Scarlet fever and the hands

The rash of scarlet fever often begins on the trunk and may spread to the limbs. The skin can feel rough, and the creases of the hands may look more flushed. Peeling on the fingers or palms can appear while the illness is settling; this does not by itself prove that the infection has cleared. Scarlet fever usually occurs with a sore throat and fever, and swollen glands may also occur. Strep Throat explains the related infection.

Keep the hands clean with lukewarm water and a gentle cleanser, then pat them dry. Apply a plain, fragrance-free moisturiser if the skin is dry or tight, unless a clinician advises otherwise. Discourage picking or pulling loose skin because broken areas can become irritated. Keep nails short and avoid sharing towels. Arrange an assessment for a new rash with fever or throat symptoms; treatment decisions may include Antibiotic Treatment.

Get urgent medical help if the child has breathing difficulty, facial swelling, severe weakness, confusion, cannot drink, or passes very little urine. Seek prompt advice if the hands become hot, increasingly painful, swollen, or ooze fluid, or if fever continues or returns. A rash with Fever or a painful throat should be reviewed rather than judged from its appearance alone.

Ask whether the hand rash and peeling fit scarlet fever, how to protect irritated skin, whether an infection test is needed, and how long peeling may continue. Ask when school or nursery attendance is appropriate and what change would require reassessment.