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Sore Throat or Strep Throat? How to Tell the Difference

Common Sore Throat or Strep Throat?

Woman feeling her neck due to a sore throat.

Your throat aches and burns. It’s painful to swallow. You know something is wrong, but how bad is it? Will it get better without antibiotics? Or will you need to visit the doctor?

This article is designed to help you find relief from your sore throat, and discover whether or not you likely have strep throat symptoms. You will find the telltale signs of strep throat and the common sore throat, as well as treatment options for both.

What Is Strep Throat?

Unlike the common sore throat, strep throat is caused by a bacterial infection. A Streptococcus bacteria (called "group A strep") infects the throat and the tonsils, and it will quickly respond to antibiotics. It’s important to distinguish strep throat from sore throat because treatment for both is very different.

What Is the Common Sore Throat?

A sore throat can be quite painful, but it is not as painful as strep throat. Unlike strep throat, the common sore throat is usually caused by a virus. This means it will not respond to antibiotics.

Even if it’s not strep throat, you may need to see a doctor for sore throat relief. It’s time to see the doctor if your sore throat

  • lasts longer than a week,
  • keeps coming back,
  • makes your voice hoarse for more than two weeks,
  • causes dehydration, or
  • worries you in some other way.

Read along to find what symptoms distinguish a common sore throat from strep throat.

What Does Strep Throat Look Like? Strep Throat Symptoms

Inside view of open mouth revealing strep throat signs of white patches, mucus and red swollen tonsils.

Some of the signs of strep throat will be visible. They may include

  • white patches on the tonsils or throat,
  • dark red splotches or spots on the roof of the mouth, and
  • a skin rash.

Those white spots are pus pockets. In addition, some patients may exhibit swollen, tender lymph nodes in the neck and some with fever above about 101-102 F. The signs and symptoms of strep throat are the same for both children and adults.

Although these signs may indicate strep throat, a visit to the doctor is necessary to make a full determination. Strep throat cannot be diagnosed by visual signs alone.

Adults are less likely to have strep throat than children. For children, their odds of a sore throat being strep throat are about 20% to 30%. For adults, the odds are more like 5% to 15%.

Sore Throat Causes

A girl with a cold blowing her nose.

Sore throats are often caused by viruses, making them difficult to cure. They can also be caused by

  • dry air,
  • irritants like pollution,
  • smoke, including cigarette smoke, and
  • allergies.

Unlike strep throat, sore throats usually go away on their own without any antibiotic treatment. In fact, antibiotics are useless against viral infections like colds and the flus. Viral strains are the common causes of the common sore throat.

Beyond the throat itself, a few more symptoms of the common sore throat include

  • runny nose,
  • watery eyes,
  • cough,
  • sneezing, and
  • a low fever (below 101 F).

Swollen lymph nodes under the chin and the front of the neck could indicate any kind of infection, not just strep throat. They could accompany an ear infection or sinus infection, for example.

Signs of Strep Throat: Fever

Man with a scarf around his neck checking his temperature with a thermometer.

If your fever is higher than 101 F, it’s usually a sign of strep throat infection. Sometimes strep throat comes with a lower fever as well, though, so not having a high fever does not necessarily mean you’re free and clear when it comes to strep throat.

Strep Throat and Rheumatic Fever

Fevers can go from bad to worse with strep throat. That’s one reason why treatment with antibiotics is so important. Without treatment, rheumatic fever can set in, usually about two weeks to a month after signs of strep throat first appear. Rheumatic fever is much more than just a fever—it may causes severe joint, heart, skin, and brain problems. It can damage heart valves as well. Although it continues to be a problem in the developing world, rheumatic fever is rare in the United States and other developed nations.

Are There Swollen Lymph Nodes?

Woman checking to see if her daughter has swollen lymph nodes.

Strep throat can be spread through direct contact, especially when mucus droplets from the mouth are spread, as in the case of kissing. It can also be spread through indirect contact by sharing things like cups, forks, and spoons.

If you don’t get antibiotics, your strep throat will be contagious for about two to three weeks after infection. But once you start taking an antibiotics regimen, your potential to infect others disappears after about 24 hours.

For this reason, the CDC recommends that people with strep throat stay home from work, school, and daycare until their fever is gone or they have taken antibiotics for at least 24 hours.

How Long Does Strep Throat Last?

Man holding his throat in extreme discomfort due to a sore throat.

