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Treatment of pityriasis rosea

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 , BA Hons (Cantab)

Further Reading

Last Updated: Sep 6, 2012

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Comments
  1. Kreyon Divinity Kreyon Divinity United States says:

    MY PITYRIASIS ROSEA STORY!!!!

    So most of the stories I've read in these forums are usually vague and don't really give people the answers and hope they need. Let me tell you my "PITY" story in hopes that it will lift your spirits and help you through this....
    AHEm..this is the story of my pityriasis rosea outbreak and healing...lol

    I am 25 years old and african american
    So one day I was driving and my friend looked at my arm and said i was breaking out. I looked at ny arm and say a couple of bumps, i simply thought they were heat bumps and brushed them off.. later that day i went home and not thinking i looked at my arm and saw it was covered in many many small bumps...i have no allergies and have never had a reaction to anything. The bumps were not itchy at all and i live in florida and I'm constantly in the sun so again i thought it was a simple heat rash, so i tried to stay inside out of the sun. The next morning I woke up and not only were there more bumps, I saw they had spread to my other arm, This is the point when I started to panic, I began to think about all the things iI had done and the only different thing i could think of was the fact I had eaten peanuts from a spanish women the day before so I thought I may have been allergic or something, But hell I've eaten peanuts all my life so I know that wasn't the issue. So like every one else I took it to the web, I ruled out any STD'd because I practice safe sex, and I haven't been active for a month (BY CHOICE lol)
    I couldn't find anything that matched my symptoms....days went by and the bumps now covered my chest, my back, my neck, shoulders, and neck, eventually they would cover my face. By this point it had been 4 days, and these tiny bumps covered my body except my hands and my feet. Day 5 I happened to get in a car accident and found myself in a hospital, the nurses took off my shirt and were confused and amazed by the rash that covered my body, the doctor asked me a few questions and explained to me that I had something called Pityriasis Rosea, I WAS RELIEVED TO FIND OUT THIS MAN KNEW WHAT THIS WAS!....until he told me there was no cure, and I thought I would catch a heart attack, WHERE DID IT COME FROM?!? was my first question, but then he tells me HES not sure of the cause...No Cause...No cure....you could imagine what I was thinking. He simply smiled and said I had absolutely nothing to worry about as it would go away In a few weeks. Now Im a good looking young man...and when he told me I would look like this for weeks i almost threw my phone away as my social life had died.
           A week had gone by and these bumps had now become Raised Skin colored Patches all over, Whe  i took my clothes off, I SAW THE CHRISTMAS TREE PATTERN all over my chest and back, by this point it started to Itch like CRAZY..THIS WAS THE WORST ITCH IMAGINABLE, It was one time were every point on my body itched at the same time and I could only choose to scratch two places...I wanted to cry. I went to the store and got some **YES TO COCONUT WIPES**, **BENEDRYL**,**HEMP LOTION**,**ORGANIC MINT BODY WASH**. I immediately took a shower and used the MINYT BODY WASH, and immediately felt relief, It was as if a cool feeling covered my body, I got out of the shower, and took some benedryl, for the first time i was able to relax. It wasn't until night time that again I had an itching episode, I used the coconut wipes, and again I was relieved..I was amazed the coconut wipes worked so well, I grabbed them randomly looking for moisturisers but yet these worked better than anything else. Morning I put on the Hemp lotion with seemed to keep the patches calm, and whenever i started itching i used the coconut wipes..I found relief using these for the next few days..

    days later all the patches seemed to get flat and now my skin looked very...scaly? and dry? if that made since. I didn't care...I was just glad the bumps were gone, but now I had this to deal with..Ithe patches seemed to get flaky and just rub off. So i thought i had begun healing...unitl the itching started again..The coconut wipes didn't seem to work on this phase but the hemp seemed to keep my skin moist whenever I was drying out.
       I was now 2 weeks into the rash and now my skin seemed to get dry and flaky where ever the bumps were...I was shedding everywhere...and itching. My friend told me about how his mom used to get flaky skin when she was doing cancer treatments. So i talked to her and she told me she used **Cocobutter Petroleum Jelly** **Jergens Shea Butter Deep conditioning moisturisers** **Lotion with Aloe extract** and **aquaphor healing ointment** and i was to apply the all in that order. I put them on and for the first time since I had this god forsaken rash...My skin Felt Normal, I could see that where my skin was peeling there was light patches, It was like the darker layer of my skin was peeling off revealing a new lighter layer. Days went by and the itch became less, but I was flaking more and more, my skin looked rough and even when i scratched my head flakes began falling out, I then went and got **HEAD AND SHOULDERS SHAMPOO AND CONDITIONER**, after about 3 times the flakes on my hair began to stop. I said hell why not, I used the head and shoulders shampoo and conditioner as body wash. After about three showers, and the application of the lotions, my skin began to look like its original texture, but i still had the light patches everywhere. at first I was scared to go back out in the sun because i thought thats what started this whole mess. But my skin tone began to even out the more time i spent in the sun. The itching became less and less, AND ONLY ITCHED IF I THOUGHT ABOUT IT.
       3 Weeks in the flakes were now non existant, you could barely notice the light patches, the first part to completely clear up was my face, and I COULDN'T stop smiling. Although my skin would get dry from time to time. I was still showering with the head and shoulders and applying all four lotions. The next week all the light spots were gone, I wasn't flaking but my skin was only getting a little dry but It was completely back to the way it was before this rash started.

    4 WEEKS PEOPLE!!! IT DOES GET BETTER I SWEAR!!!!!!!!!!!!!!!!!!!
    Heres a list of all the things i used:
    First stage (Bumps, patches, and Itching)
    Weeks 1-2
    -Say yes to coconut wipes
    -Hemp Lotion
    -Benedryl

    2nd Stage(Dry, Flaking, and Itching)
    Weeks 2-4
    -Cocobutter Petrolium Jelly
    -Jergens shae butter drep conditiong moisturiser
    -Aloe vera lotion
    -Aquaphor healing ointment

    Total: $34.76 cvs

    I HOPE THIS HELPS!! THIS WAS THE WORST!!!!

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