Roseola

Roseola is common in children ages 3 months to 4 years, and most common in those ages 6 months to 1 year.

It is caused by a virus called human herpesvirus 6 (HHV-6), although similar syndromes are possible with other viruses.

The time between becoming infected and the beginning of symptoms (incubation period) is 5 to 15 days.

The first symptoms include:

• Eye redness
• Irritability
• Runny nose
• Sore throat
• High fever, that comes on quickly and may be as high as 105°F (40.5°C) and can last 3 to 7 days

About 2 to 4 days after becoming sick, your child's fever lowers and a rash appears. This rash most often:

• Starts on the middle of the body and spreads to the arms, legs, neck, and face
• Is pink or rose-colored
• Has small sores that are slightly raised

The rash lasts from a few hours to 2 to 3 days. It usually does not itch.

Your health care provider will perform a physical exam and ask questions about your child's medical history. Your child may have swollen lymph nodes in the neck or back of the scalp.

There is no specific treatment for roseola. The disease most often gets better on its own without complications.

Acetaminophen (Tylenol) and cool sponge baths can help reduce the fever. Some children may have seizures when they get a high fever. If this occurs, call your provider or go to the closest emergency room.

Complications may include:

• Aseptic meningitis (rare)
• Encephalitis (rare)
• Febrile seizure

Contact your provider if your child:

• Has a fever that does not go down with the use of acetaminophen (Tylenol) or ibuprofen (Advil) and a cool bath
• Continues to appear very sick
• Is irritable or seems extremely tired

Go to the emergency room or call the local emergency number (such as 911) if your child has convulsions.

Careful handwashing can help prevent the spread of the viruses that cause roseola.

Exanthem subitum; Sixth disease

Cherry J, Doustmohammadi S. Roseola infantum (exanthem subitum). In: Cherry JD, Kaplan SL, Harrison GJ, Steinbach WJ, Hotez PJ, Williams JV, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2025:chap 61.

Michaels MG, Williams JV. Infectious diseases. In: Zitelli BJ, McIntire SC, Nowalk AJ, Garrison J, eds. Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 13.

Tesini BL. Roseola (human herpesviruses 6 and 7). In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 303.

Updated by: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.