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The Telltale Signs of Roseola

Written by Phong Van-Liaw, M.D., F.A.A.P. on May 26, 2018, 8:27:00 AM

A sky-high fever accompanied by a rash caused by a virus that generally affects children – these are the major symptoms of roseola. Fortunately, though, roseola is common and typically isn't life-threatening. Because it’s common among kids 6 months to 2 years old, it’s a good idea to familiarize yourself with it – especially if you have a child younger than age 6. 

It Usually Begins with a Fever

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Roseola usually starts with a sudden, high fever – usually higher than 103 degrees F. Occasionally, this fever will be accompanied by a sore throat, cough, or runny nose. It’s also possible your child’s lymph nodes will be swollen. These symptoms can obviously make it difficult to tell the difference between roseola and a run-of-the-mill cold, but waiting it out until the fever breaks will generally yield the most obvious symptom – a rash. While the rash portion of roseola doesn’t always happen, it usually does. You’ll notice small pink patches and spots, most of which will be flat, but occasionally can be raised as well. This rash will generally start on your baby’s chest, back, and abdomen and spreads outward to their neck and arms. You might also notice a white ring around some of the spots. While the rash might look painful, you’ll be happy to know it isn’t itchy or uncomfortable, and it can last from hours to several days. 

The Road to Recovery

To put it simply, almost nothing can be done to stop roseola once your child has it. It simply has to run its course. Because it’s viral and not bacterial, antibiotics can’t help. Even if you don’t suspect your child has roseola at first, chances are you’ll call your doctor about the high fever and will likely be instructed to combat the fever with acetaminophen. The only way to tell if what your child is dealing with is roseola is after the fever breaks and the rash shows up.  While the rash might look scary, its appearance actually means the worst is over. The fever is the most dangerous part of roseola, and after it breaks, your child will probably feel a lot better. 

Other Facts about Roseola

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  • Roseola is highly contagious. If your child has been exposed to someone who has the virus, chances are his or hers symptoms will start one to two weeks later.
  • While roseola typically strikes children, it can hit adults as well. If you’re an adult with a compromised immune system and think you’ve been exposed to the roseola virus, contact your doctor immediately to be monitored. There are additional risks for immunocompromised adults who have the virus that children don’t face.
  • Contact your doctor as soon as you notice a fever higher than 103 F (or greater than 100.4 for infants) – while the roseola virus doesn’t carry much risk, a very high fever can put your child at risk.
  • Other symptoms that can accompany roseola include irritability (usually the result of their fever), mild diarrhea, decreased appetite, and swollen eyelids.
  • If your child’s rash hasn’t improved after three days, or if the fever lasts more than seven days, contact your child’s pediatrician.


Dr. Van-Liaw is a board-certified pediatrician who cares for patients at Kelsey-Seybold’s Fort Bend Medical and Diagnostic Center. In addition to Pediatrics, her clinical interests include Neonatal Medicine and Dermatology.



Topics: rash, roseola signs and symptoms, roseola, high fever

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