The condition often begins as a large single pink patch on the chest or back. This patch may be scaly and is called a “herald” or “mother” patch. Often the person with this condition will think this patch is a ringworm and will apply creams that are used to get rid of fungus. This will not help since the rash is not caused by a fungus.
Within a week or two, more pink patches, sometimes hundreds of them, appear on the body and on the arms and legs. Patches may also occur on the neck, and though rare, the face. These spots usually are smaller than the “herald” patch and may also be mistaken for ringworm. The patches are oval and often form a pattern over the back that resembles the outline of a Christmas tree. Sometimes the disease can produce a more severe and wide-spread skin eruption. About half the patients will have some itching, especially when they become overheated.
Occasionally there may be other symptoms, including tiredness and aching. The rash usually fades and disappears within six to eight weeks, but can sometimes last much longer. Physical activity – like jogging and running, or bathing in hot water may cause the rash to temporarily worsen or reappear. In some cases, the patches will reappear up to several weeks after the first episode and can continue for many months.