Pharyngitis - Treating a sore throat

Sore throats are not usually serious and often pass in three to seven days. There are some treatments you can use at home to relieve your symptoms.

When to see your GP

You should see your GP if you:

fall into one of the groups of people at risk of developing complications – this includes anyone with a weakened immune system due to medication, or a condition such as HIV
have persistent symptoms that are not improving or responding to self-care

Visit your nearest accident and emergency department (A&E) or call 999 for an ambulance if you have severe symptoms such as:

difficulty breathing or swallowing
severe pain
drooling
a muffled voice
a high-pitched sound as you breathe (stridor)

Painkillers

For treating sore throats, over-the-counter painkillers, such as paracetamol, are usually recommended. These may also help reduce a high temperature (fever).

You should not take aspirin or ibuprofen if you have:

asthma
current or past stomach problems, such as a stomach ulcer
current or past liver or kidney problems

Children under the age of 16 should never be given aspirin.

Take painkillers as necessary to relieve your pain. Always read the manufacturer’s instructions so you do not exceed the recommended or prescribed dose.

Self-care tips

If you or someone in your family has a sore throat, the tips below may help relieve the symptoms:

avoid food or drink that is too hot, as this could irritate the throat
eat cool, soft food and drink cool or warm liquids
adults and older children can suck lozenges, hard sweets, ice cubes or ice lollies
avoid smoking and smoky environments
regularly gargling with a mouthwash of warm, salty water may help reduce swelling or pain
drink enough fluids, especially if you have a fever

Steam inhalation is not recommended, as it's unlikely to help a sore throat and there is a risk of scalding.

Antibiotics

The use of antibiotics is not usually recommended for treating sore throats. This is because most sore throats are not caused by bacteria.

Even if your sore throat is caused by bacteria, antibiotics have very little effect on the severity of the symptoms and how long they last, and may cause unpleasant side effects.

Overusing antibiotics to treat minor ailments can also make them less effective in the treatment of life-threatening conditions. This is known as antibiotic resistance.

Antibiotics are usually only prescribed if:

your sore throat is particularly severe
you are at increased risk of a severe infection – for example, because you have a weakened immune system due to HIV or diabetes (a long-term condition caused by too much glucose in the blood)
you are at risk of having a weakened immune system – there are some medications that can cause this, such as carbimazole (to treat an overactive thyroid gland)
you have a history of rheumatic fever (a condition that can cause widespread inflammation throughout the body)
you have valvular heart disease (a disease affecting the valves in your heart, which control blood flow)
you experience repeated infections caused by the group A streptococcus bacteria

Delayed antibiotics prescription

If your GP thinks you might need antibiotics, they may issue a prescription but ask you to wait up to three days for symptoms to improve.

If your sore throat gets worse, or has not improved after three days, you should have instructions to either:

take your prescription slip to a pharmacy
return to the GP surgery after three days to collect your medication

Recent studies show that complications of a sore throat are uncommon and usually not serious. A delayed antibiotic prescription seems to be as effective as an immediate prescription in reducing complications.

Using a delayed prescription provides similar benefits to an immediate prescription. Most importantly, this helps you to avoid taking antibiotics when they're not needed and helps prevent antibiotic resistance.

Tonsillectomy

A tonsillectomy is a surgical procedure to remove the tonsils (the two lumps of tissue on either side of your throat). If your child has repeated infections of the tonsils (tonsillitis), a tonsillectomy may be considered.

Persistent sore throat

If you have a persistent sore throat (one that lasts three to four weeks), your GP may refer you for further tests. This is because your sore throat may be a symptom of a more serious condition. Some possibilities are described below.

Glandular fever

If you are 15-25 years of age with a persistent sore throat, you may have glandular fever (also known as infectious mononucleosis, or mono). This is a type of viral infection with symptoms that can last up to six weeks.

Cancer

A persistent sore throat can also be a symptom of some types of cancer, such as throat cancer. This type of cancer is rare and mainly affects people over the age of 50. In the UK every year, 5,300 people are diagnosed with cancer of the oropharynx (the area at the back of your throat) or mouth.

Non-infectious causes

In some cases, a sore throat may be caused by substances that irritate the throat. Sources can include:

alcohol
cigarette smoke
an allergy – such as hay fever
gastro-oesophageal reflux disease (GORD) – when stomach acid leaks out of the stomach and into the gullet

You may find that avoiding these substances, or seeking treatment for an allergy or COPD, can help to reduce symptoms of a sore throat.

Giving up smoking

If you smoke, giving up will reduce irritation to your throat and strengthen your defences against infection.

The NHS Smoking Helpline can offer you advice and encouragement to help you quit smoking. You can call the helpline free of charge on 0300 123 1044 (England only) or visit the NHS Smokefree website.

Your GP or pharmacist will also be able to give you help and advice about giving up smoking, or you can read more about quitting smoking.

Preventing a sore throat

As sore throats are caused by bacterial or viral infections, they can be difficult to prevent.

If you have a sore throat caused by an infection, you can help prevent the infection spreading by practising good hygiene, such as washing your hands regularly and keeping surfaces clean and free of germs.

Read more about how to prevent germs from spreading.

Bacteria
Bacteria are tiny, single-celled organisms that live in the body. Some can cause illness and disease and others are good for you.

Immune system
The immune system is the body's defence system, which helps protect it from disease, bacteria and viruses.

Inflammation
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.

Tonsils
Two small glands found at the back of your throat, behind the tongue.