Pityriasis rosea
On white skin, the herald patch is usually pink with a red border. On brown or black skin, the herald patch may be darker with a light border.
Hives
Hives, also called urticaria, are red, itchy, raised bumps or welts on the skin. Hives are the body’s response to an irritation. The cause (trigger) may be non-allergic or allergic.
What Are Hives?
Hives are red, raised bumps on the skin that can be itchy. Hives are also called urticaria. About 1 in 5 people will get hives at some point in their lives.
Treatment of Hives
Nationwide Children’s Hospital offers treatment for hives in multiple specialty programs.
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What Are the Signs and Symptoms of Hives?
Hives can be found anywhere on the body. They can be small, like mosquito bites, or several inches wide. Even if they look different, hives often have common symptoms.
- People may have one hive or groups of hives that cover large areas of the body.
- Hives can move around on the body. They may start in one place, then move to another place on the body.
- Hives may go away quickly or come and go for many weeks or months.
- Skin swelling is common with hives. It may happen on the lips, ears, eyelids, fingers, or toes. This is common and not dangerous.
- Less commonly, hives can occur as part of a more severe allergic reaction called anaphylaxis. Anaphylaxis can cause the airway to swell, making it hard to breathe. This is a life-threatening reaction that needs to be treated right away.
What Causes Hives?
Hives happen when the body releases a chemical called histamine. It can be released because of allergies or other things, like stress, infections, or some illnesses. Whatever is causing histamine to be released is called a trigger.
- Hives not related to allergies are more common. Their triggers are:
- Viruses or infections, like a cold, strep throat, or a urinary tract infection (UTI).
- Emotional stress, like anxiety, anger, fear, or sadness.
- Exercises that make the body warm.
- Vibrations from using a lawn mower, horseback riding, or mountain biking.
- Temperatures that are too hot or too cold.
- Sunlight or tanning beds (sunlamps).
- Pressure on the skin, like being rubbed too hard or scratched, or by wearing clothes that are too tight.
Hives that are related to allergies are less common. Their triggers are:
- Foods or medicines (anaphylaxis may occur) – Symptoms include nausea, throwing up (vomiting), mouth/throat swelling, and trouble breathing. This can be very dangerous.
- Some common foods that cause allergies include eggs, peanuts, tree nuts, milk, and shellfish.
- Some medicines that cause allergies include aspirin, ibuprofen (Advil®, Motrin®), and naproxen sodium (Aleve®).
- Plants, grasses, weeds
- Acidic foods or sauces
- Scents or fragrances (soaps, detergents, lotions)
- Animal dander
- Latex or other materials
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When to Get Emergency Help
Call 911 or take your child to the closest emergency room if they have hives and any symptoms of anaphylaxis:
- Trouble breathing, swallowing, or talking
- Swelling of the mouth or tongue
- Nausea or vomiting
If they have an epinephrine auto-injector, like EpiPen®, Auvi-Q®, or Adrenaclick®, use it right away.
How Are Hives Treated?
Treatment depends on how bad the itching is. Even with treatment, hives can last days to weeks. The goals of treatment are to:
- Control the itching
- Avoid things that may trigger hives
For mild hives:
- Give an over-the-counter (OTC) antihistamine each day. Some examples are:
- Loratadine (Claritin®)
- Fexofenadine (Allegra®)
- Cetirizine (Zyrtec®)
- Levocetirizine (Xyzal®)
For severe hives:
- Give a higher dose of antihistamines or steroids, like prednisone. Oral steroids should not be used a lot. They may make hives worse when you stop taking the medicine.
- See a doctor or health care provider. They may prescribe a medicine, like Xolair® shots (injections), if you have long-term (chronic) hives.
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How to use an EpiPen®
Times when you need to use an EpiPen® can be stressful. To calmly react to an allergic reaction, it is important to know when and how to use an EpiPen, understand symptoms of allergic reactions and have an action plan in place.
Living With Hives
Living with hives isn’t easy, especially if you don’t know what’s causing them. It may help if you write down events that happened right before the hives appeared. This can help you and your child make a plan to keep the hives from coming back.
