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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Video assessment of your throat, tongue and rash, with antibiotics when it fits scarlet fever.
- Signs: a sore throat and fever, then within 12 to 48 hours a rough, sandpaper-like rash on the chest and tummy, and a strawberry tongue.
- Contagious: until 24 hours after the first dose of antibiotics; without them, for 2 to 3 weeks after symptoms start.
- Adults: scarlet fever mostly affects young children, but adults catch it too, often from a child at home, with the same symptoms.
- Emergency: call 112 for difficulty breathing, confusion, a rash that does not fade under a glass, or severe pain with spreading red skin.
Do not book a video appointment if you have difficulty breathing, feel confused or very drowsy, have a rash that looks like bruising and does not fade when you press a glass against it, or severe pain in one area with red, hot, spreading skin. These can signal sepsis or invasive strep A: call 112. A child with scarlet fever needs a paediatrician or a local doctor in person.
Can an online doctor treat scarlet fever?
Yes. Scarlet fever is diagnosed mainly by looking at the rash, the tongue and the throat, and all three can be seen clearly on camera in good light. The doctor checks the warning signs of a more serious strep A infection first, and if the picture fits scarlet fever, can prescribe an antibiotic. Difficulty breathing, confusion or a rash that does not fade under a glass needs emergency care instead.
How an online consultation helps with scarlet fever
- The rash seen properly: With good light and the camera close to your skin, the doctor can see the fine, raised rash and the strawberry tongue that set scarlet fever apart from other rashes.
- Antibiotics that make a difference: Antibiotics help you recover faster, lower the risk of complications such as pneumonia, and stop you being contagious after 24 hours.
- Serious strep A ruled out: Severe pain in one area, spreading red skin and feeling very unwell are checked first, because they point to an invasive infection that needs hospital care.
- Clear advice for your household: You leave knowing when you can go back to work and how to protect children, pregnant women and older relatives at home.
What the doctor checks in an online scarlet fever consultation
The consultation follows a fixed order, and the emergency signs come first. The doctor asks about:
- Emergency signs: difficulty breathing, confusion, a rash that does not fade under a glass, or severe pain with red, hot, spreading skin.
- The rash and tongue: where the rash started, how it feels, whether your tongue is red and bumpy, and whether your cheeks are flushed.
- The throat: how sore it is, swollen tonsils, painful neck glands, and any one-sided swelling that could mean an abscess.
- Contacts: children at home or at work with scarlet fever or a sore throat, and anyone at home who is pregnant, older or has chickenpox.
- Your medicines and allergies: especially any penicillin allergy, and whether you are pregnant.
Before the call, find bright light, such as a window or your phone torch, and be ready to show your chest, tummy and tongue on camera. Take your temperature if you have a thermometer.
Scarlet fever symptoms in adults
Scarlet fever is an infection caused by group A streptococcus (Strep A), the same bacteria that cause strep throat. The rash is a reaction to toxins the bacteria produce. Symptoms usually start 2 to 5 days after catching it:
- flu-like symptoms first: a temperature of 38°C or more, a sore throat, a headache and swollen neck glands, sometimes with nausea or vomiting
- 12 to 48 hours later, a rash of small raised bumps that feels rough, like sandpaper, starting on the chest and tummy and spreading
- on white skin the rash looks pink or red; on brown and black skin the colour is harder to see, but the rough texture can still be felt
- a white coating on the tongue that peels to leave it red, swollen and bumpy, called strawberry tongue
- flushed cheeks, while the rash itself spares the face
- peeling skin on the fingertips, toes and groin as the rash fades
Scarlet fever mostly affects children, with about 9 in 10 cases in children under 10 and the highest rates between the ages of 2 and 8. Adults catch it too, often from a child at home or at work, though it is much less common. The symptoms are the same in adults, and cases have risen in recent years.
Can you have scarlet fever without a rash?
No. The rash is what makes it scarlet fever. A strep A throat infection with the same sore throat and fever but no rash is strep throat, which also needs assessment and, when the signs fit, antibiotics.
Is it scarlet fever or another rash?
Several illnesses cause a rash with a fever. The texture of the rash and the throat give scarlet fever away.