After becoming infected with strep throat, it usually takes about two to five days to fall ill.

  • Without antibiotic treatment, strep throat can last 10-12 days.
  • The infection is likely to get better within three to five days after an antibiotic treatment is begun.

Treating strep throat earlier helps prevent more serious related conditions like rheumatic fever.

Strep Throat Rash: Scarlet Fever

Rash on the body which may be a sign of scarlet fever.

If your sore throat is associated with a fine, sandpaper-like pink rash on the skin, it could be scarlet fever, which is definitely associated with the bacteria that causes strep throat. If this occurs, see a doctor immediately.

Symptoms of scarlet fever include

  • a very red, sore throat,
  • bright red skin under arms, at the elbows and in the creases of the groin,
  • a “strawberry” tongue that appears red and bumpy,
  • nausea,
  • vomiting, and
  • abdominal pain.

Long-term, scarlet fever can lead to serious health problems. These include

  • rheumatic fever,
  • kidney disease,
  • ear infections,
  • arthritis,
  • pneumonia, and
  • skin infections.

 Scarlet fever can be treated with antibiotics.

Strep Is a Bacterial Infection

Sample of Streptococcus bacteria

Most sore throats are caused by viruses, or are side effects of infections in other parts of the nose or sinuses. However, strep throat comes from a common bacterial group, Group A Streptococcus, also known as Streptococcus pyogenes.

Group A strep is one of the most common disease-causing bacteria in humans. About 5% to 15% of people have the bacterium in their bodies without showing any signs or symptoms of infection. Only humans can carry the bacterium.

Group A strep can cause a whole range of health problems, from strep throat and scarlet fever to skin diseases like impetigo and cellulitis. It can cause the devastating flesh-eating disease necrotizing fasciitis, too, which kills about one quarter of its victims.

It is important to determine if your infection is caused by strep, as antibiotics are prescribed to decrease the chance of complications.

Antibiotics Won’t Stop a Common Sore Throat

Magnification of virus infection.

Because strep throat is caused by a bacteria, bacteria-fighting antibiotics are usually used to cure the disease. Strep throat symptoms and contagiousness dramatically improves when antibiotics are properly administered.

It’s important not to overuse antibiotics though. Overuse of antibiotics threatens to create “superbugs,” microbes that are resistant to antibiotics. Every year in the United States, at least 2 million people are infected with antibiotic-resistant bacteria.

To avoid contributing to this growing health problem, don’t try to treat viral or fungal illnesses with antibiotics. Antibiotics do not provide any benefit against viral or fungal infections. The only result of using antibiotics in these cases is the further proliferation of superbugs.

Antibiotics do not get rid of sore throats caused by the common cold. The common cold is caused by a virus, and antibiotics will not help.

Rapid Strep Test and Oral Culture

Doctor performing a throat culture on a girl to check for strep throat.

Just looking at a patient’s throat is not enough to diagnose strep throat, so your doctor will want to perform a test to be sure. The rapid strep test is attempted first to make a quick determination of the possible presence of strep-causing bacteria in a patient’s throat.

To perform a rapid strep test, a doctor will swab both tonsils and the back of the mouth. True to its name, a rapid strep test takes about 10-15 minutes to provide results.

About 5% of the time, a rapid strep test will turn out negative even if strep throat is causing one’s illness. If a doctor still suspects strep throat, he or she will follow up with a throat culture.

Throat cultures are performed the same way from a patient’s point of view. The tonsils and back of the mouth are swabbed once more. Then the throat culture is sent away for further testing. Results will take a day or two to return.

Antibiotics for Strep Throat

Person taking antibiotics for strep throat.

If your doctor diagnoses you with strep throat, you will be prescribed antibiotics or given an antibiotic shot to treat it. You need to finish the entire course of antibiotics—even if you feel better before they are finished—so the bacterial infection won’t reoccur. Strep is still contagious even if you are taking antibiotics, so follow these steps to protect others from further infection:

  • Wash your hands frequently.
  • Don't share food or utensils.
  • Throw away your toothbrush when your strep infection has resolved.

Home Remedies for Strep Throat & Sore Throat

Sprinkling salt into a glass of water.

Sometimes home remedies do a good job of easing the pain and discomfort of a sore throat, both for strep throat and sore throats caused by common illnesses like colds. However, if symptoms worsen with home remedy treatments, you should see a medical caregiver (see slide 20).

