Scarlet Fever

Medically Reviewed by Jennifer Robinson, MD on September 21, 2023
3 min read

Scarlet fever is a bacterial infection that causes a bright red rash. It looks and feels like sandpaper.

Also called scarlatina, the infection is easily spread from person to person. It gets its name from the red, bumpy rash that typically covers the body. 

Scarlet fever starts out looking like a sunburn. Most often, the rash begins on the face and neck and spreads to the rest of the body. It may itch. Other signs you or your child may have scarlet fever include:

  • Fever, with or without chills 

  • Sore, red throat that may have white blotches

  • Swollen glands in the neck

  • Headache or body aches

  • Nausea, vomiting and abdominal pain

  • Red, swollen tongue that may be bumpy or have a whitish coating

  • Flushed face with pale ring around the mouth

  • Deep red coloring in the creases of the arms, legs, neck and groin

After the rash goes away, your skin may peel for several weeks.

If your child has strep throat, there's a chance they will also develop scarlet fever. The same bacteria that causes scarlet fever causes strep throat. It's called "group A strep."

Scarlet fever can also be linked to burns or wounds that become infected -- your own or the infected wounds of another person.

Anyone can get scarlet fever, but it's most common in kids from 5 to 15 years old. The infection is often passed between classmates at school or family members who are in close contact with each other. It's most often spread by contact with the droplets emitted when an infected person coughs or sneezes. It can even be spread if you touch something -- like a plate or glass – on which these droplets have landed.

Call your doctor if your child has a sore throat, especially if they also have a rash or a fever. Your doctor will run the following tests to check for scarlet fever:

Physical exam. A doctor will take a look at the rash and throat, and see if the lymph nodes are swollen. They'll also look for other symptoms like chills, fever, and body ache. They’ll ask whether your child has nausea, vomiting, or no appetite.

Throat swab. To confirm whether scarlet fever or strep throat is causing the symptoms, they’ll swab the throat and tonsils to test for the group A strep bacteria.

Rapid strep test. A rapid test will give results before you leave the office. If that’s negative, the doctor may order a culture, a more in-depth test to see if the bacteria is actually present.

It's important to test for strep because other illnesses can cause the same symptoms. They may have different treatments.

Typically, the treatment for scarlet fever is the same as for strep throat. Antibiotics will clear up scarlet fever by killing the strep bacteria that cause it. It may take a couple of weeks to get back to normal. Be sure to let day care providers and classmates know that they may have been exposed. In the meantime, these are some things you can do to make yourself or your child more comfortable:

  • Over-the-counter medicines like acetaminophen and ibuprofen can help with pain and fever. But never give aspirin to children or teens.
  • If your child is 4 or older, soothing drops can help with throat pain.
  • Have soft foods, cold drinks, or ice pops while your throat is sore.
  • Drink plenty of liquids. They’ll help keep your throat or your child's throat moist and stop dehydration.
  • Gargle with salt water to help with mouth and throat pain.
  • Add moisture to the air in your home. Use a cool mist humidifier.
  • If the rash itches, try an over-the-counter anti-itch cream, and keep your child’s nails trimmed so they don’t hurt themselves scratching.

It’s important to get treatment to prevent possible complications. The bacteria can spread throughout the body and cause other infections, including pneumonia. In rare cases, it can lead to rheumatic fever, a serious disease affecting the heart, joints and nervous system.