By Dr Ananya Mandal, MD
Pityriasis rosea is a skin condition that manifests with widely distributed skin lesions that are red, scaly and often itchy. The condition usually affects persons between ages 10 and 40 years and is slightly more common among women than men.
In most people the condition resolves by itself within 4 to 8 weeks or at the most twelve weeks or three months time and no specific treatment is needed. The treatments are mainly aimed at relieving symptoms like itchiness or to correct secondary bacterial infections or other complications. 1-7
Treatment of pityriasis rosea includes skin moisturizers or emollients, creams containing corticosteroids and so forth.
Skin moisturizers or emollients
These are skin creams that are targeted to moisturize or soothe the skin over the lesions. This leads to relief from itching. These are available as ointments, lotions as well.
In some persons soaps with moisturizers may also be prescribed. Normal soaps cause irritation and deplete the layer of oils over the skin due to their harshness. Patients may be advised to avoid these soaps and use soaps with higher moisturizer or emollient content. These may be applied as frequently as needed to relieve itching and preventing dryness of the skin.
The moisturizer or the emollient should be applied gently in the direction of the hair growth and vigorous rubbing should be avoided.
Creams containing corticosteroids
These medications are aimed at reducing the inflammation over the lesions. These need to be prescribed by the physician for most people. Corticosteroids are prescribed if emollients fail to show efficacy. These are essentially synthetic form of hormones produced by the adrenal gland in the human body. They act by reducing itchiness caused by redness and inflammation.
The creams are to be applied lightly to affected areas of skin once or twice a day. Steroid creams are not prescribed for over a week and usually a medium dosage is advised. This is because they may lead to complications like flaring up of the inflammation if stopped abruptly. In addition some people may experience a slight burning or stinging sensation when they first apply the medication. This is usually a temporary side effect and goes away with time.
Antihistamine containing pills
These are anti-allergy medications that may relieve itching. The most common medications of this class are Hydroxyzine or chlorphenamine.
The first generation antihistamines like chlorphenamine cause sedation and drowsiness and were used earlier for allergies. These may help in pityriasis rosea as they help patients sleep better. However, patients are advised not to drive or operate heavy machinery while using this medication. The newer agents usually do not cause sedation but relieve itching.
Ultraviolet B light therapy
If patients do not respond to the common therapy they may be recommended for UV B light therapy. This involves controlled exposing the affected skin for a few minutes at regular intervals to the UV B rays under supervision of a dermatologist or a skin specialist. Exposure to natural sunlight can also be useful but sun burns should be avoided and exposure to sun’s rays may also lead to a higher risk of skin cancer.
Other medications for pityriasis rosea
Other medications that may be tried include acyclovir which is an antiviral medication that may be used for herpes infections. There is limited evidence that acyclovir is useful in pityriasis rosea and additionally it is beneficial only if it is taken during the first week of the condition.
Those who develop secondary bacterial infections over the lesions also need antibiotics to treat the infections.
Avoidance of factors that worsen the condition
Patients are advised to avoid anything that worsens their condition. This includes hot baths, physical activity that leads to sweating etc.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)
Last Updated: Sep 6, 2012