Swipe sideways to compare →
| Rash | What it looks and feels like | Other clues |
|---|---|---|
| Scarlet fever | Fine, raised and rough like sandpaper; starts on the chest and tummy; not on the face | Sore throat, strawberry tongue, flushed cheeks |
| Measles | Blotchy red or brown patches that join up; starts on the face and behind the ears | A cold-like start, red watery eyes, white spots inside the cheeks |
| Hives (an allergic rash) | Raised, itchy welts that come and go | Usually no fever or sore throat |
| A viral rash | Fine pink spots or blotches, usually smooth | Cold symptoms; fades within a few days |
| Meningitis or sepsis | Spots or blotches like bruising that do not fade under a glass | Very unwell, stiff neck, confusion: call 112 |
To do the glass test, press the side of a clear glass firmly against the rash. A scarlet fever rash fades under pressure. A rash that does not fade is an emergency: call 112. Read more about hives and other skin rashes.
How long does scarlet fever last, and how long is it contagious?
Scarlet fever lasts around a week. With antibiotics, the fever usually settles within 24 hours and you start to feel better within a few days. The rash fades over about a week, and the skin may peel like sunburn afterwards.
You can spread scarlet fever from a few days before symptoms start until 24 hours after your first dose of antibiotics. Without antibiotics, you can stay contagious for 2 to 3 weeks. Stay off work until 24 hours after the first dose. The contagious calculator works out your likely contagious period for strep A infections.
How do you catch scarlet fever, and can you get it twice?
Scarlet fever is highly contagious. It spreads through the saliva and mucus of someone who has it: by close contact, by breathing in the droplets of their coughs and sneezes, and by touching contaminated surfaces or sharing items such as cups and cutlery. People can pass it on before they show symptoms. It is most common in winter and spring.
Can you get scarlet fever twice?
It is possible, but unusual. Having scarlet fever once does not make you fully immune, though most people do not get it again. A sore throat with a sandpaper rash needs assessment each time.
How to stop scarlet fever spreading
There is no vaccine against scarlet fever, so hygiene is what protects the people around you:
- Wash your hands often with soap and water.
- Cough and sneeze into tissues, and put them in the bin straight away.
- Do not share cutlery, cups, towels, clothes, bedding or baths with anyone who has symptoms.
- Open the windows regularly.
Scarlet fever in Europe
Cases rose sharply in late 2022. Several European countries, including France, Ireland, the Netherlands, Sweden and the UK, reported more scarlet fever and invasive strep A infections, mostly in children under 10. In England, 4,622 cases of scarlet fever were notified between mid-September and mid-November 2022, more than three times the average of 1,294 for the same weeks of the previous five years. The World Health Organization linked the rise to an early start to the strep A season and more respiratory viruses after a period of low circulation during the COVID-19 pandemic.
Is scarlet fever serious? Complications to know
Usually not. With antibiotics, scarlet fever is usually a mild illness, and most cases have no complications at all. Complications are rare, and can happen during the illness or in the weeks after it:
- ear infections, sinusitis and an abscess next to the tonsil (quinsy)
- pneumonia
- cellulitis, a spreading skin infection
- rarely, invasive strep A infection, sepsis or meningitis
- rarely, weeks later, rheumatic fever, which affects the joints and heart, or inflammation of the kidneys
Invasive strep A is rare but serious. The warning signs are a high fever with severe muscle aches, pain in one area that is far worse than it looks, increasing pain, redness and swelling around a wound, unexplained vomiting or diarrhoea, and feeling very unwell or confused. These need emergency care. If you become unwell again in the weeks after scarlet fever, with painful joints or dark urine, see a doctor.
Which scarlet fever treatment might the doctor recommend?
Scarlet fever is treated with antibiotics, and the choice depends on allergies and pregnancy. This is the decision framework the doctors use, aligned with UK Health Security Agency and HSE guidance.
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Sore throat, fever and a sandpaper rash | A penicillin antibiotic, usually for 10 days | Usually yes, with the rash shown on camera | If you are very unwell or cannot swallow fluids |
| Scarlet fever with a penicillin allergy | Another antibiotic, such as azithromycin or clarithromycin | Usually yes | If you get worse on treatment |
| Pregnant, with scarlet fever symptoms | An antibiotic that is safe in pregnancy | Usually yes | If you are very unwell |
| Unwell after contact with scarlet fever, no rash yet | A look at your throat; antibiotics if strep A is likely | Usually yes | If a rash, a high fever or breathing problems develop |
| No better after 2 to 3 days of antibiotics | A review for complications such as an abscess or ear infection | For the first review | If one side of the throat is swollen or you are getting worse |
| Severe pain, spreading red skin, confusion or a non-fading rash | Emergency care | No | Call 112 now |
Not sure whether your rash is scarlet fever? A doctor can tell you in one consultation.
