Scarlet Fever : Causes, Symptoms, Treatment and Prevention

Generations ago, scarlet fever represented a deadly childhood illness that took many lives. Today, in the age of antibiotics, a diagnosis of scarlet fever isn’t as dire-sounding as it once was. In fact only about 10% of children who develop strep throat will subsequently develop scarlet fever. But it’s still an uncomfortable illness that can cause grave complications if not treated promptly. Here’s what you need to know to prevent scarlet fever.


Named for the characteristic rash it produces, scarlet fever is caused by the same family of bacteria that cause strep throat — the group A Streptococcus germ. In fact, scarlet fever often arises during or after a strep throat infection. While anyone can get scarlet fever, it usually affects children between ages five and 12.

Because scarlet fever is caused by bacteria, it can be effectively treated with antibiotics.


The hallmark of scarlet fever is a rough, red rash over the entire body. The rash is often described as feeling like sandpaper. Other characteristics of the scarlet fever rash include:

  • A clear, ‘halo’ area around the mouth
  • Bright red rash lines at the armpit and groin folds (called ‘Pastia’s lines’)
  • A swollen, bright red tongue (‘strawberry tongue’)

Other symptoms of scarlet fever include:

  • A high fever
  • Sore throat
  • Chills
  • Headache
  • Muscle aches
  • Vomiting


If you suspect your child may have scarlet fever, you should call your healthcare provider to find out if it’s OK to take the child into the office. Because scarlet fever is contagious, your healthcare provider may want you to use a separate entrance.

Your healthcare provider will diagnose scarlet fever by using a throat culture to test for strep. If your child tests positive, he or she will be given a course of antibiotic medication. It’s very important to give the antibiotics exactly as directed and to finish the entire amount, even if your child begins to feel better before the antibiotics are finished.

The rash can last two to three weeks, and it’s possible the skin will peel in certain areas. You can provide comfort care, including applying cool packs to the skin at first and applying lotion later. The skin peeling should not leave any scars.

In the rare event your child does not start feeling better within 24 hours of beginning antibiotic treatment, you should call your healthcare provider. Complications from scarlet fever can include rheumatic fever (which can damage your child’s heart valves), meningitis and liver inflammation. Rapid diagnosis and treatment can help your child avoid developing any serious complications from scarlet fever.


Because scarlet fever is caused by group A Streptococcus, a very common group of bacteria, it may not be possible to completely reduce your child’s risk of developing it. A few important measures you can take are:

  • Avoid contact with anyone who has strep throat or the symptoms of scarlet fever. Streptococcus germs are spread by coming in contact with droplets of body fluid, such as sneezes or coughs.
  • Practice good hand hygiene and teach your children to do the same. To wash your hands effectively, use warm water, lather with soap and scrub for at least 15 seconds — about the length of time it takes to sing “Happy Birthday to You.” Thorough drying is a key part of hand hygiene, since bacteria love a damp environment.
  • Isolate your child if he or she comes down with scarlet fever. This will help avoid transmitting the disease to others.
  • If your child gets a case of strep throat, monitor him or her carefully for signs of scarlet fever. Notify your healthcare provider promptly if the characteristic sandpaper rash occurs.


Scarlet fever has lost its teeth as a deadly childhood disease, but its complications can be grave if it’s not treated quickly. Don’t ignore signs of scarlet fever. Get your child on antibiotics as fast as possible to avoid serious complications from this manageable illness.

Image Credit  : Kronawitter via Creative Commons