Roseola: What Is It, Symptoms & Treatment Options

Updated in March 2022

Roseola, also known as roseola infantum, is a contagious disease that mainly affects babies and children from the ages of 3 months to 2 years. It is associated with symptoms such as sudden high-grade fever, which can go up to 104.0ºF (40ºC), decreased appetite, irritability and the emergence of a pink rash. This rash presents as small pink patches on the child's skin, especially on the torso, neck, and arms, that may or may not be itchy.

There are many types of viruses that can cause roseola, like human herpes virus types 6 and 7, echovirus 16, adenovirus, among others, which are transmitted through droplets of saliva. Although infection with the same virus doesn’t happen more than once, it is possible to get roseola more than once if the child is infected with a different virus each time.

Despite causing uncomfortable symptoms, roseola is usually benign and resolves on its own without any complications. However, the pediatrician can prescribe a treatment to relieve the child's symptoms, such as antihistamine ointments to help with itching or paracetamol to control fever.

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Main symptoms

Roseola lasts about 7 days and its symptoms appear in the following order:

  1. Sudden onset of high fever - 100.4ºF to 104.0ºF (38 to 40°C), for about 3 to 4 days;
  2. Sudden decrease or disappearance of fever;
  3. Reddish or pinkish patches on the skin, especially on the torso, neck and arms, which last for about 2 to 5 days and disappear without the skin flaking or changing color.

The child may or may not have itchy skin as well as the patches. Other symptoms that may appear in a case of roseola include loss of appetite, cough, runny nose, red throat, lumps all over the body or diarrhea.

Assessment by a doctor to confirm roseola is important, as there are several illnesses that can cause fever and reddish patches in children.

How it spreads

Roseola is transmitted through contact with the saliva of another contaminated child. It can spread with speaking, kissing, coughing, sneezing, or playing with contaminated toys. Children can be contagious even before skin patches appear. Symptoms usually appear after 5 to 15 days of the initial exposure.

This infection is usually not transmitted to adults because most individuals have sufficient immunity against roseola, even if they have never had the disease. It is possible, however, for an adult to contract roseola if their immune system is weakened. It is also rare for a pregnant woman to become infected with the roseola virus and develop the disease during pregnancy, however, even if she does become infected, there are no health risks for the fetus.

Treatment options

Roseola is benign and usually resolves on its own. The treatment typically consists of managing the presenting symptoms, like using acetaminophen to reduce fever and decrease the risk of febrile seizures. Learn more about what can cause fever in children and how to treat it

In addition to drugs, there are other measures that can help control fever, such as:

  •  Dressing the child in light clothing;
  •  Avoiding quilts and blankets, even if is winter;
  •  Bathing the child in slightly warm water;
  •  Placing a cloth soaked in cold water on the child's forehead and also under the armpits for a few minutes.

By following these guidelines, the fever should go down a little without having to resort to medication, but the child should be checked for fever several times a day. Day care and contact with other children while sick should be avoided.

Another way to help treatment and reduce fever is ash tree tea, as it has antipyretic properties.