Pityriasis Rosea: 6 Natural Ways to Help Treat 'Christmas Tree' Rash

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Pityriasis Rosea: 6 Natural Ways to Treat ‘Christmas Tree’ Rash


Pityriasis rosea - Dr. Axe

Have you ever experienced the Christmas tree rash? If not, you may have never even heard of it, but it’s actually quite common and can be experienced by anyone of any age. So why the alternative name “Christmas tree rash” to describe the skin disease pityriasis rosea? It’s because the rash patches on the back commonly appear in vertical and angled form similar to a Christmas tree or fir tree. (1)

What are the most common pityriasis rosea causes? The first description of pityriasis rosea in medical literature occurred in 1860 and since that time no one has identified what specific infectious pathogen causes this skin rash. Some researchers believe that pityriasis rosea is caused by a viral infection, but the exact cause of the rash is still unclear to this day. (2)

Thankfully, there are many forms of natural pityriasis rosea treatment, but before we get to those, let’s learn more about this somewhat bewildering rash.

What Is Pityriasis Rosea?

Pityriasis rosea (pit-uh-rahy-uh-sis row-zee-ah) is a common skin disease that causes a scaly rash on the body. Also called Christmas tree rash, pityriasis rosea differs from other rashes because it appears in stages. Pityriasis rosea stages include an initial stage when the first patch appears and then days to weeks later more patches typically form in various locations on the body.

The first singular patch is usually pink in color and round or oval in shape. This initial scaly patch is usually the largest patch with a raised border and it occurs on the torso or back. Dermatologists refer to it as the “mother” or “herald” patch. The size of this patch ranges from 0.8 inches to 3.9 inches (or about two to 10 centimeters).

Smaller patches, called “daughter patches,” show up days to weeks later. These patches are typically oval with a salmon color and are 0.4 inches to 0.8 inches (one to two centimeters). These daughter patches show up on the body in “batches” on areas like the abdomen, back, chest, arms and legs. As I mentioned earlier, these smaller patches will sometimes form a pattern resembling a Christmas tree on the back. It’s possible — but not common — to see pityriasis rosea on face, feet, palms or scalp. (3)

Is pityriasis rosea contagious? No, it is not considered contagious. (4)

Signs and Symptoms

A pityriasis rosea rash can be mistaken for a number of other skin conditions including ringworm, psoriasis or eczema. Syphilis is also known for causing a rash that can be confused with pityriasis rosea. (5)

In its initial phases, pityriasis rosea typically begins with a large, slightly raised, scaly patch called the “herald patch” or “mother patch” located on the back or torso. As time goes on, smaller “daughter” patches start popping up in groups in other areas of the body.

Pityriasis rosea symptoms include:

  • One large, slightly raised, scaly, red patch that is round or oval
  • Additional smaller rash patches on the abdomen, back, chest, arms and/or legs.
  • Mild, intermittent itching (occurs in around 50 percent of cases) that seems to occur or increase due to stress, exercise or hot showers/baths

The majority of people experiencing a case of pityriasis rosea generally feel fine with no symptoms other than a visible rash. It’s rare but possible to have flu-like symptoms (such as reduced appetite, nausea, fatigue, or sore throat) as well. (6)

Causes and Risk Factors

So how does someone get pityriasis rosea? Is pityriasis rosea caused by stress? According to the the American Academy of Dermatology, “No one knows what causes pityriasis rosea,” but we do know that allergies, fungus and bacteria are not pityriasis rosea causes. It’s theorized that a virus causes the rash. However, this theory has not been proven. Pityriasis rosea is not contagious and does not spread from an infected person to another person so it doesn’t behave like a disease with a viral root cause. (7)

In terms of a viral cause, pityriasis rosea has not been associated with the common types of herpes virus that causes chickenpox or herpes. However, some studies have linked pityriasis rosea with a virus from the human herpes family called human herpes virus types 6 and 7 (HHV-6 and HHV-7). (8)

In terms of risk factors, people who are more likely to experience pityriasis rosea include anyone between the ages of 10 and 35 years of age. Pregnant women are also more likely to experience this rash. (7)

Conventional Treatment

Many doctors and dermatologists can identify pityriasis rosea simply by examining your skin. However, since this scaly rash can sometimes be confused with other skin conditions, particularly ringworm, a small sample of the rash may be taken and tested for a more definitive diagnosis.

Most cases of pityriasis rosea last between two to six weeks, but it’s possible for the rash to continue for three to four months. It may take some time, but conventional medical experts all seem to agree that pityriasis rosea will go away on its own. (9)

If your rash is itchy, then your doctor or dermatologist may recommend prescription medications such as corticosteroids, antihistamines or antiviral drugs like acyclovir. 

What is pityriasis rosea? - Dr. Axe

6 Natural Ways to Treat Pityriasis Rosea

Since this rash is considered a self-limiting disorder “most patients just need to be counseled regarding the natural course of the disease instead of putting them on an aggressive treatment protocol.” (10) If you’re not good at waiting or you’re struggling with an itching rash, there are ways to improve pityriasis rosea naturally. The majority of these effective natural remedies are also backed by conventional medicine.

