Is It Fifth Disease? Why Your Skin Is Red and What to Do Next

If you or your child suddenly develops red cheeks or a blotchy red rash, it's natural to wonder: Is it fifth disease?

Fifth disease—also known as erythema infectiosum or slapped cheek syndrome—is a common viral illness that mainly affects children but can also occur in adults. In most healthy people, it's mild and goes away on its own. Still, it's important to understand what causes it, what symptoms to watch for, and when to speak to a doctor.

Below is a medically grounded, easy-to-understand guide based on trusted public health and infectious disease sources.

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What Is Fifth Disease?

Fifth disease is caused by parvovirus B19, a common virus that spreads through:

• Respiratory droplets (coughing, sneezing)
• Close contact
• Blood (rare)
• From pregnant parent to unborn baby (rare but important)

It's called "fifth disease" because historically it was the fifth of the classic childhood rash illnesses identified by doctors.

The good news:
For most children and healthy adults, fifth disease is mild and self-limited.

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Why Is My Skin Red?

The red skin seen in fifth disease happens because of your immune system's response to the virus—not the virus itself.

Classic Skin Changes

1. Bright red cheeks

   • Often described as a "slapped cheek" appearance
   • Usually the first visible sign

2. Lacy or net-like rash

   • Appears on arms, legs, or trunk
   • May fade and return for weeks
   • Can worsen with:
     • Heat
     • Sun exposure
     • Exercise
     • Stress

The rash is typically not painful, though it may be mildly itchy.

Importantly, by the time the rash appears, the person is usually no longer contagious.

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Other Symptoms of Fifth Disease

Before the rash, mild flu-like symptoms may occur:

• Low-grade fever
• Runny nose
• Headache
• Fatigue
• Mild sore throat

In adults, especially women, joint pain and swelling are common. This can affect:

• Hands
• Wrists
• Knees
• Ankles

Joint symptoms may last days to weeks, and rarely longer.

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Who Is Most at Risk of Complications?

While fifth disease is usually mild, certain groups need special attention.

1. Pregnant Individuals

Parvovirus B19 infection during pregnancy can, in rare cases, affect the unborn baby and lead to:

• Severe fetal anemia
• Hydrops fetalis (a serious condition involving fluid buildup)
• Miscarriage (uncommon but possible)

If you are pregnant and exposed to someone with fifth disease, contact your healthcare provider promptly—even if you feel fine.

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2. People With Blood Disorders

Those with conditions such as:

• Sickle cell disease
• Thalassemia
• Chronic hemolytic anemia

may develop temporary severe anemia because the virus temporarily stops red blood cell production.

This can be serious and requires immediate medical care.

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3. People With Weakened Immune Systems

Individuals undergoing chemotherapy, living with HIV, or taking immunosuppressive medications may have:

• Prolonged infection
• Severe anemia

Medical evaluation is essential in these cases.

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How Is Fifth Disease Diagnosed?

In most children, doctors diagnose fifth disease based on:

• The classic rash appearance
• Symptom history
• Known exposure

Lab testing is usually not needed unless:

• The patient is pregnant
• The patient has anemia
• The immune system is weakened
• Symptoms are unusual or severe

If you're experiencing red cheeks, a lacy rash, or flu-like symptoms and want to better understand whether it could be fifth disease, Ubie's free AI-powered Erythema Infectiosum (Slapped Cheek Syndrome) symptom checker can help you assess your symptoms and determine the right next steps.

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How Is Fifth Disease Treated?

There is no specific antiviral treatment for fifth disease in healthy individuals.

Treatment focuses on symptom relief:

• Rest
• Fluids
• Acetaminophen or ibuprofen for fever or discomfort
  (Avoid aspirin in children due to the risk of Reye syndrome.)

For itching:

• A gentle moisturizer
• An oral antihistamine (if recommended by a doctor)

The illness usually resolves within 1–3 weeks.

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When Should You Speak to a Doctor?

While fifth disease is often mild, do not ignore serious warning signs.

Seek medical care if:

• You are pregnant and exposed
• You or your child have a blood disorder
• There is unusual paleness, fatigue, or shortness of breath
• Fever lasts more than several days
• Joint pain is severe or persistent
• The rash looks unusual (blistering, painful, or widespread bruising)
• The person appears very ill

If symptoms feel severe, rapidly worsening, or life threatening, seek urgent medical attention immediately.

When in doubt, it is always appropriate to speak to a doctor.

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How Long Is Fifth Disease Contagious?

A common concern is spreading the virus.

People with fifth disease are most contagious:

• Before the rash appears
• During the mild, early flu-like phase

Once the rash develops, they are usually no longer contagious.

This means that excluding a child from school after the rash appears often does not prevent spread.

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Can Adults Get Fifth Disease?

Yes. Adults who were not infected as children can develop fifth disease.

In adults:

• Rash may be mild or absent
• Joint pain may be the main symptom
• Fatigue can be more noticeable

Adults working in childcare or school settings are more likely to be exposed.

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Is It Definitely Fifth Disease?

Red skin and rash are common symptoms with many possible causes.

Other conditions that may look similar include:

• Allergic reactions
• Scarlet fever
• Measles
• Roseola
• Contact dermatitis
• Lupus (in adults with facial rash)
• Viral exanthems from other viruses

Because several conditions can resemble fifth disease, especially early on, a medical professional should evaluate:

• Persistent fever
• Severe illness
• Atypical rash patterns
• Concerning systemic symptoms

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What You Should Do Next

If you suspect fifth disease:

1. Monitor symptoms carefully.
2. Ensure adequate rest and hydration.
3. Treat fever and discomfort appropriately.
4. Avoid close contact with pregnant individuals until you are sure you are no longer contagious.
5. Consider using a structured tool like a symptom check for Erythema Infectiosum (Slapped Cheek Syndrome) to help organize your symptoms before seeing a clinician.
6. Speak to a doctor if anything feels serious, unusual, or prolonged.

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The Bottom Line

Fifth disease is a common viral illness that often causes bright red cheeks and a lacy rash. In most healthy children and adults, it is mild and resolves without complications.

However:

• Pregnant individuals
• People with blood disorders
• Those with weakened immune systems

should take potential exposure seriously and consult a healthcare professional.

Red skin is not always fifth disease, and it's important not to self-diagnose when symptoms are severe, persistent, or unclear.

If something feels off—or if there is any risk of complications—speak to a doctor promptly. Early guidance can provide reassurance and, in rare cases, prevent serious outcomes.

Most cases turn out to be manageable and temporary. The key is knowing when to monitor and when to act.