Is it painful to swallow? Or is your throat scratchy? You likely have a sore throat that’s caused by a virus.
Most sore throats, except for strep throat, do not need antibiotics.
Causes of sore throat include:
- Viruses, like those that cause colds or flu
- The bacteria group A strep, which causes strep throat (also called streptococcal pharyngitis)
- Smoking or exposure to secondhand smoke
Of these, infections from viruses are the most common cause of sore throats.
Strep throat is an infection in the throat and tonsils caused by bacteria called group A Streptococcus (also called Streptococcus pyogenes).
A sore throat can make it painful to swallow. A sore throat can also feel dry and scratchy. Sore throat can be a symptom of strep throat, the common cold, allergies, or other upper respiratory tract illness.
The following symptoms suggest a virus is the cause of the illness instead of the bacteria called group A strep:
- Runny nose
- Hoarseness (changes in your voice that makes it sound breathy, raspy, or strained)
- Conjunctivitis (also called pink eye)
Symptoms of sore throat, whether caused by viruses or by the bacteria called group A strep, can often be similar.
The most common symptoms of strep throat include:
- Sore throat that can start very quickly
- Pain when swallowing
- Red and swollen tonsils, sometimes with white patches or streaks of pus
- Tiny red spots on the roof of the mouth
- Swollen lymph nodes in the front of the neck
Sometimes someone with strep throat also has a rash known as scarlet fever (also called scarlatina).
The most common type of sore throat is caused by a virus and is not strep throat.
- Only 3 in 10 children with a sore throat have strep throat.
- Only about 1 in 10 adults with a sore throat has strep throat.
See a doctor if you or your child have symptoms of strep throat. You or your child may need to be tested for strep throat.
Also see a doctor if you or your child have any of the following:
- Difficulty breathing
- Difficulty swallowing
- Blood in saliva or phlegm
- Excessive drooling (in young children)
- Joint swelling and pain
This list is not all-inclusive. Please see your doctor for any symptom that is severe or concerning.
Follow up with a doctor if symptoms do not improve within a few days, get worse, or if you or your child have recurrent sore throats.
A doctor will determine what type of illness you have by asking about symptoms and doing a physical examination. Sometimes they will also swab your throat.
baby icon See a doctor right away if your child is younger than 3 months old and has a fever of 100.4 °F (38 °C) or higher.
Since bacteria cause strep throat, antibiotics are needed to treat the infection and prevent rheumatic fever and other complications. A doctor cannot tell if someone has strep throat just by looking in the throat. If your doctor thinks you might have strep throat, they can do a test to determine if it is the cause of your illness.
Anyone with strep throat should stay home from work, school, or daycare until they no longer have fever AND have taken antibiotics for at least 12 hours.
If a sore throat is caused by a virus, antibiotics will not help. Most sore throats will get better on their own within one week. Your doctor may prescribe other medicine or give you tips to help you feel better.
When antibiotics aren’t needed, they won’t help you, and their side effects could still cause harm. Side effects can range from minor issues, like a rash, to very serious health problems, such as antibiotic-resistant infections and C. diff infection, which causes diarrhea that can lead to severe colon damage and death.
Some ways you can feel better when you have a sore throat:
- Suck on ice chips, popsicles, or lozenges (do not give lozenges to children younger than 2 years).
- Use a clean humidifier or cool mist vaporizer.
- Gargle with salt water.
- Drink warm beverages and plenty of fluids.
- Use honey to relieve cough for adults and children at least 1 year of age or older.
- Ask your doctor or pharmacist about over-the-counter medicines that can help you feel better. Always use over-the-counter medicines as directed.
Be careful about giving over-the-counter medicines to children. Not all over-the-counter medicines are recommended for children of certain ages.
- Pain relievers:
- Children younger than 6 months: only give acetaminophen.
- Children 6 months or older: it is OK to give acetaminophen or ibuprofen.
- Never give aspirin to children because it can cause Reye’s syndrome, a rare but very serious illness that harms the liver and brain.
- Cough and cold medicines:
- Children younger than 4 years old: do not use unless a doctor specifically tells you to. Use of over-the-counter cough and cold medicines in young children can result in serious and potentially life-threatening side effects.
- Children 4 years or older: discuss with your child’s doctor if over-the-counter cough and cold medicines are safe to give to your child for temporary symptom relief.
Be sure to ask your doctor or pharmacist about the right dosage of over-the-counter medicines for your child’s age and size. Also, tell your child’s doctor and pharmacist about all prescription and over-the-counter medicines they are taking.