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Slapped Cheek Syndrome

Just rosy, or a case of Slapped Cheek?

Rosy cheeks are adorable but if your little one’s are unusually red all of a sudden you may be looking at a case of Slapped Cheek.

What is Slapped Cheek Syndrome?

Slapped Cheek (also known as fifth disease or erythema infectiosum) is so-called because of the distinctive bright red rash that appears on the cheeks. It’s caused by an airborne virus (parvovirus B19) spread through coughs and sneezes and, as people are most contagious before symptoms begin, it’s very difficult to avoid. Most cases develop late winter/early spring.

Symptoms of slapped cheek

‘Initial symptoms are flu-like – fever, sore throat, headache, upset tummy, joint pain - and usually last a few days though in around 20-30% of cases there are no symptoms or they’re so mild they’re barely noticeable,’ says Dr Sarah Temple, The Essential Parent Company’s expert GP ( ‘This is when your child’s most contagious.’

Then there’s usually a period of around 7 to 10 days without any further symptoms until a rash appears.

‘The rash occurs in three distinct stages,’ Dr Temple explains. ‘In the first stage children develop a bright red rash on both cheeks that usually fades over two to four days. One to four days after the facial rash appears a light pink raised rash that’s a bit itchy usually spreads on the chest, arms, stomach and thighs. By now your little one is probably uncomfortable but no longer contagious. 

‘In some cases there’s a third stage when the rash fades the reappears over a period of weeks. Re-appearances are often triggered if your child is hot, anxious or has just exercised.’

Treatment of slapped cheek syndrome

‘Paracetamol or ibuprofen will help with fever and pain while antihistamines will reduce the itchiness. A gentle moisturiser might also sooth irritation,’ says Dr Temple. 

And the good news is once your baby’s been infected they should develop lifelong immunity.

When to see your GP

In most cases this is mild infection that clears up on its own but if you are worried you should speak to your GP – especially if your child has any known blood abnormalities (such as sickle cell anaemia) or is immunosuppressed.

Also speak to your GP if your child catches it while you are pregnant because parvovirus B19 can, in rare cases, cause miscarriage.

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