How Scarlet Fever Is Treated

Treating scarlet fever involves killing the bacteria that's causing it and doing what you can to ease symptoms as the infection resolves. Antibiotics, such as penicillin and amoxicillin, are essential. But warm salt gargles, oatmeal baths, and other home remedies can be beneficial additions to your treatment plan, too, working to soothe a sore throat and itchy skin.

Over-the-counter options like throat sprays and pain relievers may also help you deal with discomfort.

While you're treating yourself or a loved one, though, remember that an important part of dealing with scarlet fever is preventing it from spreading, as it is highly contagious.

Prescriptions

Scarlet fever must be treated with an antibiotic in order to kill the group A streptococcus bacteria responsible for the infection.

According to the Centers for Disease Control and Prevention (CDC), the drugs of choice for treating scarlet fever are broad-spectrum antibiotics (medications that work against a wide range of bacteria), such as penicillin and amoxicillin. For someone who's allergic to penicillin, narrow-spectrum cephalosporins typically are safe options. Some examples of these medications are Keflex (cephalexin), cefadroxil (which is only sold as a generic drug), Cleocin (clindamycin), Zithromax (azithromycin), and Biaxin (clarithromycin).

 

After two to three days of antibiotic treatment, most of the symptoms of scarlet fever are likely to resolve, although the rash may linger for some time. If non-rash symptoms don't go away, it may be a good idea to let your doctor know.

In any case, it's important to complete the entire course of antibiotics for scarlet fever, like any other illness for which you're prescribed these drugs.

It's common to feel better rather quickly after starting them, but that doesn't mean that the bacteria that made you sick is gone.

Stopping a course of antibiotics early can increase the risk of further complications from any bacterial infection. In the case of scarlet fever (and other illnesses caused by group A strep), these can range from secondary infections of structures near the throat, such as the tonsils or ears.

Although uncommon, two potentially serious conditions have been associated with scarlet fever: One is rheumatic fever, an inflammatory disease that can cause permanent heart damage. The other, post-streptococcal glomerulonephritis (PSGN), also is an inflammatory illness. It affects the kidneys.

Home Remedies and Lifestyle

Relieving the symptoms of scarlet fever is key to helping someone feel more comfortable during their illness. Tending to discomfort— a nasty sore throat, headache, itchy rash—may even help to speed recovery by making it easier for a patient to get enough sleep and rest.

Sore Throat Relief

You can experiment with these options to find the ones that bring the most relief:

  • Frozen foods: Ice cream, popsicles, slushies, or smoothies made with frozen fruit, for instance, can temporarily numb a sore throat. Sucking on ice chips can help as well.
  • Warm liquids: Choices such as chicken soup or tea with honey can be soothing. The operative word here is "warm." Swallowing a too-hot liquid could make throat pain worse, not better. 
  • Throat lozenges or hard candy: Note that these are only safe options for older kids and adults. Although scarlet fever rarely affects very young children, these items are potential choking hazards for those 2 and under.
  • Warm salt water: The Mayo Clinic recommends mixing a ratio of a quarter teaspoon of salt to four cups of water to gargle (and then spit out, of course).
  • cool-mist humidifier: It will help keep the air moist, especially during sleeping hours. Sitting for a few minutes in a steamy bathroom may help as well.
  • Avoidance: Irritants like cigarette smoke and the fumes from cleaning products can exacerbate throat pain.

Soothing Itchy Skin

Soaking in a warm oatmeal bath can help ease itchy, irritated skin. You can purchase pre-packaged oatmeal bath products or make your own: Churn regular oatmeal in a food processor until it's powdery and add half a cup to bath water.

Keep the fingernails of young children who are tempted to scratch short and clean to avoid damaging skin.

Over-the-Counter Medications

You can find relief from symptoms like a headache, fever, and throat pain in your medicine cabinet, drugstore, or supermarket.

Non-steroidal Anti-inflammatory Drugs (NSAIDs) 

OTC medications such as Tylenol (acetaminophen) and Advil and Motrin (ibuprofen) can help bring down a fever as well as relieve body aches and pains. If you're giving an NSAID to a child, make sure to measure out a dose that's appropriate for her age and her weight. You'll find guidelines on the package label, but if you aren't sure what's safe, check with your pediatrician. 

Do not give a child under the age of 19 aspirin or any OTC product that contains aspirin. The drug has been linked to a serious disease called Reye's syndrome, which causes swelling of the brain and liver.

Throat-Numbing Products

Adults and children over 12 can use sprays containing ingredients that temporarily numb the throat. They can be especially effective because the spray can be targeted to exact area that's experiencing pain. One such sore throat spray, Chloraseptic (phenol), comes in a variety of flavors, including cherry, wild berry, citrus, and honey lemon. To use a sore throat spray, spritz the area five times allow the medicine to sit for at least 15 seconds, and then spit it out. The numbing effect should last for a couple of hours.

Prevention

As with any contagious illness, prevention involves protecting yourself and those you care for from being infected when people around you have the infection, as well as taking measures to prevent the spread of the illness if you or loved ones become ill.

If you know that scarlet fever is going around (perhaps a classmate of one of your children has been sick), proper and frequent hand washing is essential. Remind your kids to wash often while at school, and make it a house rule that everyone scrubs up as soon as they come home and before they start touching surfaces in the house.

If you or someone in your household becomes ill with scarlet fever, it's important to know that group A strep bacteria spread easily through the air by hitchhiking on droplets of liquid contained in sneezes and coughs. The best way to keep bacteria out of the air, then, is to cough or sneeze into the crook of an elbow or sleeve. This strategy also will keep the organisms from landing on hands where they can then transfer to frequently handled surfaces like doorknobs and remote controls.

If a tissue is used to catch a cough or sneeze, it should be disposed of right away (flushing a bacteria-laden tissue down the toilet is a great way to banish bacteria). Never drink from a cup or glass that's been used by someone with scarlet fever, or share eating utensils.

Finally, anyone who's been diagnosed with scarlet fever must be on antibiotics for at least 24 hours before returning to school or daycare. This is to prevent the risk of spreading the illness to others. It's also important to give the body time to rest and recuperate.

Sources:

Centers for Disease Control and Prevention. "Scarlet Fever: A Group A Streptococcal Infection." Jan 22, 2018.

Mayo Clinic. "Sore Throat: Diagnosis & Treatment.." Aug 8, 2017. 

MedlinePlus. "Over-the-Counter Medicines." Mar 5, 2018.