Here are a few home remedies that may work to ease your sore throat:

  • Gargle: Stir 1/2 tsp of salt into 1 cup of warm water, and gargle from this solution several times a day. This helps loosen mucus and draw excess fluid out of inflamed throat tissue.
  • Throat lozenges: over-the-counter throat lozenges and hard candy can help ease the pain of a sore throat.
  • Throat sprays: These can help numb the throat, which helps to stop the pain associated with both strep throat and sore throats.
  • Tea with honey: Honey has been shown to relieve throat irritation, and hot water from a mild tea can do the same.

Remedies are aimed at keeping the throat moist, as well as symptom relief.

Sore Throat Home Remedies: Humidifier or Vaporizer

Man with a cold breathing steam from a bowl.

Part of the pain and irritation of a sore throat comes from having a dry throat. One solution is to plug in a humidifier or vaporizer to increase the humidity in your room.

If you don’t have a vaporizer or humidifier, another solution is to hold your head over hot, steaming water. Put a towel over your head to hold the moist steam close to your face, and breathe in as deeply as you comfortably can.

Sore Throat Home Remedies: Warm Compress

Woman with cup of tea and hot water bottle.

One of the effective methods of relieving pain comes from applying heat. Keeping the throat warm may help soothe tender lymph nodes. Use a warm compress on your neck to help relieve the pain. This can be done via a

  • towel soaked in hot water,
  • a heating pad, or
  • a hot water bottle.

Sore Throat Home Remedies: Soothing Foods

Woman sitting beside refrigerator eating ice cream.

While keeping your throat warm can relax the throat muscles, cold foods can numb the pain of a sore throat.

Wondering what to eat when you have strep throat? Soft, cool foods are good choices to eat when you have a sore throat. Try these:

  • ice cream
  • milkshakes
  • gelatin
  • pudding
  • frozen fruits like bananas and blueberries
  • ice chips

The coolness of the food soothes the pain, and soft foods are easy to swallow past the inflamed areas.

Hydration

Sick man sitting on bed drinking water.

Staying hydrated helps your body fight off an infection. Here are some tips to help make sure you stay well-hydrated:

  • Drink plenty of water when you have a sore throat.
  • Use a straw to sip water or other fluids to make it easier for the fluid to go down the middle of the throat.
  • Avoid citrus juices or alcoholic beverages when fighting an infection. Citrus juices can be painful on a swollen, tender sore throat. Alcoholic beverages will actually dry out your body, doing more harm than good in the long run.

What Helps a Sore Throat? Pain Relievers

Woman taking pill from bedside table.

To help relieve the pain of a sore throat, over-the-counter pain relievers may be used. These include

  • ibuprofen (Advil, Motrin),
  • acetaminophen (Tylenol), or
  • naproxen (Aleve).

Children and teens should not be given aspirin due to the risk of Reye’s syndrome, which can be fatal.

What Helps a Sore Throat? Sore Throat Sprays and Lozenges

Cough lozenges in pill strip.

Over-the-counter numbing sprays or lozenges are helpful to relieve the pain of sore throats. A lozenge or sugar-free hard candy can help relax the throat, and lozenges and throat sprays sometimes include additional helpful ingredients, such as

  • anesthetics, which reduce pain,
  • cooling agents, which help numb pain,
  • anti-inflammatory agents, which can help reduce swollen tissue, and
  • antiseptic agents, which help reduce the growth of harmful microorganisms.

What Helps a Sore Throat? Decongestants

Woman inhaling nasal spray.

Sometimes postnasal drip is the cause of an irritated throat. If that’s the case, decongestant sprays or pills may help relieve congestion and some symptoms of sore throat pain. Some common decongestant sprays and pills include

  • Afrin,
  • Contac,
  • Mucinex,
  • Sudafed (suphedrine), and
  • Zicam.

Be sure to use these products as directed, and consult your doctor before taking decongestants if you are taking other medications.

Persistent Sore Throat

Doctor checking woman's throat.

A sore throat that does not respond to initial medical treatment may be a sign of another cause. A persistent sore throat may be a sign of other problems, for example:

  • mononucleosis (a sexually transmitted disease),
  • tumors in the throat,
  • meningitis, or
  • acid reflux.

See your doctor if you have been treated for strep throat and it has not improved or resolved within three to four days.

Reviewed by Charles Patrick Davis, MD, PhD on 10/28/2016

Sore Throat or Strep Throat? How to Tell the Difference

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