Scarlet fever: what it looks like and what to do
Scarlet fever is a bacterial infection caused by group A streptococcus — the same bug behind strep throat. It often starts like a bad sore throat and fever, then a red, rough rash shows up. These days it’s usually treatable with antibiotics, but knowing the signs and acting quickly matters.
Recognize the symptoms
Look for a sudden high fever, sore throat, swollen tonsils, and headache. The rash usually appears within a day of fever: it feels like sandpaper, is bright red, and often starts on the neck and chest before spreading. The tongue may look red and bumpy (people call it a "strawberry tongue"). In lighter skin the rash is obvious; in darker skin it may be felt more than seen. Kids between about 5 and 15 get it most, but anyone can catch it.
How doctors confirm scarlet fever
Your clinician will consider symptoms and usually take a throat swab for a rapid strep test or lab culture. That confirms whether group A strep is the cause. Tests are quick and help decide the right antibiotic. If the test is positive, starting treatment lowers the risk of complications and shortens contagiousness.
Treatment is straightforward: most people get a course of penicillin or amoxicillin. If someone is allergic to penicillin, doctors often choose azithromycin or erythromycin. Finish the full antibiotic course even if symptoms improve fast. After 24 hours on effective antibiotics the person is usually much less contagious and can return to school or work, but check with your clinician first.
Home care helps comfort and recovery. Keep hydrated, offer soft foods if the throat hurts, and use weight-appropriate fever relievers like acetaminophen or ibuprofen. Cool drinks and salt-water gargles can ease throat pain. Rest and avoid close contact with others until 24 hours of antibiotics are completed or the doctor says it’s safe.
Left untreated, scarlet fever can lead to complications such as middle ear infection, sinusitis, rheumatic fever, or kidney inflammation. These are less common now that antibiotics are available, but they’re the main reason doctors treat suspected cases promptly.
Prevent spread by practicing good handwashing, not sharing utensils or cups, and keeping infected children home until they’ve had at least a day of antibiotics. There’s no vaccine for scarlet fever, so hygiene and early treatment are the best defenses.
If your child has a high fever, trouble breathing, severe throat pain, or can’t keep fluids down, seek medical care right away. For general info on antibiotics and safe medicine use, check our site’s articles on common antibiotics and tips for taking them safely.