See available times →Treatment options for scarlet fever
What you can do yourself
- Drink plenty of cool fluids, and eat soft foods if swallowing hurts.
- Take paracetamol or ibuprofen for fever and pain, at the dose on the pack. Ibuprofen does not suit everyone, including people with a stomach ulcer, kidney problems or heart failure, or anyone who is pregnant.
- For itching, calamine lotion or an antihistamine tablet from a pharmacy can help.
- Stay off work until 24 hours after your first dose of antibiotics.
Prescription treatment
A prescription is never issued without a consultation. If the picture fits scarlet fever, the doctor may prescribe a penicillin antibiotic, usually for 10 days, or another antibiotic such as azithromycin or clarithromycin if you are allergic to penicillin. Take the whole course, even when you feel better, to lower the risk of complications. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Antibiotics do not help a viral rash or a viral sore throat, which is why the doctor checks the signs first. Stopping antibiotics early because you feel better makes it more likely that the infection comes back.
Special situations
Scarlet fever in pregnancy
There is no evidence that scarlet fever harms an unborn baby, but it can make you unwell. Many antibiotics used for it are safe in pregnancy, and erythromycin is an option if you are allergic to penicillin. If you are pregnant and have symptoms, or have been in close contact with someone who has scarlet fever, speak to a doctor.
When a child at home has scarlet fever
Adults often catch scarlet fever from a child. Wash your hands after caring for them, keep their cups, cutlery and towels separate, and watch for a sore throat or fever in yourself. Household contacts have a higher risk of strep A infections, particularly in the 2 to 3 weeks after the scarlet fever was diagnosed, so get medical advice promptly if you feel unwell in that time, and mention the contact. The child should stay off nursery or school until 24 hours after starting antibiotics.
Scarlet fever and chickenpox at the same time
Having scarlet fever and chickenpox together, in you or someone at home, raises the risk of a serious strep A infection. Speak to a doctor promptly.
Scarlet fever while travelling
Antibiotics for scarlet fever are widely available in European pharmacies, though the brand names differ. Avoid travelling until 24 hours after your first dose, so you do not pass the infection on.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When scarlet fever is treated online, and when you need in-person care
Treated online: scarlet fever in adults, sore throats with a rash, advice after contact with a case, antibiotics when the signs fit, and advice on work and protecting your household.
In-person care: signs of invasive strep A or sepsis, a rash that does not fade under a glass, a suspected throat abscess, difficulty breathing or swallowing fluids, and any child with scarlet fever.
When to get in-person care
Call 112 or go to an emergency department now for:
- difficulty breathing
- a rash that looks like bruising and does not fade when you press a glass against it
- confusion, drowsiness or being hard to wake
- severe pain in one area with red, hot, swollen or spreading skin
- a high fever with severe muscle aches and feeling very unwell
Get medical advice the same day for:
- no improvement after 2 to 3 days of antibiotics
- scarlet fever and chickenpox at the same time
- feeling unwell again in the weeks after recovering, with painful joints or dark urine
- being unable to keep fluids down, or passing very little urine
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your symptoms: show your rash, tongue and throat on camera in good light, and mention any penicillin allergy.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s scarlet fever? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Strep throat can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about scarlet fever
What is scarlet fever?
Scarlet fever is a contagious infection caused by group A streptococcus (Strep A), the bacteria behind strep throat. It causes a sore throat, a fever and a rough, sandpaper-like rash, which is a reaction to toxins the bacteria produce. It mostly affects young children, and it is easily treated with antibiotics.
What are the first signs of scarlet fever in adults?
Scarlet fever usually starts like flu, with a high temperature, a sore throat, a headache and swollen neck glands. A rough, sandpaper-like rash follows 12 to 48 hours later, starting on the chest and tummy, and the tongue often becomes red and bumpy.
What does a scarlet fever rash look like?
The scarlet fever rash is made of tiny raised bumps that feel rough, like sandpaper. It starts on the chest and tummy and spreads, but not to the face, where the cheeks look flushed instead. It looks pink or red on white skin and is harder to see on brown and black skin, though the texture can still be felt.
Can adults get scarlet fever?
