What is the treatment for pityriasis rash?

From the FDA Drug Label

Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: eczema psoriasis poison ivy, oak, sumac insect bites detergents jewelry cosmetics soaps seborrheic dermatitis Directions for itching of skin irritation, inflammation, and rashes: adults and children 2 years of age and older: apply to affected area not more than 3 to 4 times daily

The treatment for pityriasis rash is not explicitly mentioned in the provided drug labels. However, hydrocortisone (TOP) can be used to temporarily relieve itching associated with minor skin irritations, inflammation, and rashes.

• Key points:
  • Apply to affected area not more than 3 to 4 times daily for adults and children 2 years of age and older.
  • For children under 2 years of age, ask a doctor.
  • For children under 12 years of age with external anal and genital itching, ask a doctor 1 1

From the Research

Pityriasis rosea is a self-limiting rash that typically resolves on its own within 6-8 weeks, and the most effective treatment option is acyclovir, which has been shown to shorten the duration of illness and improve rash symptoms. The condition is characterized by a herald patch, followed by a generalized rash that can cause itching, fatigue, and other systemic symptoms 2.

Treatment Options

• For mild cases, over-the-counter antihistamines like diphenhydramine (Benadryl) 25-50mg every 6 hours or cetirizine (Zyrtec) 10mg daily can reduce itching 3.
• Topical treatments include calamine lotion applied to affected areas 2-3 times daily, hydrocortisone cream 1% applied thinly twice daily for up to two weeks, or moisturizers to soothe dry skin 4.
• For more severe or persistent cases, prescription-strength corticosteroid creams like triamcinolone 0.1% may be prescribed, and oral antihistamines such as hydroxyzine 25mg three times daily can help with significant itching 3.
• UVB phototherapy administered by a dermatologist might be considered for extensive rashes, and lukewarm baths with colloidal oatmeal can provide relief, and wearing loose cotton clothing helps prevent irritation 4.

Evidence-Based Recommendation

The most recent and highest-quality study, a network meta-analysis published in 2024, found that acyclovir is the best option for patients with pityriasis rosea that have extensive, persistent lesions or systemic symptoms, with a surface under the cumulative ranking (SUCRA) score of 0.92 2. This study provides strong evidence for the effectiveness of acyclovir in treating pityriasis rosea, and acyclovir should be considered as the first-line treatment option for patients with severe or persistent symptoms.