Scarlet fever, also known as scarlatina, is a pediatric illness caused by strep throat or strep skin infections. Group a streptococci bacteria makes a toxin that causes a bright, red rash to spread over most of the body, giving scarlet fever its name. Like other acute infections, strep bacteria can be treated with antibiotics and usually clears up in about a week, but it’s still important to see your pediatrician right away if your child starts experiencing symptoms. Here’s what you need to know about scarlet fever.


A rash that looks like bad sunburn with the addition of itchy bumps is the first major sign your child has scarlet fever. Starting on the face and neck, the rash tends to travel down the torso to other parts of the body. While underarm, elbow and groin creases are usually affected by red streaks, the area around the mouth tends to stay clear. More symptoms of scarlet fever include:

  • A sore throat
  • Swollen neck glands
  • Papules
  • Pastia's lines
  • A fever above 101° F
  • Red, swollen tonsils with a white or yellow coating
  • A whitish or yellowish coating on the tongue
  • Loss of appetite
  • Chills or body aches
  • Nausea or vomiting
  • Dermatology or respiratory problems

In rare cases, a streptococcal skin infection called impetigo can develop from scarlet fever.  Children with this type of infection may not experience a sore throat as a symptom.

Diagnosis and treatment

Similar to strep throat, your pediatrician will conduct a rapid strep test or throat cultures (painless throat swabs) to confirm a scarlet fever diagnosis. A positive strep test or throat swab will result in a prescription antibiotic that will need to be taken for around 10 days. Even though the antibiotics will heal the infection, the tonsils, swollen glands and peeling skin may take a few weeks to return to normal.

Home care is an important part of treating scarlet fever. Serve kids a liquid diet or soft foods like tea, soup, cool drinks or popsicles to soothe sore throats. Make sure that your child drinks plenty of fluids to prevent dehydration and administer over-the-counter pain relievers like acetaminophen or ibuprofen for a mild fever or throat pain. Additionally, keep your child’s fingernails trimmed to prevent scratching and use an over-the-counter anti-itch medicine to help relieve the itching.


In terms of contagiousness, scarlet fever is caused by a bacterial infection and can be spread between kids through sneezing and coughing, while impetigo can be spread through skin contact. If you have a sick child at home, wash your hands often and protect the rest of your household by washing his toothbrush, drinking glasses and eating utensils with hot, soapy water.

When should I call the doctor?

Call your pediatrician if your child suddenly develops a rash, especially combined with a fever, sore throat or swollen glands. This is especially important if your child, a family member or peer recently had strep throat.

Learn more about pediatrics at Rocky Mountain Hospital for Children.