Common cold vs. strep throat: How to help tell the difference

There are a lot of illnesses in the world, and many of them can cause similar symptoms. The common cold and strep throat happen to be two of them. Knowing how to help tell them apart can help people access the right kind of care quickly. (And for strep throat, the sooner people begin treatment, the sooner they should start feeling better.)

 So, here’s the inside scoop on the common cold versus strep throat. It’ll help people understand what causes each illness, what symptoms may overlap and why they require different types of management.

In this article:

What is the common cold?

There are more than 200 types of respiratory viruses out there that can cause a cold. Rhinoviruses are the most common culprits throughout the U.S., but there are others that can get people sick. These illnesses can spread throughout the air when an infected person coughs or sneezes. A lot of respiratory viruses make their way around during the winter months, but people can catch colds any time of year.

They’re also quite common. Each year, adults experience an average of two to three colds. Children tend to get even more.

What is strep throat?

Strep throat is a bacterial infection that affects the throat and tonsils. It’s caused by group A Streptococcus (group A strep bacteria). Symptoms typically show up anywhere from two to five days after exposure. Close contact with someone who has strep throat is the most common factor for getting sick. Health care providers can test for strep throat using a rapid strep test or throat culture. If the results come back positive, they’ll usually prescribe antibiotics to help treat the infection.

Why do people confuse the common cold with strep throat?

A reason why so many people confuse the common cold with strep throat is because of the symptoms they cause. Both illnesses can cause throat pain, but there are important differences in how symptoms appear.

The common cold causes redness and soreness around the throat. Strep throat does the same, but it can also cause tiny red spots to appear on the roof of the mouth. People with strep throat might also notice white patches or streaks of pus on their tonsils.

The common cold vs. strep throat: What’s the difference?

Both the common cold and strep throat can cause throat pain. But there are differences between the two illnesses. Knowing how to tell the two apart can help make it easier to decide how to manage symptoms and when to see a health care provider.

Causes

Common cold. Respiratory viruses, including rhinoviruses, human coronaviruses (these are not the same as the SARS-CoV-2 viruses), parainfluenza viruses, adenoviruses, enteroviruses (including EV-D68) and human metapneumovirus.

Strep throat. Group A Streptococcus (group A strep bacteria)

Symptoms

Potential complications

Common cold

• Asthma attacks
• Bronchitis
• Bronchiolitis (infection of the airways)
• Middle ear infections (infection behind the ear drum)
• Pneumonia (infection of the lungs)
• Sinus infections
• Worsening of some chronic medical conditions

Strep throat

• Abscesses (pockets of pus) around the tonsils or in the neck
• Ear infections
• Post-streptococcal glomerulonephritis (a kidney disease)
• Rheumatic fever (a disease affecting the heart, joints, brain and skin)
• Sinus infections

Management options

Speak with a health care provider before starting or stopping any medication.

Common cold. Over-the-counter (OTC) medications, like acetaminophen or ibuprofen, may be used. Saline nasal sprays, cough drops and throat lozenges can also help manage symptoms. It is also important to get plenty of rest.

Strep throat. Antibiotics (must be prescribed by a health care provider). Gargling with warm saltwater and using a cool mist humidifier can also help manage symptoms. OTC medications, like acetaminophen or ibuprofen, may help provide symptom relief, and throat lozenges can also help manage symptoms.

When to see a health care provider

If someone has strep throat, it’s important to speak with a health care provider if their symptoms don’t improve within a couple of days after starting an antibiotic. People should also plan a visit if their sore throat is accompanied by tender or swollen lymph nodes.

Some people who have strep throat may also spike a fever, develop a rash or experience problems breathing or swallowing. These are often signs of more serious infections that require medical attention.

Key takeaways

People sometimes have a hard time distinguishing between a common cold and something more serious, like strep throat. Most of that confusion revolves around throat pain. If it’s strep throat, people might notice tiny red spots on the roof of their mouths. White patches might also appear on the tonsils. These symptoms don’t occur with the common cold. Instead, people might develop a cough, runny nose or other issues with the upper respiratory tract.

Here's the other thing: Colds typically go away on their own. People with colds can help manage their symptoms with OTC medications and by getting plenty of rest. Strep throat is usually treated with antibiotics. If someone is unsure of which illness they have, they should visit a health care provider. That way, they can get answers and any medication they might need.