When Your Child Has Roseola

Infant with roseola rash on neck, arms, and torso.

Roseola is a common viral infection in children. It is also known as 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 1. Your child will have 3 to 7 days of high fever, such as 102°F (39°C) to 104°F (40°C). Your child is likely to feel cranky and uncomfortable during the fever.

  • Stage 2. A rash appears on the neck down to the torso after the fever goes away. The rash is red and can be raised or flat. It may sometimes spread to the face or limbs. The rash is not painful. It tends to get better and worse over 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 can’t be diagnosed until the fever has gone away and the rash has shown up. In some cases, your child’s healthcare 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 healthcare provider may suggest giving acetaminophen or ibuprofen to help relieve fever or discomfort. Do not give ibuprofen to an infant age 6 months or younger, 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 (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 healthcare provider 

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

  • Fever ( see fever section below)

  • 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

Fever and children

Always use a digital thermometer when checking your child’s temperature. Never use mercury thermometers.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s instructions for proper use. If you don’t feel comfortable taking a rectal temperature, use a different method. When you talk to your child’s healthcare provider, tell him or her which type of method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit (axillary) temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • 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