‘Sandpaper’ rash could be a sign of a strep A infection – what to look out for

Strep A is a common type of bacteria and while infections are more common in children, adults can also get them.

The bacteria can also cause a condition known as scarlet fever, which has the potential to be a serious illness.

An infection commonly presents as a sore throat, but symptoms can also appear on other parts of the body.

Some people can develop a rough rash, one that feels like sandpaper, which is indicative of a strep A infection presenting as scarlet fever.

The contagious infection first shows up as flu-like symptoms, which include a high temperature, a sore throat and swollen neck glands.

Then, the NHS says: “A rash appears 12 to 48 hours later. It looks like small, raised bumps and starts on the chest and tummy, then spreads.”

The health body adds: “The rash makes your skin feel rough, like sandpaper.”

On fair skin, the rash can look pink or red; on darker skin, the colour of the rash may be harder to notice, but the bumps will still be raised.

Other common symptoms of strep A include:

Scabs and sores (impetigo)
Pain and swelling (cellulitis)
Severe muscle aches
Nausea and vomiting.

Most strep A infections are not considered serious and can be treated with antibiotics.

In rare cases, the infection can cause serious problems, which is then referred to as invasive group A strep (iGAS).

The NHS advises if you or your child has a strep A infection to stay away from nurses, school or work for 24 hours after you start taking antibiotics.

“This will help stop the infection spreading to other people,” it says.

While strep A infections are spread by close contact with an infected person, other things can make a person more at risk, such as a weakened immune system, open sores or wounds, and some viral infections, such as a cold or flu.

The health body says to get an urgent GP appointment or get help from NHS 111 if:

Your child is unwell and is getting worse
Your child is feeding or eating much less than normal
Your child has fewer wet nappies than usual or is peeing less than usual, or shows other signs of dehydration
Your baby is under three months and has a temperature of 38C, or is three to six months and has a temperature of 39C or higher
Your child is very tired or irritable

You should call 999 or go to A&E if:

Your child is having difficulty breathing – they may make grunting noises, or you may notice their tummy sucking under their ribs
There are pauses when your child breathes
Your child’s skin, tongue or lips are blue or grey – on black or brown skin this may be easier to see on the palms of the hands or soles of the feet
Your child is floppy and will not wake up or stay awake

Strep A bacteria can also lead to tonsillitis, impetigo, cellulitis, and pneumonia.

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