Scarlet Fever: Symptoms, Rash, and First Aid Awareness
Scarlet fever is a bacterial illness caused by a throat infection with group A streptococcus. While there are several strains of streptococcal bacteria, this specific strain is responsible for most cases of scarlet fever.
The illness occurs when the bacteria release toxins that enter the bloodstream, triggering a distinctive skin rash. Scarlet fever is most common in children under the age of 10, with peak incidence around 4–8 years old.
Signs and Symptoms of Scarlet Fever
The illness usually begins with symptoms of a strep throat infection, followed by the characteristic rash.
Early Symptoms
- Sore throat
- Fever
- Headache
- Loss of appetite
- Vomiting or nausea
- General feeling of being unwell
Scarlet Fever Rash
- A bright red rash made up of tiny red spots
- Begins on the neck and upper chest, then spreads to the rest of the body
- Feels rough or sandpaper-like to the touch
- Turns pale (blanches) when pressed
- The face may appear flushed, while the area around the mouth, eyes, and nose remains pale
Tongue Changes
- Initially appears pale with red bumps (“white strawberry tongue”)
- Becomes bright red after a few days (“red strawberry tongue”)
The fever and sore throat usually improve within a few days. The rash typically lasts about 5–6 days, after which skin peeling may occur, especially on the hands and feet. Not all children develop a rash, as sensitivity to the toxins varies.
Treatment and Management
Antibiotics
Treatment with antibiotics is essential to:
- Speed recovery
- Reduce contagiousness
- Prevent complications such as rheumatic fever
A 10-day course of antibiotics is commonly prescribed. Even if symptoms improve quickly, the full course must be completed.
Managing Fever and Discomfort
- Paracetamol (acetaminophen) may be used to reduce fever and pain
- Avoid overheating; dress the child comfortably
- Encourage fluids to prevent dehydration
Children with scarlet fever should stay home from school or daycare until advised by a healthcare provider.
When to Seek Medical Care
A doctor should be consulted if a child has:
- A sore throat with fever and rash
- Difficulty swallowing
- Worsening symptoms despite treatment
- Signs of dehydration or unusual drowsiness
Early treatment significantly reduces the risk of complications.
First Aid & Medical Disclaimer
This information is provided for educational and first aid awareness purposes only and is not a substitute for professional medical diagnosis or treatment. Scarlet fever requires medical assessment and prescription antibiotics.
St. Mark James Training, Canada’s largest 100% Canadian-owned and operated first aid and CPR training provider, teaches participants how to recognize serious infections, manage fever safely, and understand when medical care is required.