How Scarlet Fever Is Treated

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Treating scarlet fever involves killing the bacteria that's causing it and doing what you can to ease symptoms as the infection resolves. Antibiotics, such as penicillin and amoxicillin, are essential. But warm salt gargles, oatmeal baths, and other home remedies can be beneficial additions to your treatment plan, too, working to soothe a sore throat and itchy skin. Over-the-counter (OTC) options like throat sprays and pain relievers may also help you deal with discomfort.

While you're treating yourself or a loved one, though, remember that an important part of dealing with scarlet fever is preventing it from spreading, as it is highly contagious.

This article discusses how scarlet fever is treated, including prescription medications, OTC options, and home remedies for symptom relief.

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Prescriptions

Scarlet fever must be treated with an antibiotic in order to kill the group A streptococcus bacteria responsible for the infection.

According to the Centers for Disease Control and Prevention (CDC), the drugs of choice for treating scarlet fever are broad-spectrum antibiotics (medications that work against a wide range of bacteria), such as penicillin and amoxicillin

For someone who's allergic to penicillin, narrow-spectrum cephalosporins are typically safe options. Some examples of these medications include:

  • Cephalexin
  • Cefadroxil
  • Cleocin (clindamycin)
  • Zithromax (azithromycin)
  • Biaxin XL (clarithromycin)

After two to three days of antibiotic treatment, most of the symptoms of scarlet fever are likely to resolve, although the rash may linger for some time. If non-rash symptoms don't go away, it may be a good idea to let your healthcare provider know.

In any case, it's important to complete the entire course of antibiotics for scarlet fever, like any other illness for which you are prescribed these drugs. It's common to feel better rather quickly after starting them, but that doesn't mean that the bacteria that made you sick is gone.

Stopping a course of antibiotics early can increase the risk of further complications from any bacterial infection. In the case of scarlet fever (and other illnesses caused by group A strep), these can range from secondary infections of structures near the throat, such as the tonsils or ears, to pneumonia.

Although uncommon, two potentially serious conditions have been associated with scarlet fever: One is rheumatic fever, an inflammatory disease that can cause permanent heart damage. The other, post-streptococcal glomerulonephritis (PSGN), also is an inflammatory illness, which affects the kidneys.

Home Remedies and Lifestyle

Relieving the symptoms of scarlet fever is key to helping someone feel more comfortable during their illness. Tending to discomfort— a nasty sore throat, headache, and itchy rash—may even help to speed recovery by making it easier for a patient to get enough sleep and rest.

Sore Throat Relief

You can experiment with these options to find the ones that bring the most relief:

  • Frozen foods: Ice cream, popsicles, slushies, or smoothies made with frozen fruit, for instance, can temporarily numb a sore throat. Sucking on ice chips can help as well.
  • Warm liquids: Choices such as chicken soup or tea with honey can be soothing. The operative word here is "warm." Swallowing a liquid that's too hot could make throat pain worse, not better. 
  • Throat lozenges or hard candy: Note that these are only safe options for older kids and adults. Although scarlet fever rarely affects very young children, these items are potential choking hazards for those younger than 4.
  • Warm salt water: Try gargling a mixture of 1/4 teaspoon of salt in water and then spit it out.
  • Cool-mist humidifier: This will help keep the air moist, especially during sleeping hours. Sitting for a few minutes in a steamy bathroom may help as well.
  • Avoidance: Irritants like cigarette smoke and the fumes from cleaning products can exacerbate throat pain.

Soothing Itchy Skin

Soaking in a warm oatmeal bath can help ease itchy, irritated skin. You can purchase pre-packaged oatmeal bath products or make your own: Churn regular oatmeal in a food processor until it's powdery and add 1/2 cup to bathwater.

Keep the fingernails of young children short to avoid scratching and clean to avoid damaging skin.

OTC Medications

You can find relief from symptoms like a headache, fever, and throat pain in your medicine cabinet, drugstore, or supermarket.

Non-Steroidal Anti-inflammatory Drugs (NSAIDs) 

OTC medications such as Tylenol (acetaminophen), Advil, and Motrin (ibuprofen) can help bring down a fever as well as relieve body aches and pains. If you're giving an NSAID to a child, make sure to measure out a dose that's appropriate for their age and weight. You'll find guidelines on the package label, but if you aren't sure what's safe, check with your pediatrician. 

Do not give aspirin or any OTC product that contains aspirin to a child under the age of 19. The drug has been linked to a serious disease called Reye's syndrome, which causes swelling of the brain and liver.

Throat-Numbing Products

Adults and children ages 3 to 12 can use sprays containing ingredients that temporarily numb the throat. Children should be supervised when using the product.

Throat-numbing sprays can be especially effective because the spray can be targeted to the exact area that's experiencing pain. One such sore throat spray, Chloraseptic (phenol), comes in a variety of flavors, including cherry, wild berry, citrus, and honey lemon.

To use a sore throat spray, spritz the area once, allow the medicine to sit for at least 15 seconds, and then spit it out. The numbing effect should last for a couple of hours.

Rash Treatments

To help soothe an itchy rash, you can try an OTC anti-itch treatment. Examples include cortisone anti-itch creams or calamine lotion.  

Prevention

As with any contagious illness, prevention involves protecting yourself and those you care for from being infected when people around you have the infection, as well as taking measures to prevent the spread of the illness if you or loved ones become ill.

Frequent Hand Washing Can Help

If you know that scarlet fever is going around, proper and frequent hand washing is essential. Remind your kids to wash often while at school, and make it a house rule that everyone scrubs up as soon as they come home and before they start touching surfaces in the house.

If you or someone in your household becomes ill with scarlet fever, it's important to know that group A strep bacteria spread easily through the air by hitchhiking on droplets of liquid contained in sneezes and coughs. The best way to keep bacteria out of the air is to cough or sneeze into the crook of an elbow or sleeve. This strategy also will keep the organisms from landing on hands where they can then transfer to frequently handled surfaces like doorknobs and remote controls.

If a tissue is used to catch a cough or sneeze, it should be disposed of right away in the trash.

Never drink from a cup or glass that's been used by someone with scarlet fever, or share eating utensils.

Finally, anyone who's been diagnosed with scarlet fever must be on antibiotics for at least 24 hours before returning to school or daycare. This is to prevent the risk of spreading the illness to others. It's also important to give the body time to rest and recuperate.

Summary

Scarlet fever is treated with antibiotics to kill group A streptococcus bacteria. These antibiotics may include cephalexin, cefadroxil, clindamycin, azithromycin, or clarithromycin.

Home remedies and OTC medications are not a substitute for antibiotics. However, they can help relieve symptoms while you're finishing your prescription medication. Pain relievers such as Tylenol, Advil, or Motrin can help bring down a fever and relieve body aches. You can ease a sore throat with frozen foods, warm liquids, throat lozenges, or OTC throat-numbing sprays. For an itchy rash, try an oatmeal bath or OTC cortisone or calamine lotion.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Group A Streptococcal (GAS) Disease: Scarlet Fever: All You Need to Know.

  2. Centers for Disease Control and Prevention. Group A Streptococcal (GAS) Disease: Scarlet Fever.

  3. American Academy of Pediatrics (healthychildren.org). Choking Prevention.

  4. Stanford Medicine. Reye Syndrome in Children.

  5. Chloraseptic. Cherry spray directions.

  6. Cedars Sinai. Scarlet fever in children.

By Kristina Herndon, RN
Kristina Herndon, BSN, RN, CPN, has been working in healthcare since 2002. She specializes in pediatrics and disease and infection prevention.