10 weeks. Creams & phototherapy accelerate clearance.
Topical anti-inflammatory creams should be used in areas involved. For larger areas,
phototherapy is more useful.
Phototherapy is delivered in a medical light box. It’s very different from a tanning bed.
Medical phototherapy uses only one wavelength. It’s safe, efficient & effective. Light reduces
inflammation, clearing up the rash & reducing symptoms such as itch.
Learn more (link to phototherapy)
No, it is not. Oh, it’s also unlikely that you will get the rash again (2% recurrence).
Phototherapy is of no charge as it is bulk billed via Medicare.
Reception will discuss the appointment with you & advise you of charges (if there are any).
Call reception for a phototherapy slot that will be supervised by a dermatologist.
There is no charge for narrowband phototherapy as this is covered under Medicare .
By the time the rash comes up, most patients are well. Most people will have a flu-
like illness the week preceding the rash.
Our dermatologists can prescribe –
- Oral anti-inflammatories including erythromycin macrolides
- Wet wraps
- Doxepin antihistamines & others
Narrowband phototherapy can markedly shorten the duration of pityriasis rosea, often improving the rash within a week of treatment. This treatment is fully covered under Medicare.
This medical treatment uses UVB light via a specialized device that filters out the other
spectrums & delivers only one single wavelength. Phototherapy-
- Reduces inflammation, & clears up pityriasis faster
- Reduces itch
- Aids in pigment formation post inflammation, normalizing skin colour
Between 3 to 8 weeks. Sessions are performed 2-3 times a week. Each session takes
between 30 second to just over 180 seconds. Your rash will start to improve after the 3rd to
Yes, it can recur in 2% of cases. That means once you get pityriasis rosea, the chances of
it coming back are rare!
The most common variant is the patch followed by rash – the classic pityriasis rosea.
Other uncommon variants include-
- Patch only
- Multiple patches with no rash
- Rash only
- Atypical rash
- Flexural variants
- Chronic & recurrent
The less common variant occurs for 2% of pityriasis rosea cases.
No, but in light skin it can leave white patches that take 6 months to resolve. In darker skin
types, PIH can result, but pico lasers can fix that.
Your physician will be able to tell the difference between pityriasis rosea and other similar
conditions including –
Guttate psoriasis; smaller spots, can be tricky to diagnose as often follows a sore throat.
Scalp involvement in some, unlike pityriasis. Scale morphology is different. Pityriasis points
Fungus, esp. Eruptive m.canis. Again, with pityriasis rosea, the scale is the give-away. If no
doubt, take a skin scraping. If you have cats, dogs, pups, guinea pigs, consider this.
Discoid eczema is common, it's itchier, & the scale is different compared to pityriasis
Syphilis. If you got a rash on your hands, it’s probably not pityriasis rosea. See a specialist.
Drug eruption; can look like pityriasis rosea. You can figure it out by looking carefully at
your drug history & or stopping medications. Skin test biopsy can tell the difference.
Tinea versicolor: is finer than pityriasis & has not got the same scale type.
Relatively easy for us to tell the difference.
In over 90% of the time, we can tell if it’s pityriasis or another skin condition. If not, we
can perform a very small 2 mm skin biopsy or a simple skin scraping.
If you have a personal or family history of melanoma,, you cannot have phototherapy.
Additionally, you should consider that you require 2-3 sessions over the course of 3-8
Factor in the travel time.
An oatmeal bath, aloe vera gel to relieve the itch, & natural sunlight.
UVB medical phototherapy is much more effective than natural UV as it concentrates light
exposure to only a few minutes.
You can take zinc supplements if you are into placebo treatments, or an anti-inflammatory
diet if you are bored. Diet has no scientific role in the management of pityriasis rosea.
- Diagnosis. Pityriasis rosea is common, but other diagnoses are conserved in some cases.
- Narrowband phototherapy logistics. You need to get here 2-3 times a week for 4-8
It’s most common in adults & teens, from 12 to mid 30s.
As it is a virus, Brisbane has a peak from April to August.