1. Oatmeal Baths

In general, it’s best to bathe or shower in lukewarm water while you have any type of skin rash. Avoid hot water because it can make symptoms worse. When taking a lukewarm bath, try adding oatmeal to the water. This is a common natural remedy that can really help to soothe the rash and improve symptoms. (11) Scientific research reveals that oats naturally contain compounds called avenanthramides which have strong anti-inflammatory and anti-itch effects. (12)

Add around one cup of ground oatmeal to the bath and soak for 15 to 20 minutes. If you’re looking for less of a mess, you can add whole oats to a wash cloth or stocking (making sure to tie up the ends so the oats don’t leak out) and put it in the water to infuse the bath with its calming goodness.

2. Aloe Vera

As with most rashes or itchy skin problems, moisture can come to the rescue, helping to keep the skin hydrated, which promotes healing and discourages itching. One of the best, most highly acclaimed natural skin relievers is definitely aloe vera. In addition to being an amazing moisturizing, anti-inflammatory and soothing skin care aid, aloe vera has also been shown to have inherent antiviral properties. In fact, an in vitro study demonstrates how aloe vera exhibits antiviral activity against some strains of the herpes virus. (13)

Aloe vera is also loaded with vitamins, minerals, antioxidants, and fatty acids that can all give a major boost to skin health. (14) You can use the fresh leaf of an aloe vera plant or purchase pure aloe vera gel. If you’re using a fresh leaf, then you simply break the leaf open and scoop out the gel and apply it to the rash areas. For extra cooling effects, put your aloe source in the refrigerator before use and apply it as needed a few times per day.

3. Coconut Oil

Applying a moisturizer to the rash is a common recommendation for self treatment. (15) Coconut oil is loaded with beneficial fatty acids making it a great natural choice that will help to discourage inflammation, dryness and itchiness. Even though it’s not 100 percent clear what causes pityriasis rosea, there is research to support viral roots to this skin disease. Want another good reason to choose this oil as a natural remedy for this scaly rash? Coconuts are known to possess potent antiviral, antibacterial and antifungal properties. (16) Simply apply coconut oil liberally to the rash areas as needed.

4. Natural Light

Sometimes a conventional form of treatment for pityriasis rosea is exposing the skin to artificial ultraviolet light, but another common recommendation is to use natural sunlight to help fade the rash. Some mild exposure to sunlight may actually help to heal the rash quicker. Aim for five to 10 minutes per day for several days. (17)

5. Stay Cool

Avoiding strenuous workouts and other activities that are likely to leave you feeling overheated can really help with symptoms like itchiness. The symptom of itchiness is said to occur in about 50 percent of cases and is often brought on by exercise or hot showers. According to the American Academy of Dermatology, the rash can worsen and become more obvious for a while if you become overheated. (7)

To encourage keeping the body cool, it’s also wise not to wear certain clothing while you have this rash (or any rash, for that matter). The type of clothing you’ll definitely want to avoid is anything that is tight and/or made from synthetic material. Instead, opt for loose-fitting cotton clothing that is breathable. Wearing clothing like this can make it less likely that you’ll experience itching and promote faster healing.

6. Patience

According to the National Organization for Rare Diseases, “The rash is usually located on the back, chest and stomach and resolves on its own within one to three months.” (18) While the possible time frame of having a case of pityriasis rosea varies between reliable sources, one thing is clear — this is a rash known for its ability to resolve itself (hopefully on the shorter side of the estimated healing window).

So try to be patient because it should only be a matter of time before the rash goes away on its own. Want to hear some more really good news? Most people don’t have more than one outbreak of pityriasis rosea in their lives. (7)

Possible Complications and Precautions

According to the Mayo Clinic, it’s not common to experience complications due to pityriasis rosea, but if complications occur they may include severe itchiness. Brown spots may also remain for months even though the rash has healed. These brown spots sticking around are more likely to occur on darker skin tones. (19)

If you or your child is itchy, avoid scratching at the rash and keep finger nails cut short to discourage any damage to the skin.

Final Thoughts

  • Pityriasis rosea is also called Christmas tree rash due to the rash pattern that it often forms.
  • This rash is sometimes confused with other skin conditions like ringworm.
  • The exact cause of pityriasis rosea is still unknown, but it may be caused by a strain(s) of the herpe virus. However, this skin rash is not considered to be contagious even though it may have viral roots.
  • About 50 percent of cases include the symptom of mild itching.
  • Natural pityriasis rosea treatment options include:
    • Lukewarm oatmeal baths
    • Applying aloe vera gel and unrefined virgin coconut oil
    • Getting five–10 minutes of natural sunlight daily
    • Avoiding situations that will overheat your body, like intense exercise or hot showers
    • Good old-fashioned patience since this rash is known for clearing up on its own and many people don’t even experience any symptoms other than a visible rash

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