From the Research
Aciclovir treatment for pityriasis rosea should be administered for 14 days, as this duration has been shown to be effective in reducing symptoms and duration of the disease, particularly when started early in the disease course 1. The standard dosage is 800 mg five times daily for adults, though this may be adjusted based on severity and patient factors.
- While aciclovir is not considered first-line therapy for pityriasis rosea, some studies suggest it may help reduce symptoms and duration, particularly when started early in the disease course.
- This antiviral medication may be beneficial because pityriasis rosea is potentially associated with human herpesvirus 6 and 7 infections, though this link remains controversial.
- Treatment should be initiated within the first week of symptom onset for maximum effectiveness.
- Patients should complete the full 14-day course even if symptoms improve earlier, and should stay hydrated while taking the medication.
- Side effects may include headache, nausea, and dizziness.
- It's essential to note that many cases of pityriasis rosea resolve spontaneously without specific treatment, and symptomatic management with antihistamines and topical steroids remains the mainstay of therapy for most patients. According to a recent network meta-analysis, acyclovir represents the best option for patients with PR that have extensive, persistent lesions or systemic symptoms 1. In terms of rash improvement, only acyclovir resulted significantly superior to placebo, and acyclovir outperformed all the other tested interventions 1. The use of high-dose acyclovir in pityriasis rosea has been studied, and the results suggest that it may be effective in hastening recovery, especially in patients treated in the first week from onset 2. However, the most recent and highest quality study, a network meta-analysis, supports the use of acyclovir for 14 days as the best option for patients with extensive, persistent lesions or systemic symptoms 1.