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What Do Measles Look Like?

written by: Cordie Kellerman • edited by: Leigh A. Zaykoski • updated: 5/23/2011

It used to be a very common childhood disease, but vaccination has made the measles less of a problem. So, what do measles look like? Could you recognize the measles rash?

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    Two Kinds of Measles

    There are actually two kinds of measles and they are caused by completely different viruses.

    When people think of measles they are usually thinking about the disease called "red measles", or "hard measles". It is caused by the rubeola virus. It produces both a fever and a rash and typically lasts 7 to 12 days. It is commonly just called "measles".

    German measles is caused by the rubella virus. It has much milder symptoms and is also called "three-day measles". In medical references it is usually referred to as rubella.

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    Common Measles - What Do Measles Look Like?

    Kaplik's spots in the mouth of a patient with measles Symptoms of the measles appear after an incubation period of 10-14 days (from time of exposure to symptoms).

    Immediately before the measles rash appears, patients often experiences a mild to moderate fever, very runny nose, cough and conjunctivitis with light sensitivity. They may feel tired and lose their appetite.

    In 2-4 days the first visible sign of the measles appear as bright red spots in the mouth. These spots have very small (grain of salt) white to bluish-white centers. These are known as Koplik's spots and are approximately 1-2mm in diameter. They first appear opposite the molars but soon spread to much of the inside cheeks and the inside of the lower lip. Typically Koplik's spots fade away and will disappear after a rash appears on the face and trunk.

    Image: CDC-Public Health Image Library (PHIL) License: Public Domain: United States Federal Government

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    By day three, the measles rash has spread to the trunk 

    The fever will climb, sometimes reaching 104 or 105 F. As the fever spikes, the typical measles rash will appear. It begins behind the ears and near the hairline (on the forehead and neck).

    The measles rash can include both flat patchy areas and red raised bumps. As the rash spreads, many of the smaller individual lesions an patchy areas will join together.

    Image: CDC-Public Health Image Library (PHIL) License: Public Domain: United States Federal Government

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    The rash is more difficult to see on darker skin 

    A day or two after the rash appears on the face, it will spread to the body, starting down the neck and truck and on to the buttocks and extremities. As the rash spreads, the fever will start to drop and the Koplick spots will disappear. As it spreads to new areas, the rash on the first areas to be affected will begin to fade.

    The measles rash may be slightly itchy but it is not intensely uncomfortable. When the rash has faded away, the skin will remain discolored and may eventually peel or flake off (much like it does after a sunburn). Although the skin may remain blotchy and discolored for several weeks, there is usually no long term scarring

    Image: Wikimedia Commons License: Public Domain: United States Federal Government

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    Rubella - What Do German Measles Look Like?

    The rubella rash is very similar to the regular measles rash. It is less intense and not as red. Rubella has milder symptoms than the common measles. In fact, children who are infected with it often have no symptoms other than a rash. Adults are more likely to experience symptoms before the rash appears, including a mild fever, swollen and tender lymph nodes (usually in the back of the neck or behind the ears), headache, fatigue.

    The rubella rash is pink or light red in color. The spots are flat and very small. As with the measles rash, it starts as many individual spots and then merges to form large patches. Other similarities between the two diseases is that the rubella rash also starts on the face and then spreads to the rest of the body. It fades in one spot as it spreads to the next.

    It does not last as long as the measles - typically not more than 3 days.

    Rubella is usually not very itchy. As with measles, the skin may flake as the rash clears. However, since the rash is milder and less extensive, the flaking is also milder.

    Image: CDC-Public Health Image Library (PHIL) License: Public Domain: United States Federal Government


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