Sore throat: Is it strep throat?

There’s a tickle or sting in the throat that might just be a passing irritation. Or it could be the start of something more. When swallowing starts to feel uncomfortable, it’s natural to wonder: Is that sore throat strep throat?

While sore throats are a common symptom of many mild illnesses, strep throat is a specific bacterial infection that needs medical treatment. Understanding the difference can help someone get the right care and avoid potential complications. From symptoms and testing to treatment, here are some things to know.

In this article:

What is strep throat?

Strep throat is a common bacterial infection in the throat. The symptoms can come on quickly and may include a sore throat and pain when swallowing. Some people might notice little white spots around their tonsils. Headaches and nausea or vomiting can develop, too, but they are less common.

Strep throat is more common during the winter and early spring months. It is most common in school-aged children, especially those between 5 and 15 years old, and spreads easily through close contact with someone who has it. It’s less typical in children under 3 years.

Each year, strep throat causes over 5 million visits to the doctor's office for people younger than 65 years old. It is estimated these visits may result in 2.8 million antibiotic prescriptions annually.

How does someone get strep throat?

The bacteria that cause strep throat is very contagious. It spreads most easily in close quarters like schools, homes or shared spaces. The bacteria behind strep travels through tiny droplets that are released when someone coughs or sneezes. If those droplets land on a surface and someone else touches it and then their mouth or nose, the bacteria can find its way into their respiratory system.

It’s also possible to pick strep throat up through more direct contact. Sharing things like drinks or utensils with someone who has strep might increase the chances of catching it. Because the bacteria can spread through saliva, close contact like kissing or even hugging could raise the risk of infection, too.

What is a sore throat?

Also called pharyngitis, a sore throat can be a sign of something else going on. When someone has a sore throat, it means that the tissue that lines their throat has become inflamed. A sore throat might show up as a symptom in people with a cold or the flu or be part of a more serious infection, like strep throat.

Someone might have a scratchy or painful feeling in their throat. If a virus is the cause of the sore throat, people might also notice other familiar cold symptoms (like a runny nose) happening along with it.

While many sore throats clear up on their own within one week, some people might want support to help ease their symptoms. These options may include gargling saltwater, drinking warm beverages or using a humidifier at home.

What are some causes of sore throats?

Not every sore throat needs treatment. But understanding what’s behind it can help guide possible next steps, such as rest, fluids or checking in with a health care provider.

Sore throats have a wide range of possible causes. Potential reasons for a sore throat may include:

• Allergies
• Cold or flu viruses
• Exposure to secondhand smoke
• Smoking
• Strep throat

Strep throat is caused by a bacteria called group A Streptococcus, also known as Streptococcus pyogenes.

How to know if it’s strep throat

It’s not always easy to tell strep throat apart from a viral sore throat, especially since strep can sometimes look and feel like a viral sore throat at first. In fact, group A strep can cause a range of symptoms. Some people might not show symptoms at all, which can make things a little tricky.

In young children, strep might not surface as classic throat pain. It could look more like poor appetite, congestion, unusual tiredness or general fussiness. In older kids and adults, it’s often a sharp sore throat that seems to come out of nowhere, without the usual cold symptoms like a runny nose or cough (since those are typical symptoms caused by viruses).

That said, Group A Streptococcus is a type of bacteria that can cause many different infections, including strep throat. If symptoms suggest it might be strep throat, a way to know for sure is by visiting a health care provider.

Signs and symptoms of strep

A sore throat, a strep throat symptom, usually comes on quickly. Swallowing might suddenly feel painful, and the throat might have red spots and white patches or streaks of pus on the tonsils. The discomfort can spread to both tonsils and sometimes even come with other symptoms, like a fever or swollen lymph nodes.

When to visit a health care provider

Knowing when to get care for strep throat can be especially important for children and teens who are more likely to get it. There can be complications if the bacteria that causes strep throat goes untreated. These complications may include:

• Ear or sinus infections: can occur when bacteria cause swelling and inflammation in ears or sinuses.
• Guttate psoriasis: a skin condition that involves small, red, scaly teardrop-shaped spots on the arms, legs and torso.
• Invasive streptococcal infection: can occur when the group A Streptococcus bacteria infect someone’s tissue.
• Post-streptococcal glomerulonephritis: an inflammatory response (which affects the kidneys) to the immune system fighting off group A Streptococcus bacteria.
• Rheumatic fever: an inflammatory condition that can develop about five weeks after infection and impact the heart, joints, brain or skin.
• Scarlet fever: a bright red, sandpaper-like rash that forms from strep. Some people might experience a “strawberry tongue,” which may turn red and bumpy.
• Tonsil abscesses: a buildup of bacteria behind or around the tonsils that forms a painful pocket, almost like a boil.

