Springdale Mason Pediatrics

Scarlet Fever


  • Scarlet Fever is a speckled, red rash all over due to the Strep bacteria

Call or Return If

  • Fever lasts more than 48 hours after starting the antibiotic
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic


  • Reddened, sunburned-looking skin
  • Starts on upper chest and quickly spreads to lower chest and stomach
  • The rash is almost everywhere within 24 hours
  • Looking closely, the redness is speckled with tiny pink dots
  • Rough, sandpaper-like feeling to the reddened skin
  • Increased redness in skin folds (especially the groin, armpits, and elbow creases)
  • Flushed face with paleness around the mouth
  • Sore throat and fever usually occur before the rash by 18 to 24 hours


  • Caused by a toxin produced by strep bacteria
  • A strep throat infection with a rash
  • Can also occur with a strep infection in a wound
  • Can get scarlet fever up to 3 times (reason: 3 different toxins)

Prevention of Spread to Others

  • Good hand washing can prevent the spread.

After Care Advice

  • Scarlet fever is a strep throat infection with a rash.
  • The complication rate is no different than for strep throat alone.
  • Here is some care advice that should help.
Antibiotic by Mouth:
  • Scarlet fever needs a prescription antibiotic to clear it up.
  • This medicine will kill the Strep bacteria causing the rash and sore throat.
  • Give the medicine as directed.
  • Try not to forget any of the doses.
Sore Throat Pain Relief:
  • Age over 1 year. Can sip warm fluids such as chicken broth or apple juice.
  • Age over 6 years. Can also suck on hard candy or lollipops. Butterscotch seems to help.
  • Age over 8 years. Can also gargle. Use warm water with a little table salt added. A liquid antacid can be added instead of salt. Use Mylanta or the store brand. No prescription is needed.
  • Medicated throat sprays or lozenges are generally not helpful.
Soft Diet:
  • Offer a soft diet. Cold drinks and milk shakes may soothe the pain.
Pain Medicine:
  • To help with the throat pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
  • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
  • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
Scarlet Fever Rash Treatment:
  • The rash itself usually needs no special treatment.
  • When the rash peels, it may become a little itchy.
  • If that's the case, apply a moisturizing cream as needed.
Strep Tests for the Family:
  • Scarlet fever and strep throat can spread to others in the family.
  • Household members who develop symptoms in the next 5 days should have a Strep test.
What to Expect:
  • The red rash often lasts 5 to 7 days.
  • When the rash clears, the skin often peels for another week. Peeling is common in the groin.
Return to School:
  • Your child can return after the fever is gone. Your child should also be taking an antibiotic by mouth for 24 hours.
  • The rash cannot spread to others, but the strep throat can.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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