Measles Rash on the Forehead
Yes, measles characteristically occurs on the forehead as the rash begins on the face and then spreads downward to the rest of the body. 1, 2
Characteristic Rash Distribution Pattern
The measles rash follows a predictable cephalocaudal (head-to-toe) progression:
- The rash begins on the face, which includes the forehead, and typically appears behind the ears initially 2, 3
- The rash then spreads downward from the face to the trunk and subsequently out to the extremities 1
- The rash appears approximately 3-4 days after the onset of fever and coincides with the peak of symptoms 4
- The rash is described as maculopapular or morbilliform in character 1
Clinical Context Before Rash Appearance
Before the characteristic rash appears on the forehead and face, patients experience a prodrome:
- Prodromal symptoms include high fever, cough, coryza (runny nose), and conjunctivitis ("the three C's") 2, 3
- Koplik spots (small white spots on a red background inside the mouth) appear during the prodrome and are pathognomonic for measles 1, 2
- The incubation period averages 10-12 days from exposure to prodrome and 14 days from exposure to rash 2, 3
Contagious Period
Patients are contagious from 4 days before the rash appears until 4 days after rash onset, meaning they are infectious even before the forehead rash becomes visible 1, 3
Clinical Pitfall to Avoid
Do not dismiss measles based on rash location alone—the forehead is actually one of the first areas where the rash appears, making it a key diagnostic feature rather than an unusual presentation 2, 5