Scarlett Fever Pediatric Care Plan

By David Shafran, MD
Medically reviewed
December 14, 2020

What is Scarlett Fever?

Scarlett fever is strep throat with a bumpy, ‘sandpapery’ rash. It is caused by the same bacteria that causes strep pharyngitis and is therefore diagnosed and treated in exactly the same way.

The rash usually starts in the armpit and the groin and then spreads to the rest of the body. It tends to show up most in skin folds such as the elbow creases and the groin. Your child might also have pale skin around the mouth and a ‘strawberry tongue.’

The diagnosis can only be made after your child’s throat has been swabbed to ensure antibiotics are not administered unnecessarily. Sometimes, the rash of Scarlett Fever can be itchy but it will go away on its own with the help of antibiotic treatment.

How to Treat Scarlett Fever

Just like strep throat, scarlett fever is treated with antibiotics for 7 to 10 days. The rash usually gets better on its own. If it’s not itchy, then you don’t need to put anything on the rash. 

If the rash is itchy:

  • You can apply an unscented moisturizing cream like Aveno or Eucerin. It’s best to do this after a warm bath while the skin is tsill damp.
  • You can apply an over-the-counter 1% hydrocortisone cream up to 3 times per day to the itchy areas.

Note: It is normal for your child’s skin to peel as the rash is getting better especially on the palms of the hand and the soles of the feet. 

Additional supportive care for fever and a sore throat include:

  • Tylenol or ibuprofen
  • Sucking candies
  • Cool or cold foods such as ice cream or popsicles
  • Salt water gargles

When can my child return to school?

  • Once they no longer have a fever even if the rash is still present
  • The rash is not spreading or is starting to go away
  • The rash didn’t come from measles or chickenpox. In this case you must get clearance from your child’s primary care provider

Check in with K if…

  • You have general questions about your child’s condition
  • You want general followup for your child
  • You have questions about supportive care
  • Your child’s symptoms don’t go away after treatment but are not alarming

See a doctor in person if…

  • Your child’s pain becomes severe
  • Symptoms last for more than 5 to 7 days
  • Your child has difficulty swallowing or is drooling excessively
  • You think your child needs to be seen
  • Your child isn’t drinking enough to stay hydrated
  • Your child has blood in their urine
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.