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Strep Throat with a Rash

Strep throat rash is a symptom of scarlet fever, which is almost always accompanied by a sore throat. This condition is more common in children. Elucidated in this article, are its causes and symptoms, along with a few treatment options.
Chandramita Bora
Last Updated: May 11, 2018
Strep throat rash is nothing but a symptom of scarlet fever, which many a time comes along with a rash and a strep or sore throat. Both strep throat and scarlet fever are caused by the Streptococcus bacteria. The disease got its name for the striking scarlet-colored skin rash that develops on the entire body, along with a strep throat. The characteristic skin rash of scarlet fever develops when the infectious bacteria release toxins into the blood. These toxins can produce allergic reactions in the body, which can manifest into skin rash, first in the neck, then the face, and then on the chest and back. Gradually, the rash spreads to the entire body, and disappears in about five days. Scarlet fever or scarlatina, has been found more commonly to affect children in the age group of 5 to 15 years. However, it should also be kept in mind that not all the cases of strep throat lead to scarlet fever.
Causes of Strep Throat and Rash
As has been mentioned already, strep throat and rash accompanying it are caused by Streptococcus bacteria or group A streptococcus (GAS), mainly Streptococcus pyogenes bacteria. Although, scarlet fever develops only when a particular strain of this bacteria release toxins in the body. It can take about two to four days to develop scarlatina from the time of exposure to the bacteria. In rare cases, it can also develop due to a skin infection caused by the strep bacteria. The bacteria can enter the body through any cut, scrape or burn injury, and then cause skin rash. However, such a rash is not accompanied by the typical symptoms of strep throat along with a rash.

Is This Rash Contagious?

Yes, rash with a strep throat is highly contagious. As the Streptococcus bacteria particularly reside in the nose and throat, they tend to spread through direct contact or via air in the form of droplets, when an infected individual sneezes or coughs, and also if he shares his food or beverages with anyone else. Even after receiving treatment, the infected person can spread the disease up to 24 hours later. Therefore, its frequency is more common in areas where people are in close propinquity with each other, like in colleges, schools, daycare centers, and in ménages.
Various Symptoms
The most important and distinguishing symptom of this condition is skin rash, that initially looks like a sunburn. The affected skin becomes quite rough and gives a sandpaper-like feel when touched. The rash following the strep throat can affect almost all parts of the body, except the palms, soles, and the skin around the mouth. After a few days, the skin of the affected area starts to peel off, and this skin flaking or peeling can last for several days. Apart from these, some other common symptoms of scarlet fever are:

❒ Sore throat

❒ Flushed cheeks
❒ Swelling and redness of the throat
❒ Red dots on the soft or hard palate -- the area at the back of the roof in the mouth
❒ Fever and chills
❒ Difficulty swallowing
❒ Headache
❒ Persistent nasal discharge (especially in children below 3 years)
❒ Enlarged tonsils, covered with gray spots or streaks of pus
❒ Swollen and tender lymph nodes in the neck region
❒ Stomach ache, and in certain cases, vomiting, especially in younger children
❒ A very red-colored tongue with red dots on the surface (strawberry-like appearance)
❒ Darkening of the skin creases or Pastia's lines, especially in the underarms, elbows, neck and groin areas
Treatment Options for Strep Rash
The antibiotics that are commonly used for the treatment for this condition are:
  • Penicillin - if the child is facing difficulty in swallowing a tablet due to the rash in the throat, then this drug may be given through an injection also.
  • Amoxicillin - although being from the penicillin family, amoxicillin is the more preferred choice, especially for children, as it also available in the chewable form and does not taste bitter.
In cases where an affected patient is allergic to penicillin, then the physician might prescribe the following antibiotics:
  • Azithromycin (Zithromax)
  • Erythromycin
  • Cephalexin (Keflex)
  • Clindamycin
These above-mentioned antibiotics curb the risk of the spread of this infection, and also help in reducing the severity and duration of the various symptoms. Once the course of treatment commences, the patient should ideally start recovering and feel better in couple of days. At the same time, one should ensure to finish the entire course of antibiotics that has been given. However, even after taking the medication, if for more than two days the affected person does not feel any better, then it is a must that the doctor is contacted ASAP.

The doctor might suggest a few of the following over-the-counter symptom relievers to get rid of the pain and discomfort in the throat, and to reduce the fever.
  • Acetaminophen (Tylenol)
  • Ibuprofen (Advil, Motrin, Nuprin, Medipren, etc.)
Note.- Drugs like acetaminophen should not be taken in large doses, as this can lead to liver problems, and hence, you should consult your doctor, carefully read and follow the label directions always. Besides, aspirin should not be given to adolescents due to the danger of Reye's syndrome - a life-threatening malady.
Home Remedies & Preventive Measures
Keep yourself well-hydrated by drinking 8 to 10 glasses of water and other fluids, a day

Gargle several times a day with lukewarm saltwater to relieve the prickly sensation in the throat

Keep off from irritants like cigarettes, fumes from paints and cleaning products, dust particles, etc.

Sucking on lozenges or hard candy might soothe your throat

Get ample rest; a minimum of 8 to 9 hours of sleep a day is essential for the antibiotics to fight the infection

Make use of a humidifier, as moisture prevents the mucus membranes from getting dry

Saline nasal sprays also help to keep mucous membranes moist

Wash your hands frequently with either soap or an antibacterial hand sanitizer -- the best way to keep all possible infections at bay

Do not share your personal belongings like utensils, handkerchiefs, and anything that you use regularly, with others

If you are having strep rash, then make sure that you cover your mouth whenever you cough or sneeze
If this infection is left untreated, it might lead to some serious complications like rheumatic fever, acute glomerulonephritis (related to kidney), meningitis, sepsis, i.e. infection of the blood, and erythema nodosum (a skin condition). As the disease is contagious, it is very important to prevent its transmission by maintaining proper hygiene. At the same time, inform your physician, as prompt treatment can effectively cure the disease and prevent its associated complications.
Disclaimer: This article is for informative purposes only, and should not be used as a replacement for professional medical advice.