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Medical Author:

Nili N. Alai, MD, FAAD

Nili N. Alai, MD, FAAD

Dr. Alai is an actively practicing medical and surgical dermatologist in south Orange County, California. She has been a professor of dermatology and family medicine at the University of California, Irvine since 2000. She is U.S. board-certified in dermatology, a 10-year-certified fellow of the American Academy of Dermatology, and Fellow of the American Society of Mohs Surgery.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is pityriasis rosea?
• Who gets pityriasis rosea?
• What are signs and symptoms of pityriasis rosea?
• What causes pityriasis rosea?
• How is pityriasis rosea diagnosed?
• What are some common misdiagnoses of pityriasis rosea?
• How is pityriasis rosea treated?
• What home remedies can I use for pityriasis rosea?
• Can pityriasis rosea be prevented?
• What is the prognosis for pityriasis rosea?
• Where can I find more information and facts about pityriasis rosea?
• Pityriasis Rosea At A Glance
• Patient Comments: Pityriasis Rosea - Treatments
• Patient Comments: Pityriasis Rosea - Symptoms
• Pityriasis Rosea Glossary
• Pityriasis Rosea Index
• Find a local Dermatologist in your town

What are some common misdiagnoses of pityriasis rosea?

The first herald patch of pityriasis rosea may look very similar in appearance to ringworm (tinea corporis). However, upon treatment with a topical antifungal, there will be no improvement. Pityriasis has also been mistaken with eczema and psoriasis, which can occur as similar scaly patches, but not in the same distribution as pityriasis rosea.

Pityriasis rosea may be misdiagnosed as

• psoriasis,



• eczema,



• fungal infection (tinea corporis),



• secondary syphilis,



• drug eruption (a diffuse body rash caused commonly by a reaction to a medications like an oral antibiotic),



• fixed drug eruption (a single small, circular or oval patch of skin rash caused by taking a medication),



• pityriasis lichenoides chronica,



• parapsoriasis,



• HIV-associated rash, or



• folliculitis.

How is pityriasis rosea treated?

Most cases of pityriasis rosea require no treatment and resolve spontaneously. Treatment is not necessary if the rash is completely without any symptoms. Typically, pityriasis will usually clear on its own in six to eight weeks without medical intervention or therapy.

The most common symptom is itching, which can be treated with topical steroid creams (like hydrocortisone cream, clobetasol cream, etc.) and oral antihistamines (like diphenhydramine [Benadryl], loratidine [Claritin], etc.). These will not shorten the duration of the rash but will decrease the itching. Another treatment for itching is UVB light or sunlight. However, exposure to sunlight increases the risk of skin cancer. Generally, the best treatment is to avoid being overheated by reducing exercise and avoiding hot showers and baths.

There has been some evidence of reduced duration of pityriasis rosea with the off-label use of the antibiotic erythromycin or off-label use of antiviral medications such as acyclovir (Zovirax) or famciclovir (Famvir). However, neither of these medications has been proven to be uniformly effective in the treatment of pityriasis rosea and they are not usually necessary or required for treatment.