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

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

Go to ER Now

  • Rash becomes purple or blood-colored without fever

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

Call 911 Now

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

Go to ER Now

  • Rash becomes purple or blood-colored without fever

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

Copyright 2000-2025 Schmitt Pediatric Guidelines LLC. Date Updated: Mar 31 2025 13:45 Version 0.1

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February 12, 2026
There have been cases of measles in NC, with exposures in Chapel Hill, Durham, and Wake County. We can give the MMR dose early to families who want it. This applies to infants 6-12 months who have not gotten a dose yet or kids under 4-5 years who have not gotten their second MMR dose. At this time, the NC DHHS and health departments are not recommending this unless traveling or living in an area with sustained transmission. Two doses of the MMR vaccine are highly effective (97%) at preventing measles infections. At CHCAC, children receive their first dose at 12 months of age and a second dose at 4 years of age, ensuring they are fully protected as soon as possible, in accordance with the most up-to-date AAP recommendations. Some infants aged 6 months to 11 months who travel internationally or in high-prevalence areas may need a dose to protect them; however, they still require the 1-year and 4-year-old doses as well. If you are ever concerned about a possible exposure to measles, please CALL before entering our office. DO NOT ENTER the office. NC DHHS keeps a list of areas with measles exposures here . This is a highly contagious illness, and special precautions must be taken to prevent spread. The virus can be present in the air for 2 hours after an infected person is in the room, and 90% of susceptible patients can be infected. As always, if you have questions, we are here to help make sense of it all!
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