Scarlet fever - Symptoms of scarlet fever

Symptoms of scarlet fever generally take two to five days to appear after infection.

The illness often starts with a sore throat, headache and a high temperature (fever), with a rash developing 12 to 48 hours later.

Rash

Red blotches are the first sign of the rash. These turn into a fine pink-red rash that feels like sandpaper to touch and looks like sunburn.

The rash usually starts in one place, but soon spreads to other parts of the body. It commonly affects the ears, neck, chest, elbows, inner thighs and groin, and may be itchy.

It does not normally spread to the face. However, the cheeks become flushed and the area just around the mouth stays quite pale. The rash will turn white if you press a glass on it.

The rash usually fades after about a week, but the outer layers of skin, usually on the hands and feet, may peel for several weeks afterwards.

In milder cases, sometimes called scarlatina, the rash may be the only symptom.

Other symptoms

Other symptoms may include:

swollen neck glands
loss of appetite
nausea or vomiting
red lines in the folds of the body, such as the armpit, which may last a couple of days after the rash has gone
a white coating on the tongue, which peels a few days later leaving the tongue red and swollen (this is known as strawberry tongue)
a general feeling of being unwell

When to seek medical advice

See your GP as soon as possible if you suspect you or your child has scarlet fever.