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The Signs And Symptoms Of Scarlet Fever In Children

Medically reviewed by Regina Victoria Boyles, MD · Pediatrics

Written by Lorraine Bunag, R.N. · Updated Mar 25, 2023

The Signs And Symptoms Of Scarlet Fever In Children

Strep throat is a common condition among children aged 5 to 15 years old. And while many children will only have to endure sore throat and its accompanying mild symptoms, some may also develop scarlet fever or scarlatina, a contagious bacterial infection. How can you tell if your child is experiencing both strep throat and scarlet fever? Find out here. 

What Is Scarlet Fever?

Group A Streptococcus bacteria causes scarlet fever. This strain of bacteria also commonly causes strep throat, that’s why most children who have scarlet fever also have strep throat (but not vice versa). 

Because the bacteria live in the nose, throat and on the skin, too, that’s why people can serve as carriers of the bacteria. However, it usually spreads to other people by sneezing, coughing, or even talking.

You may get scarlet fever if you breathe in droplets that contain the bacteria, touch contaminated surfaces and then touch your nose or mouth, or share glass, plates, or utensils used by someone who’s infected. 

Note: Anyone can get scarlet fever, but it is most common among children aged 5 to 15 years old. 

Signs And Symptoms Of Scarlet Fever

A distinguishing sign of scarlatina is the red or bright pink rash all over the body. The rash first appears on the face or neck (save for the ring around the mouth), then spreads to the trunk, and then limbs. If you press on the rash, they blanch or become pale. Finally, the rash feels like sandpaper and may be itchy. 

Besides the rash, the folds of the skin in the neck, underarm, elbows, knees, and groin area, may appear redder than the rest of the body with the rash. Early in the disease, the child may also have strawberry tongue that looks bumpy and red with a white coating on top. 

The other symptoms of scarlet fever include:

  • Fever of 38 C or higher
  • Very sore and red throat; sometimes with white patches on the surface 
  • Difficulty swallowing
  • Swollen lymph nodes 
  • Headache
  • Body aches and joint pains 
  • Nausea and vomiting
  • Abdominal pain 

What To Do If You Suspect Scarlatina In Your Child

If you notice the signs and symptoms above, the first – and most important – thing to do is to bring your child to the doctor.

This is not just proper diagnosis, but for treatment. You see, if it’s confirmed that your child has scarlet fever, then they need to receive antibiotics to get better faster, reduce the possibility of transmission, and prevent more serious complications, such as pneumonia. 

Before heading home, your doctor will leave you instructions to relieve the symptoms of the infection. These may include:

  • Giving plenty of fluids to your child
  • Preparing soft foods, so that they can still eat well despite their sore throat. Soothing teas and warm nutritious soups are excellent choices, as well as cool drinks, slushies, and popsicles. 
  • Giving them paracetamol or other medicine for fever and aches 
  • Applying calamine lotion for the itchy rash. To prevent further injury, trim your child’s fingernails. 

Be Cautious With Antibiotics

Scarlet fever is best treated with the prescribed antibiotics. Without antibiotic therapy, they will continue to be contagious for a week or two after the onset of symptoms and might even develop complications.

However, please remember that your child is still contagious for 24 hours after beginning the antibiotic treatment. Hence, don’t allow them to go to the playground or school during that period. 

Finally, please finish the antibiotic therapy as ordered by the doctor. Most kids will feel better after 4 or 5 days of treatment, but if the prescription says they need to take it for 7 or 10 days, please follow the order. 

Key Takeaways

Scarlet fever may sometimes occur in children with strep throat. If you notice the telltale signs (red rash, red lines, strawberry tongue), please bring your child to the doctor for proper assessment and treatment.

Learn more about Infectious Diseases in Children here


Hello Health Group does not provide medical advice, diagnosis or treatment.

Medically reviewed by

Regina Victoria Boyles, MD


Written by Lorraine Bunag, R.N. · Updated Mar 25, 2023

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