What should you know about chickenpox and scarlet fever?

Chickenpox commonly starts with feeling unwell, fever, and an itchy rash that changes from spots to fluid-filled blisters and then scabs. New spots may appear while older ones are healing. Scarlet fever is linked to group A streptococcal infection and often begins with a sore throat, fever, tender neck glands, and a fine rash that can feel like sandpaper. The rash may be more noticeable in skin folds. A rash alone cannot confirm which illness is present, and some children have mild or less typical symptoms.

A person with scarlet fever may need antibiotic treatment after clinical assessment. Antibiotics do not treat chickenpox because it is caused by a virus. Avoid giving aspirin to a child with suspected chickenpox, and check with a clinician before using medicines for fever or itching.

Offer frequent fluids, rest, and light clothing. Keep fingernails short and discourage scratching, which can damage the skin and allow infection. A pharmacist or clinician can advise on suitable itch relief. Keep a child with a spreading blistering rash away from pregnant people, newborn babies, and anyone with a weakened immune system until a clinician explains when contact is safe. Do not share towels, cups, or bedding, and wash hands regularly.

For suspected scarlet fever, arrange a medical assessment, especially when fever and sore throat occur together. Complete any prescribed antibiotic course as directed. Do not return to school or childcare until the clinician or local guidance says it is appropriate.

Seek urgent help if the person has trouble breathing, is unusually drowsy, cannot keep fluids down, shows signs of dehydration, develops a rapidly worsening skin infection, or has a severe headache with a stiff neck. Contact a clinician promptly for a baby with fever, a very unwell child, a rash involving the eyes, or fever that is worsening rather than settling. Medical advice is also sensible when the diagnosis is uncertain, because chickenpox and scarlet fever require different management.

Ask whether the rash pattern and throat symptoms fit chickenpox, scarlet fever, or another illness; whether testing is needed; how to manage itching or fever safely; when the person can return to school or work; and which household contacts need particular protection.