When Your Child Has Roseola

Roseola is a common viral infection in children. It is also known as erythema subitum or sixth disease. Roseola is not a major health problem. It goes away on its own without treatment. But you can help your child feel better.

What causes roseola?

Roseola is caused by a viral infection in the human herpes virus family. It is spread by droplets in the air when someone who is infected sneezes or coughs. It most often affects children ages 6 months to 2 years. 

What are the symptoms of roseola?

Symptoms progress in stages. The stages are:

  • Stage one. 3 to 7 days of high fever (102°F to 104°F  or 39°C to 40°C). Your child is likely to feel cranky and uncomfortable during the fever.

  • Stage two. A rash that appears on the neck down to the torso after the fever goes away. The rash is red and can be raised or flat, and may sometimes spread to the face or limbs. The rash is not painful. It tends to wax and wane (get better and worse) over the course of 3 to 4 days. Your child may feel cranky or itchy during the rash stage of roseola.

How is roseola diagnosed?

There is no test for roseola. It cannot be diagnosed until the fever has gone away and the rash has shown up. In some cases, your child’s health care provider will examine your child and do some tests to rule out other causes of fever.

How is roseola treated?

Roseola needs no treatment. It will go away on its own. To help your child feel better until it does:

  • Be sure he or she gets plenty of rest and fluids.

  • Your child’s health care provider may suggest giving acetaminophen or ibuprofen to help relieve fever or discomfort. Do not give ibuprofen to an infant 6 months of age or less, or to a child who is dehydrated or constantly vomiting. Don’t give your child aspirin to relieve a fever. Using aspirin to treat a fever in children could cause a serious condition called Reye syndrome.

  • An anti-itch medicine called an antihistamine may be recommended if the rash is itchy.

Return to school

Once the fever has gone away for 24 hours, your child is no longer contagious. So, even if your child still has the rash, he or she can attend daycare.

What are the long-term concerns?

Roseola is rarely a problem for children who are otherwise healthy.

Call your child’s health care provider 

Contact your child's health care provider right away if your child has any of the following:

  • Fever:

    • In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher

    • In a child 3 to 36 months, a rectal temperature of 102°F (39.0°C) or higher

    • In a child of any age who has a temperature of 103°F (39.4°C) or higher

    • A fever that lasts more than 24-hours in a child under 2 years old, or for 3 days in a child 2 years or older

    • Your child has had a seizure caused by the fever

  • Fever that returns after rash has gone away

  • Rash that gets much worse or does not begin to fade after 4 to 5 days

  • Rash that lasts longer than several weeks