What should you know about scarlet fever causes and symptoms?

Group A streptococcal bacteria commonly affect the throat and may produce substances that cause the skin to become red and rough. The rash can start on the chest or abdomen, spread, and look more noticeable in skin creases. A red or coated tongue, flushed face, headache, nausea, and peeling skin later in the illness may also occur.

Symptoms do not appear in exactly the same combination for everyone. [Fever](/symptoms/fever/) and [Sore Throat](/symptoms/sore-throat/) are useful details to report, and tender [Swollen Glands](/symptoms/swollen-glands/) may support the clinical picture. A rash is not enough to establish the cause, so examination and any recommended testing are relevant.

Seek medical advice for a new rough rash with throat symptoms, especially when the person is unwell or has had close contact with a throat infection. Note the first symptoms, temperature readings, rash location, and medicines already used. Encourage fluids, rest, and handwashing. Do not share drinks, cutlery, towels, or toothbrushes. Use prescribed [Antibiotic Treatment](/treatments/medical-management/antibiotic-treatment/) exactly as instructed.

Urgent assessment is needed for breathing or swallowing problems, inability to drink, signs of dehydration, confusion, severe weakness, rapidly increasing neck swelling, or a sudden decline. Contact a clinician promptly if the rash is spreading quickly, throat pain is intense, or symptoms are not settling as expected.

Which features suggest scarlet fever rather than another rash? Is a throat swab or other test appropriate? What treatment is needed, and how should close contacts be managed?