Depending on what’s causing your child’s hives, you can keep their hives from getting worse by having them:
- Avoid scratching or rubbing their skin.
- Wash their hands after touching pets or animals.
- Wear loose-fitting clothes.
- Wear warm clothes.
- Wear sunblock and long sleeves and pants in the sun.
- Avoid contact with cold water if they’re sensitive to cold.
- Use mild, unscented soap on their skin and for washing clothes.
Family Resources and Education
Stay informed and get the support you and your family need with resources ranging from classes to patient stories and support groups.
When to Call the Doctor
Call the doctor or health care provider if your child’s hives get worse or prescribed medicine isn’t helping.
Helping Hands Patient Education Materials
Written and illustrated by medical, nursing and allied health professionals at Nationwide Children’s Hospital, Helping Hand instructions are intended as a supplement to verbal instructions provided by a medical professional. The information is periodically reviewed and revised to reflect our current practice. However, Nationwide Children’s Hospital is not responsible for any consequences resulting from the use or misuse of the information in the Helping Hands.
HH-I-82 | ©1989, revised 2023, Nationwide Children’s Hospital
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Pityriasis rosea
Pityriasis rosea is a common skin rash. It’s mild and usually goes away on its own without treatment.
Pityriasis rosea is different to pityriasis versicolor.
Check if you have pityriasis rosea
The main symptom of pityriasis rosea is a rash.
Some people get flu-like symptoms a few days before the rash appears, including:
- tiredness
- a sore throat
- a high temperature
- a headache
The rash appears in 2 stages.
Stage 1: single, round patch
The first stage of the rash is a single, scaly patch called a herald patch.
The herald patch is usually oval or round, slightly raised and about 2cm to 5cm across. It usually appears on the chest, thigh, upper arm or neck, but you can get it anywhere on the body.
On white skin, the herald patch is usually pink with a red border. On brown or black skin, the herald patch may be darker with a light border.
DR H.C.ROBINSON / SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/260599/view
Stage 2: widespread rash
A widespread rash of small, scaly spots appears about 5 to 15 days after you get the herald patch.
Usually you get the rash on your chest and back, but it can appear on the arms or legs. In children, it may appear on the face or scalp.
It usually appears in the same place on both sides of the body and may be itchy.
On white skin, the spots are pink or red.
ISM/SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/694054/view
On black or brown skin, the spots can be grey, dark brown or black.
Richard Usatine MD
After the rash has gone, you may have some darker or lighter areas of skin. This may be more obvious on brown or black skin. In most people, these should go back to normal within a few months and will not leave permanent scarring.
Information:
If you’re not sure it’s pityriasis rosea
Other conditions can have similar symptoms to pityriasis rosea.
For example, scaly spots could be psoriasis or eczema, and a single, round patch could be ringworm.
Do not try to diagnose the problem yourself. See a GP if you’re worried.
Urgent advice: Call your midwife, maternity unit, GP or NHS 111 immediately if:
- you have a new rash and you’re pregnant
Getting pityriasis rosea in the first 15 weeks of pregnancy has been linked with miscarriage and premature birth.
Treatment for pityriasis rosea
Pityriasis rosea usually gets better on its own within a few months without any treatment. It might get worse before it goes away completely.
If the rash is uncomfortable or itchy, a pharmacist might advise:
- using an emollient (moisturising treatment for the skin) on the rash
- taking antihistamine tablets to help with the itching
- avoiding using soaps and body washes
A pharmacist will tell you how often to take or apply any treatments.
If these treatments do not work or if you have severe pityriasis rosea, your GP may recommend steroid cream or refer you to a skin specialist (dermatologist).
Non-urgent advice: See a GP if:
- you have a rash that’s still itchy after trying pharmacy treatments like emollients or antihistamines
- you have a rash that has not gone away after 3 months
How you get pityriasis rosea
The exact cause of pityriasis rosea is not known. It may be caused by a virus.
Pityriasis rosea cannot spread from person to person.
Page last reviewed: 07 September 2023
Next review due: 07 September 2026Support links
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