Roseola: Symptoms and What to Watch For

What roseola is

Roseola, also called sixth disease or roseola infantum, is a viral infection caused most often by human herpesvirus 6 (HHV-6). It mostly affects young children between 6 months and 2 years old.

The hallmark of roseola is its order: a high fever comes first and lasts a few days, and then a rash appears right as the fever goes away. Because the rash shows up after the fever, many parents do not realize it was roseola until the fever is already gone.

Most children stay reasonably active and playful despite the fever, and roseola usually resolves without specific treatment.

The typical course of roseola

Symptoms tend to follow a predictable pattern over about a week.

Phase	Timing	What you see
High fever	3 to 5 days	Sudden fever often between 102 and 105°F (38.9 to 40.5°C), sometimes with fussiness, mild cough, runny nose, or loose stools
Fever breaks	Around day 3 to 5	Temperature drops, often suddenly
Rash	As fever ends, lasts 1 to 4 days	Pink or red flat or slightly raised spots; starts on the chest, stomach, and back, then spreads outward; usually not itchy; whitens when pressed

Other symptoms you may notice

Along with the fever, some babies have mild cold-like signs.

• Fussiness or irritability
• Reduced appetite
• Mild diarrhea or vomiting
• Runny nose or mild cough
• Swollen eyelids or puffiness around the eyes
• Swollen lymph nodes (glands) in the neck

Febrile seizures and roseola

Because the fever rises quickly, roseola is a common cause of febrile seizures. KidsHealth reports that about 10% to 15% of young children with roseola have one. A febrile seizure is frightening to watch but is usually brief and most often does not cause lasting harm.

Call 911 if a seizure lasts more than 5 minutes, if your child has trouble breathing, or if this is the first seizure your child has had. A first-time febrile seizure should always be evaluated by a doctor.

How roseola is treated

There is no specific treatment for roseola in an otherwise healthy child, and most recover within about a week. Care is supportive: offer plenty of fluids, let your child rest, and treat discomfort or fever as your pediatrician advises.

For fever, acetaminophen can be used per the dosing for your child's age and weight. Ibuprofen is an option for babies 6 months and older; it is not used under 6 months unless your pediatrician tells you to. Never give aspirin to a child with a viral illness because of the risk of Reye syndrome. Call your pediatrician before giving any fever medicine to a baby under 3 months.

Reflects AAP HealthyChildren, Nemours KidsHealth, and Cleveland Clinic guidance on roseola, 2024-2026.

Related questions

How long is roseola contagious?

Roseola spreads through saliva and respiratory droplets, and a child is most contagious during the fever phase, before the rash appears. Once your child has been fever-free for 24 hours, they can usually return to daycare even if the rash is still present. Check your daycare's policy.

Is the roseola rash itchy or dangerous?

No. The roseola rash is usually not itchy or painful, whitens when you press on it, and fades on its own in about 1 to 4 days. It needs no special treatment. If a rash does not whiten when pressed, or your child seems very ill, call your pediatrician.

Can adults or older kids catch roseola?

Roseola is most common in babies and toddlers, and most children are exposed by their second birthday. Older children and adults can be infected but often have mild or no symptoms. Good hand washing helps limit spread.

My baby has a fever but no rash — is it roseola?

You usually cannot tell until the rash appears, because in roseola the rash shows up only after the fever breaks. Many illnesses cause fever. If the fever is high, lasts more than a few days, or your baby is under 3 months, call your pediatrician rather than waiting for a rash.

Sources & further reading

1. AAP HealthyChildren — Roseola in Babies and Toddlers
2. Nemours KidsHealth — Roseola
3. Cleveland Clinic — Roseola (Sixth Disease)
4. Cleveland Clinic — Febrile Seizure
5. AAP HealthyChildren — Medications Used to Treat Fever

This article reflects current AAP, CDC, FDA, and other public-health guidance and is for educational purposes only. It does not constitute medical advice. ParentFlow is a wellness companion — not a substitute for your pediatrician. For any medical concern, contact your healthcare provider.