Yes. Scarlet fever mostly affects children under 10, but adults can catch it too, often from a child at home or at work. The symptoms in adults are the same, and it is treated with antibiotics.
What causes scarlet fever, and how do you catch it?
Scarlet fever is caused by group A streptococcus bacteria, which release a toxin that produces the rash; the same bacteria cause strep throat and impetigo. They spread in droplets from coughs and sneezes, through close contact and kissing, and on shared cups, cutlery and towels, so it passes easily within families and nurseries, and symptoms start 2 to 5 days after contact. Adults most often catch scarlet fever from a child at home.
How can I avoid catching or spreading scarlet fever?
There is no vaccine, so scarlet fever is prevented by stopping the bacteria spreading: wash hands often, do not share cups, cutlery, towels or bedding with someone who has it, cough and sneeze into tissues and bin them, clean surfaces, and keep anyone infected home until 24 hours of antibiotics are done. If you are pregnant or have a weakened immune system and develop a sore throat after contact, get medical advice the same day, because early antibiotics prevent complications.
Is scarlet fever contagious, and for how long?
Yes, scarlet fever is highly contagious. It spreads through close contact, coughs, sneezes and shared items, from a few days before symptoms start until 24 hours after your first dose of antibiotics. Without antibiotics, it can spread for 2 to 3 weeks. Stay off work until 24 hours after starting antibiotics.
How long does scarlet fever last?
Scarlet fever lasts around a week. With antibiotics, the fever usually settles within 24 hours and you feel better within a few days. The skin may peel like sunburn as the rash fades.
Is scarlet fever dangerous?
Usually not. With antibiotics scarlet fever is usually a mild illness, and most cases have no complications. Rarely, it leads to ear or sinus infections, a throat abscess, pneumonia or, very rarely, an invasive strep A infection, so a rash that does not fade under a glass, difficulty breathing or confusion need emergency care.
Can you get scarlet fever twice?
It is possible, but unusual. Having had scarlet fever does not make you fully immune, though most people do not get it again. Each new sore throat with a sandpaper rash needs to be checked.
How is scarlet fever treated?
Scarlet fever is treated with antibiotics, usually a penicillin for 10 days, or another antibiotic if you are allergic to penicillin. Antibiotics speed up recovery, lower the risk of complications and stop you being contagious after 24 hours. Paracetamol or ibuprofen ease the fever and pain.
What can I do at home for scarlet fever?
Take the full course of antibiotics, rest, drink plenty of fluids, take paracetamol or ibuprofen for the sore throat and fever, eat soft cool food, use a cool compress or calamine lotion on the itchy rash, keep nails short so scratching does not break the skin, and stay home until 24 hours after the first antibiotic dose. Scarlet fever in an adult should start improving within 2 days of antibiotics; if not, or if the fever returns, see a doctor.
Is scarlet fever the same as strep throat?
Both are caused by group A streptococcus. Scarlet fever is a strep A infection with a rash, caused by a toxin some strains release. Strep throat affects the throat without the rash. Both are treated with antibiotics.
Can an online doctor treat scarlet fever?
Yes, in adults. A doctor can see the rash, tongue and throat on camera in good light and, if they fit scarlet fever, prescribe an antibiotic. You can use the prescription at a pharmacy near you. Children need a paediatrician or local doctor in person.
When is scarlet fever an emergency?
Call 112 or go to an emergency department for difficulty breathing, a rash that looks like bruising and does not fade under a glass, confusion or drowsiness, severe pain in one area with spreading red skin, or a high fever with severe muscle aches.
- Scarlet fever, NHS, National Health Service (UK), 2024.
- Scarlet fever, HSE, Health Service Executive (Ireland), 2025.
- Scarlet fever: symptoms, diagnosis and treatment (factsheet), UK Health Security Agency, updated 29 March 2019.
- Strep A, NHS, National Health Service (UK), 2026.
- Group A Streptococcus: guidance and data, UK Health Security Agency, updated 21 November 2025.
- Meningitis, NHS, National Health Service (UK), 2026.
- What are the symptoms of scarlet fever and is it contagious?, UK Health Security Agency blog, 21 September 2026.
- Scarlet fever, InformedHealth.org, Institute for Quality and Efficiency in Health Care (IQWiG, Germany), updated 21 September 2023.
- Increased incidence of scarlet fever and invasive Group A Streptococcus infection: multi-country, WHO, World Health Organization, Disease Outbreak News, 15 December 2022.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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