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Published on: 2/27/2026
Bright red cheeks and a lacy rash are classic signs of fifths disease, a usually mild parvovirus B19 infection that is most contagious before the rash and typically improves with rest, fluids, and appropriate fever or pain medicine. There are several factors to consider, including adult joint pain, how long the rash lasts, and when it is safe to return to school or work; see the complete information below.
Seek medical care sooner if you are pregnant, have a blood disorder or weakened immune system, or if symptoms are severe, persistent, or suggest anemia; the medically approved next steps, red flags, testing guidance, and prevention tips are outlined below.
If you or your child suddenly develops bright red cheeks and a lacy rash, you may be dealing with fifths disease. While the name can sound alarming, fifths disease is usually a mild viral illness that clears up on its own. Still, understanding what's happening in your body—and knowing when to seek medical care—is important.
Here's what you need to know about fifths disease, why it causes red skin, and the next medically approved steps to take.
Fifths disease (also called erythema infectiosum or slapped cheek syndrome) is a common viral infection caused by parvovirus B19. It most often affects children between ages 5 and 15, but adults can get it too.
The name "fifths disease" comes from a historical list of common childhood rash illnesses. It was the fifth condition on that list.
The infection spreads through:
It is most contagious before the rash appears. Once the rash shows up, most people are no longer contagious.
The bright red rash happens because of your immune system's response to the virus.
Here's what typically occurs:
The rash of fifths disease has a recognizable pattern:
The rash is usually not painful, but it may itch slightly.
In many children, fifths disease is mild. Some may not feel sick at all.
Common symptoms include:
In adults, symptoms can be different. Adults are more likely to experience:
Joint discomfort in adults can last several weeks, and in rare cases, longer.
For most healthy children and adults, fifths disease resolves without complications. However, certain groups need closer monitoring:
Parvovirus B19 can, in rare cases, affect an unborn baby and lead to anemia or complications. If you are pregnant and exposed to fifths disease, contact your healthcare provider promptly.
Those undergoing chemotherapy, living with HIV, or taking immune-suppressing medications may have difficulty clearing the virus.
Individuals with conditions like sickle cell disease or certain types of anemia may experience a temporary drop in red blood cell production.
If you fall into one of these categories, medical guidance is especially important.
In most cases, doctors diagnose fifths disease based on:
Blood tests are usually not necessary unless:
If you're experiencing symptoms like a distinctive facial rash, body rash, or joint pain and want to understand whether they could be related to Erythema Infectiosum (Slapped Cheek Syndrome), a free AI-powered symptom checker can help you assess your condition and decide whether to seek medical care.
There is no specific antiviral treatment for fifths disease. Because it's caused by a virus, antibiotics will not help.
Most care focuses on symptom relief:
The rash itself does not usually require treatment.
While fifths disease is often mild, you should speak to a doctor if:
If there are signs of severe anemia (such as extreme fatigue, dizziness, rapid heartbeat, or shortness of breath), seek medical care immediately.
Never ignore symptoms that feel serious or life-threatening.
Typical timeline:
Joint pain in adults may last longer but usually improves gradually.
Most people recover fully without long-term problems.
There is currently no vaccine for fifths disease.
Prevention strategies include:
Because people are contagious before the rash appears, complete prevention can be difficult.
In most cases, once the rash appears, the person is no longer contagious.
Children with fifths disease can usually return to school when:
Adults can typically return to work under similar conditions.
If unsure, consult a healthcare provider.
For most healthy children and adults, it is mild and self-limited. However, complications can occur in pregnant individuals, those with weakened immune systems, or people with certain blood disorders.
It is uncommon. Most people develop lasting immunity after infection.
No. Fifths disease does not usually leave scars.
No. By the time the rash appears, the person is generally no longer contagious.
Fifths disease is a common viral illness that often causes a bright red "slapped cheek" rash and sometimes a lacy body rash. In most healthy children and adults, it is mild and resolves on its own with supportive care.
That said, certain groups—especially pregnant individuals and people with blood or immune disorders—should take symptoms seriously and seek medical advice.
If you're unsure whether your red rash is fifths disease, consider using a trusted online symptom assessment tool and follow up with a healthcare provider if anything seems concerning.
And most importantly: if symptoms are severe, worsening, or potentially life-threatening, speak to a doctor immediately. Early evaluation is always the safest next step.
(References)
* Baka A, Sadek S, Puthalath A, Khouly M, Farhat M, Abbas M, Ghaddar N, Aftimos P. Parvovirus B19 infection: Clinical features, diagnosis, and management. Rev Med Virol. 2022 Sep;32(5):e2380. doi: 10.1002/rmv.2380. Epub 2022 Jul 28. PMID: 35914561.
* Broliden K, Tolfvenstam T, Norbeck O. Parvovirus B19 infections: an update on epidemiology, clinical manifestations, and diagnosis. Expert Rev Anti Infect Ther. 2018 Jan;16(1):15-27. doi: 10.1080/14787210.2018.1408891. Epub 2017 Nov 22. PMID: 29161726.
* Servettaz A, Lefrère F, Le Besnerais M. Parvovirus B19: clinical manifestations and new insights into diagnosis and treatment. Presse Med. 2019 Jan;48(1):71-78. doi: 10.1016/j.lpm.2018.11.002. Epub 2018 Dec 4. PMID: 30522108.
* Wang Y, Zheng Y, Li H. Parvovirus B19 infection in children: Clinical manifestations and management. Front Pediatr. 2023 Aug 15;11:1232845. doi: 10.3389/fped.2023.1232845. eCollection 2023. PMID: 37626359.
* Iacobelli R, Cota C, Fimiani G, De Rosa R, Coppola L, Di Meo L, Perri A, Coppola M. Human Parvovirus B19: New Insights in a Persistent Pathogen. Viruses. 2023 Jun 20;15(6):1398. doi: 10.3390/v15061398. PMID: 37367359.
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