Scarlet fever

Scarlet fever is a bacterial illness that mainly affects children. It causes a distinctive pink-red rash.

Symptoms of scarlet fever 

The symptoms of scarlet fever usually take two to five days to appear after infection.

The symptoms include:

The distinctive pink-red rash develops 12 to 48 hours later.


Red blotches are the first sign of the rash. These turn into a fine pink-red rash that feels like sandpaper to touch. It may also be itchy. The rash usually starts on the chest and stomach before spreading to other areas of the body, such as the ears and neck.

Picture showing pink-red rash of scarlet fever
The fine pink-red rash feels like sandpaper to touch

The rash doesn't usually spread to the face. However, the cheeks become flushed and the area just around the mouth stays quite pale. The rash will turn white if you press a glass on it.

Outer layers of skin, usually on the hands and feet, may peel for several weeks afterwards.

Other symptoms may include:

  • swollen neck glands
  • loss of appetite
  • nausea or vomiting
  • red lines in the folds of the body, such as the armpit, which may last a couple of days after the rash has gone
  • a white coating on the tongue, which peels a few days later leaving the tongue red and swollen (this is known as strawberry tongue)
  • a general feeling of being unwell

Picture showing a red and swollen tongue
Scarlet fever can cause the tongue to be red and swollen


Treating scarlet fever 

Most cases of scarlet fever clear up after about a week without treatment. However, treatment is recommended.

Treatment reduces the length of time you're contagious, speeds up recovery and lowers the risk of complications of scarlet fever. Scarlet fever is usually treated with a course of antibiotics.

When to seek medical advice 

You should contact your GP as soon as possible if you think you or your child has scarlet fever. They will be able to confirm a diagnosis and recommend treatment.

Self care 

Many of the symptoms of scarlet fever can be relieved using some simple self care measures, such as:

  • drinking plenty of cool fluids
  • eating soft foods (if your throat is painful)
  • taking paracetamol to bring down a high temperature
  • using calamine lotion or antihistamine tablets to relieve itching

Preventing the spread of scarlet fever

Scarlet fever is very contagious. It is caused by Streptococcus pyogenes bacteria, also known as group A streptococcus, which are found on the skin and in the throat.

If your child has scarlet fever, you should keep them away from nursery or school for at least 24 hours after starting treatment with antibiotics. Adults with the illness should also stay off work for at least 24 hours after starting treatment.

Children and adults should cover their mouth and nose with a tissue when they cough or sneeze. They should also wash their hands with soap and water after using or disposing of tissues.

There’s currently no vaccine for scarlet fever.

Scarlet fever is a notifiable disease. This means that doctors must report cases to the Director of Public Health so they can monitor the spread of the disease.


The information on this page has been adapted from original content from the NHS website.

For further information see terms and conditions.

This page was reviewed April 2018

This page is due for review June 2021

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