Sore Throat

Is it painful to swallow?  Or is your throat scratchy? A virus may be causing your sore throat.

Most sore throats, except for strep throat, do not need antibiotics.

Causes

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)
  • Allergies
  • 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. These bacteria are called group A Streptococcus (also called Streptococcus pyogenes).

Symptoms of Sore Throat

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. Sore throat caused by a virus or the bacteria called group A Streptococcus can have similar symptoms.

Sometimes the following symptoms suggest a virus is causing the illness instead of Strep throat:

  • Cough
  • Runny nose
  • Hoarseness (changes in your voice that makes it sound breathy, raspy, or strained)
  • Conjunctivitis (also called pink eye)

Symptoms of Strep Throat

In general, strep throat is a mild disease, but it can be very painful.

Common symptoms may include:

  • Fever
  • Pain when swallowing
  • Sore throat that can start very quickly and may look red
  • Red and swollen tonsils
  • White patches or streaks of pus on the tonsils
  • Tiny, red spots on the roof of the mouth, called petechiae
  • Swollen lymph nodes in the front of the neck

The following symptoms suggest a virus is causing the illness instead of strep throat:

  • Cough
  • Runny nose
  • Hoarseness (changes in your voice that makes it sound breathy, raspy, or strained)
  • Conjunctivitis (also called pink eye)

When to Seek Medical Care

Talk to your doctor if you or your child have symptoms of sore throat. They may need to test you or your child 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)
  • Dehydration
  • Joint swelling and pain
  • Rash

This list is not all-inclusive. Please see your doctor for any symptom that is severe or concerning.

See a doctor if symptoms do not improve within a few days or get worse. Tell your doctor if you or your child have recurrent sore throats.

Treatment

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.

A virus causes the most common type of sore throat 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.
Sore Throat
Anatomy of the mouth, showing inflamed tonsils in a sore throat.

A healthy throat and a sore throat, including uvula and tongue, showing inflamed tonsils.

Talk to a healthcare professional right away if your child is under 3 months old with a fever of 100.4 °F (38 °C) or higher.

More about
rheumatic fever

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 test you to determine if it is causing 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 virus causes a sore throat, 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 mild reactions, like a rash, to more serious health problems. These problems can include severe allergic reactions, antibiotic-resistant infections and C. diff infection. C. diff causes diarrhea that can lead to severe colon damage and death.

How to Feel Better

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 4 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.

Over-the-Counter Medicine and Children

Carefully read and follow instructions on over-the-counter medicine product labels before giving medicines to children. Some over-the-counter medicines are not 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. Reye’s syndrome is a very serious, but rare illness that can harm the liver and brain.
  • Cough and cold medicines:
    • Children younger than 4 years old: do not use over-the-counter cough and cold medicines in young children unless a doctor specifically tells you to. Cough and cold medicines can result in serious and sometimes life-threatening side effects in young children.
    • 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.

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.

Prevention

You can help prevent sore throats by doing your best to stay healthy and keep others healthy, including:

  • Clean your hands.
  • Avoid close contact with people who have sore throats, colds, or other upper respiratory infections.
  • Don’t smoke and avoid exposure to secondhand smoke.