If a child runs a fever with a sore throat and a day or two later a rough, sandpaper-like rash spreads from the chest and tummy, it may be scarlet fever. The NHS says it is very contagious, mainly affects children but adults can get it. First come a high temperature, sore throat and swollen neck glands; the rash appears 12 to 48 hours later; the tongue gets a white coating that peels, leaving it red like a strawberry. A GP prescribes antibiotics, and you stay off nursery, school or work until 24 hours after the first dose. Untreated, it’s infectious for 2 to 3 weeks after symptoms start.
1. Fever, sore throat, swollen neck glands → sandpaper rash 12 to 48 hours later, strawberry tongue — usually about a week.
2. Stay off nursery, school or work until 24 hours after the 1st antibiotic dose — untreated, infectious for 2 to 3 weeks.
3. Finish the antibiotics; no aspirin under 16 — first dose 9:00 on 21 October: back from 9:00 on the 22nd.
Calculator
Updates as you type. The NHS: with antibiotics, infectious until 24 hours after the 1st dose; untreated, for 2 to 3 weeks after symptoms start. Dates are our sums.
Symptoms — NHS
| Type | What the NHS says | Worth noting (ours) |
|---|---|---|
| First | Flu-like — high temperature, sore throat, swollen neck glands (a large lump at the side of the neck) | — |
| Rash | 12 to 48 hours later; rough like sandpaper, starting on the chest and tummy and spreading; pink or red on white skin, harder to see on brown and black skin but the bumps can be felt | — |
| Tongue | A white coating that peels to a red, swollen strawberry tongue | — |
| Face | No rash on the face, but cheeks can look red | — |
| Later | Skin may peel like sunburn as the rash fades | — |
Treatment and spread — NHS
| Type | What the NHS says | Worth noting (ours) |
|---|---|---|
| Diagnosis | Often by looking at the tongue and rash; a throat swab or blood test may be done | — |
| Antibiotics | Speed recovery and cut the risk of serious illness such as pneumonia and of passing it on; finish them even if you feel better | Course length not given |
| Infectious | With antibiotics, until 24 hours after the 1st dose; untreated, 2 to 3 weeks after symptoms start | — |
| At home | Cool fluids, soft food if the throat hurts, paracetamol for fever (no aspirin under 16), calamine lotion or antihistamine tablets for itching | — |
| Stopping spread | Wash hands often, use tissues; don’t share cutlery, cups, towels, clothes, bedding or baths | — |
When to see a GP — NHS
| If | Where | Worth noting (ours) |
|---|---|---|
| Symptoms of scarlet fever | See a GP (non-urgent) | They may suggest a phone consultation first |
| Not better within a week after seeing a GP | See a GP | — |
| Scarlet fever and chickenpox at the same time | See a GP | — |
| Ill again weeks after recovering | See a GP — possibly a complication such as rheumatic fever | — |
| Unwell after contact with someone who has it | See a GP | — |
Complications are rare but include ear infection, throat abscess, sinusitis, pneumonia, meningitis and rheumatic fever, the NHS says. There’s no evidence scarlet fever in pregnancy harms the baby, but it can make you unwell, so avoid close contact and contact a GP if you have symptoms; many antibiotics used for it can be taken in pregnancy.
For example, a first dose at 9:00 on 21 October means back from 9:00 on the 22nd (our sum). Symptoms from 20 October left untreated could be passed on until roughly 3 to 10 November.
This page gives no 999 or urgent criteria. Other sore throats are in sore throat and tonsillitis; chickenpox in chickenpox.
Checklist
- ☐ Sandpaper rash or strawberry tongue: see a GP
- ☐ Note the time of the 1st dose — back 24 hours later
- ☐ Finish the antibiotics
- ☐ No aspirin under 16
- ☐ Separate cutlery, cups and towels
Questions that remain
Are Korean nursery rules the same?
This post follows the NHS. Check the nursery, school or health authority for local exclusion rules.
Do adults get it?
The NHS says symptoms are the same in children and adults, though it’s less common in adults.
Sources
- NHS — Scarlet fever — source (page shows: reviewed 23 December 2024, next review 23 December 2027; checked 21 October 2026). Symptom sequence (rash at 12 to 48 hours, strawberry tongue, peeling), diagnosis, antibiotics, infectious periods (24 hours; 2 to 3 weeks), home care, five GP criteria, complications, pregnancy, preventing spread.
- Not read. Korean exclusion rules.
- What we added. The “worth noting” column and the Korean care gloss.
Where to check further
- A paediatrician — diagnosis and antibiotics.
- The nursery or school — return rules.
Written on 21 October 2026. The content is from the NHS; the glosses are ours.
