Scarlet Fever

Medically reviewed by Drugs.com. Last updated on Apr 6, 2025.

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What is scarlet fever?

Scarlet fever is an infection caused by bacteria. This bacteria makes a toxin (poison) that can cause a red rash on the skin. Scarlet fever is most common in children between 5 and 15 years of age.

What causes scarlet fever?

Scarlet fever is caused by bacteria called group A strep. This is the bacteria that also causes strep throat. In those with scarlet fever, the bacteria is found in the mouth and nose. Scarlet fever can be spread from an infected person to another by touching, coughing, sneezing, or sharing food or drinks. Scarlet fever can also come from a skin infection caused by strep bacteria.

What are the signs and symptoms of scarlet fever?

The most common sign of scarlet fever is a rash. The rash first appears as tiny red bumps on the neck, chest, and abdomen. Then, it spreads all over the body. It looks like a sunburn and feels rough. The rash may last for 6 days. After the rash is gone, the skin on the tips of the fingers and toes usually begins to peel. Your child may also have one or more of the following:

• Bright red lines under the arms and in the groin
• Fever with chills
• Headache and body aches
• Nausea or vomiting
• Sore throat with white or yellow patches
• Swollen, red tongue

How is scarlet fever diagnosed?

A throat culture is done to check for scarlet fever. Healthcare providers will swab the back of your child's throat with a cotton swab. You may get the results in minutes or days.

How is scarlet fever treated?

Antibiotic medicine is used if the throat culture shows that strep bacteria is the cause of your child's infection. Give the antibiotics to your child exactly as suggested by your healthcare provider. It is very important for your child to finish all of the antibiotics even if he or she feels better. Left untreated, scarlet fever may cause a throat abscess, swelling of the sinuses, or a middle ear infection. Your child may also develop pneumonia, heart or kidney disease, or meningitis (swelling of the coverings of the brain and spinal cord).

Treatment options

The following list of medications are related to or used in the treatment of this condition.

• Penicillin VK
• levofloxacin
• Bicillin L-A
• Bicillin C-R
• Pfizerpen

View more treatment options

How can the spread of germs be prevented?

• Wash your hands and your child's hands often. Use soap for at least 20 seconds. Rinse with warm running water. Dry with a clean towel or paper towel. Wash your hands several times each day. Wash after you use the bathroom, change a child's diaper, and before you prepare or eat food. Wash your child's hands after he or she uses the bathroom or sneezes. Wash your child's hands before he or she eats. Use hand sanitizer if soap and water are not available.
• Keep your child away from others who are sick. Separate your child from brothers or sisters who are sick. Ask friends and family not to visit if they are sick. Your child's healthcare provider will tell you when your child can return to school or work. This is usually 24 hours after he or she begins antibiotics and the fever is gone.
• Clean toys and surfaces. Clean toys that are shared with other children. Use a disinfectant solution to clean common surfaces.

Drugs used to treat this and similar conditions

How can I manage my child's symptoms?

• Give your child warm liquids, such as soup, or cold foods such as popsicles or milkshakes. This may help ease the pain of the sore throat.
• Use a cool mist humidifier to increase air moisture in your home. This may make it easier for your child to breathe and help decrease his or her cough.
• Your child needs rest to heal. Quiet play will keep your child safely busy. Have your child read or draw quietly when he or she is awake. Follow instructions for how much rest your child should get while he or she heals.

When should I seek immediate care?

• It becomes difficult for your child to eat, drink, or breathe.
• Your child cries without tears.
• Your child has a dry mouth or cracked lips.
• Your child is more sleepy or irritable than usual.
• Your child has a sunken soft spot on the top of his or her head.
• Your child urinates less than usual or not at all.
• Your child says he or she feels dizzy.

When should I call my child's doctor?

• Your child has a fever.
• Your child is tugging at his or her ears or has ear pain.
• You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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