From the Research
Acyclovir is recommended for the treatment of pityriasis rosea, particularly in cases with extensive, persistent lesions or systemic symptoms, at a dose of 400 mg three times daily for 7 days, as it has been shown to be effective in reducing rash improvement and itch resolution. The most recent and highest quality study, a network meta-analysis published in 2024 1, found that acyclovir outperformed all other tested interventions in terms of rash improvement, with a risk ratio of 2.55 and a 95% confidence interval of 1.81-3.58. Additionally, a systematic review and meta-analysis published in 2019 2 found that oral acyclovir significantly reduced erythema and limited lesion formation compared to non-acyclovir treatment on the 14th day.
Some key points to consider when using acyclovir for pityriasis rosea include:
- The optimal dose and duration of treatment are not well established, but 400 mg three times daily for 7 days has been used in some studies 3, 4
- Acyclovir may be more effective in reducing symptoms and improving quality of life in patients with severe or persistent pityriasis rosea 1, 2
- The use of acyclovir in pityriasis rosea is off-label, and patients should be closely monitored for adverse effects and treatment response 3, 4
- Other treatments, such as topical corticosteroids and phototherapy, may also be effective in managing symptoms and improving quality of life in patients with pityriasis rosea 1, 5
Overall, while the evidence is not yet conclusive, the available data suggest that acyclovir may be a useful treatment option for patients with pityriasis rosea, particularly those with severe or persistent symptoms. However, further studies are needed to fully establish the efficacy and safety of acyclovir in this context.