If a sore throat sticks around for more than a week — or the pain starts making it hard to eat, drink or sleep comfortably — it might be time to check in with a provider. It’s also important to notice any high fevers (over 101 degrees), trouble breathing or swallowing. If someone is experiencing unusual symptoms, like blood in saliva or phlegm, that may also be a sign that something more is going on.

If something doesn’t feel right, a health care provider can help get to the cause of the discomfort.

Diagnostic testing in sore throat

When someone has a sore throat or a rash, a health care provider might check to see if strep or scarlet fever is the cause. To do this, they may ask a few questions, do a quick exam, or run a test. The two main tests are: 

• Rapid test
• Throat culture

Here’s how each test works:

Rapid strep throat test

If a health care provider thinks an infection is strep throat or scarlet fever, they might first start off by doing a rapid strep test. During the test, patients are asked to tilt their head back and open wide. 

The provider will then use a special swab to gently collect a sample from the back of the throat and over the tonsils. This checks for group A Streptococcus bacteria. The test shows whether the bacteria is likely causing illness.

Results are usually available quickly. If the rapid test comes back positive, it means group A Streptococcus is likely behind the sore throat or rash symptoms. If it's negative, the provider might still order a throat culture to be sure.

Throat culture

A throat culture is collected in the same way as a rapid test. The difference is that the sample is sent to a lab, where experts check to see if group A Streptococcus bacteria grow over time.

This process takes a little longer, but it can help confirm a strep infection that a rapid test might miss. Throat cultures are especially important for children and teens, since untreated strep infections can sometimes lead to complications like rheumatic fever.

As a note, it’s also a good idea to let a provider know if someone used mouthwash or took antibiotics recently, as that can sometimes impact the accuracy of strep throat test results. 

Managing strep and a sore throat

Someone might’ve taken a test a few days ago — and now the results are in. What happens next depends on what that test says.

If it’s not strep, it might be a viral sore throat. Treatment might be focused on symptom relief and home care.

If it is strep, the next step usually involves a prescription for antibiotics to help clear the infection and lower the risk of complications or spreading it to others. Even then, there are symptom relievers that might help someone feel better while the antibiotic does its work.

Options for managing a sore throat

Does strep throat go away on its own?

Unlike a viral sore throat, strep throat doesn’t usually clear up on its own. Letting it linger without treatment can lead to more serious issues down the line.

Even when treated, strep can occasionally return. In some cases, a person may become a carrier. That means that the bacteria can stick around in the tonsils without causing obvious symptoms. It might not make someone feel sick right away. But if their immune system is under stress, the infection could come back or even get worse. That’s why it’s important to check in with a health care provider if strep throat is suspected.

Sore throat and strep throat medication support

If a patient tests positive for group A strep bacteria — either through a rapid strep test or a throat culture — a health care provider will likely prescribe antibiotics. These medications can help shorten the duration of symptoms, reduce the risk of spreading the infection to others and lower the chance of complications.

If the test is negative for group A strep, antibiotics won’t help. Most sore throats resolve on their own within a week. In these cases, a health care provider may recommend options to help support symptom relief.

Key takeaways

Understanding strep throat is important for getting the right care. While some sore throats are caused by viruses or environmental factors and tend to resolve on their own, strep throat is different. It’s a bacterial infection caused by group A streptococcus and requires treatment with antibiotics. Although strep throat shares symptoms with other types of sore throats (such as discomfort or irritation), only a diagnostic test — like a rapid strep test or a throat culture — can tell whether the cause is group A strep.

If the test is positive, a health care provider may prescribe antibiotics to treat the infection. Treatment helps relieve symptoms but also reduces the risk of spreading the bacteria to others and prevents potential complications. If someone is experiencing sore throat symptoms or is unsure about what’s causing them, they should consult with a health care provider, who can help evaluate what's going on and get them the right care.