What Parents Need to Know About Roseola

Roseola is a common viral infection in kids that mostly affects children between the ages of 6 months and 3 years. (Children under 6 months are protected from roseola through maternal antibodies; children older than 2 or 3 usually are immune.) Medically, roseola is known as exanthem subitem or sixth disease. The telltale symptom of roseola is a rash that develops three to seven days or so after a high fever. It first shows up on the torso and then spreads to the face, arms, and legs. Because it seems to suddenly "bloom" on a child's body, the roseola rash has been called the "rash of roses."

Close up, this rash looks like clusters of tiny pink or red spots that can merge together to form larger patches. Some children with roseola also develop Nagayama's spots—red papules on the roof of the mouth or on the base of the uvula.

Experts believe roseola can be caused by one of two viruses—the human herpesvirus 6 (HHV-6) or human herpesvirus 7 (HHV-7). These bugs can bring on the same kinds of symptoms kids get from other infections, such as a runny nose, cough, swollen glands, irritability, and diarrhea. Infants who get roseola sometimes have a bulging fontanel, the "soft spot" on the top of the head where the skull hasn't yet closed up. Some children can become infected with the roseola virus and not have any symptoms at all.

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Roseola on baby's torso
Roseola on baby's torso. DermNet / CC BY-NC-ND​Owner

Fever Is the Trickiest Roseola Symptom

Unlike many other rashes kids get, the roseola rash isn't itchy and it never lasts very long, a few hours to a few days at most. In fact, by the time the rash shows up, the child is already better. And that's OK: There's no treatment for roseola and there doesn't need to be. Unless your child's immune system is compromised, he'll recover just fine on his own.

Here's where it gets tricky, though. Although the rash that's caused by roseola isn't harmful, for some kids the fever that comes before it can be. A child who's been infected by the roseola virus can run a temperature of 104 F, putting him at risk of having a seizure.

About a third of febrile seizures in young children are thought to be caused by the roseola virus. It's also estimated that up to 25 percent of emergency room visits for fever in young children is because of roseola.

If your child runs a very high fever, always call your pediatrician, even if he doesn't have any other symptoms. Besides the risk of seizure, a high temperature can be a sign of an illness other than roseola, such as a blood infection or a urinary tract infection.

Should You Treat Roseola?

In a word, no. Remember, by the time you and your pediatrician know for sure your little one has been infected by the roseola virus, he'll already have recovered. If he runs a fever, however, acetaminophen or ibuprofen might help him feel better. Beyond that, there's nothing else you can, or should, do beyond giving your child some extra TLC. After all, a fever can make a little kid feel pretty rotten.

Roseola infections can happen at any time of year and aren't especially contagious. Most experts think children become infected from people (usually family members) who have no symptoms, although some believe kids can pass along the virus when they cough or sneeze. Either way, outbreaks are uncommon. So although your child will need to stay away from other kids while he has a fever, once it clears up he can go back to daycare or school—even if his "rash of roses" hasn't quite faded.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Tesini BL, Epstein LG, Caserta MT. Clinical impact of primary infection with roseolovirusesCurr Opin Virol. 2014;9:91–96. doi:10.1016/j.coviro.2014.09.013

  2. Agut H, Bonnafous P, Gautheret-dejean A. Laboratory and clinical aspects of human herpesvirus 6 infections. Clin Microbiol Rev. 2015;28(2):313-35. doi:10.1128/CMR.00122-14

  3. Parra M, Alcala A, Amoros C, et al. Encephalitis associated with human herpesvirus-7 infection in an immunocompetent adultVirol J. 2017;14(1):97. doi:10.1186/s12985-017-0764-y

  4. Mullins TB, Krishnamurthy K. Roseola Infantum (Exanthema Subitum, Sixth Disease). In: StatPearls [Internet]. 2019. 

  5. Leung AK, Hon KL, Leung TN. Febrile seizures: an overviewDrugs Context. 2018;7:212536. doi:10.7573/dic.212536

  6. Tesini BL, Epstein LG, Caserta MT. Clinical impact of primary infection with roseoloviruses. Curr Opin Virol. 2014;9:91-6. doi:10.1016/j.coviro.2014.09.013

Additional Reading
  • Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition).

By Vincent Iannelli, MD
 Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years.