Scarlet Fever Symptoms and Treatments for Children

Hispanic doctor checking patient's throat
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Scarlet fever is an infection that is caused by group A streptococcus, the same bacteria that causes strep throat. Scarlet fever, also known as scarlatina, is basically strep throat that includes a rash. It occurs mainly in children under the age of 18.


Symptoms of scarlet fever include:

  • Red rash that feels like sandpaper and typically starts on the chest and spreads to the arms and legs. This rash may last between 2 and 7 days. After the rash disappears, the skin on the fingers and toes may peel.
  • Sore throat
  • Fever
  • Pink or red color to the face with pale area around the lips
  • "Strawberry tongue" — red, swollen bumps on the tongue with whitish coating
  • Swollen glands in the neck

Less common symptoms of scarlet fever may include:

  • Upset stomach or vomiting
  • Headache
  • Body aches


Scarlet fever is diagnosed in the same way as strep throat. A throat swab is taken and either a rapid test is performed or it is cultured to see if the streptococcus bacteria is present. The rapid test can show a positive result for 5 to 10 minutes but the culture may take up to two days to get results. Often both tests will be performed because the rapid tests may be unreliable.


Scarlet fever must be treated with antibiotics to kill the streptococcus bacteria that is causing the infection. If your child has been diagnosed with scarlet fever, he will need to be treated with antibiotics for at least 24 hours before returning to school or daycare to be sure he is no longer contagious.

You can also give your child fever-reducing medications, such as Tylenol or Motrin, to help make him more comfortable and ease the pain of a sore throat. Cold foods such as ice cream, popsicles, and jello are soothing to a sore throat. Warm liquids such as soup may also be comforting. Running a cool-mist humidifier while your child is sleeping will help keep the throat and nose moist and help prevent discomfort during the night.

In most cases, scarlet fever is not dangerous. Although some people confuse it with rheumatic fever (which is a much more serious but far rarer complication of strep throat), it is not the same. If your child has symptoms of strep throat and a rash but it looks much different than the scarlet fever rash described above, talk to her health care provider to be sure you get an accurate diagnosis.

If your child has been diagnosed with scarlet fever but does not improve after taking antibiotics for 2 to 3 days, contact her pediatrician. Although the rash may take longer to disappear, fever and other symptoms should improve after taking antibiotics.


"Scarlet Fever." National Center for Immunization and Respiratory Diseases: Division of Bacterial Diseases 13 Apr 08. US Centers for Disease Control and Prevention. 14 Jan 10.