How Long Can Strep Throat Last?

Sometimes a sore throat may not always result from a simple cold, especially if your throat feels raw or like it’s on fire. Viral infections or the common cold cause most sore throats. An easily spread bacteria called Streptococcus pyogenes causes strep throat. 

Strep throat infections often disappear within ten days of proper treatment with antibiotics like penicillin or amoxicillin. This article provides an overview of strep throat, how long it can last, and how to manage it.

What is strep throat?

Strep throat¹ is a contagious infection of the tonsils and the throat. It is more prevalent in school-aged children.

In rare cases, strep throat can cause more severe conditions like rheumatic fever, which can damage the heart valves. Therefore, if you have strep throat, you must seek treatment. 

Even though strep throat is regarded as a mild condition, it can still be very uncomfortable. 

Typical signs include:

• Sore throat

• Discomfort when swallowing

• Fever

• Red or swollen tonsils with white patches

• Swollen lymph nodes

• Headache, stomachache, nausea, and vomiting

• Strep rash

What does strep rash look like?

Group A Streptococcus, the bacteria that causes strep throat, can cause scarlet fever² (also called scarlatina). This causes a red rash that often appears with a sore throat and fever. The rash first emerges as flat red patches before developing into tiny bumps with a grainy, sandpapery texture. 

Strep rash may initially appear on the neck, underarms, or groin areas, but it can spread to other body parts. It can seem brighter red in regions like the elbows and underarms. Your tongue could also appear red and rough.

The rash usually resolves in about a week, but the skin can peel for several weeks afterward.

How do you get strep throat?

Group A strep lives in the throat and nose and can readily transmit to other people. Infected people spread the bacteria by chatting, coughing, or sneezing, creating microscopic respiratory droplets that contain the bacteria. Strep also spreads through infected sores on the skin.

Like cold-causing viruses, you can also contract strep throat by touching your mouth or nose after handling a doorknob or other surface.

If you’re exposed to group A strep, you’ll typically develop strep throat in two to five days. Not all infected people exhibit symptoms or appear ill, but those who have strep throat symptoms are far more contagious than those who don't.

Strep throat vs. sore throat

Although a sore throat is a common indicator of strep throat, a sore throat doesn’t always indicate strep throat. Viral infections frequently cause a sore throat, congestion, runny nose, cough, hoarseness,  fever, and swollen, itchy tonsils.

Although other illnesses can also cause these symptoms, white patches on the back of the throat, tiny red spots on the roof of the mouth, headaches, and swollen lymph nodes under the ears are common signs of strep throat. A cough, congestion, or runny nose are not characteristic of strep throat.

How is strep throat diagnosed?

A doctor uses a strep test to probe your throat for Streptococcus bacteria. The test is quick, and it doesn't hurt. The doctor takes the test sample from the back of your throat using a cotton swab before testing the swab with a rapid test.

Some physicians may send the sample to the lab instead of testing it immediately. It takes 15 minutes or less to complete the rapid strep test. You have strep throat if the test detects Streptococcus bacteria.

The doctor might send the throat swab to a lab for further testing if the rapid strep test is negative. 

Risk factors

Strep throat can affect anyone. However, children from 5–15 are most affected. Adults who frequently interact with kids and parents of school-age children are more susceptible to contracting strep throat.

Crowded environments pose an increased risk because infectious diseases are more likely to spread there regardless. Some of them include:

• Schools 

• Childcare facilities

• Military training facilities

How is strep throat treated?

Doctors treat strep throat with antibiotics. They administer these antibiotics as shots or prescribe them as liquid or pills. Common medications include penicillin and amoxicillin. If you’re allergic to penicillin, your doctor will prescribe other antibiotics.

Usually, you’ll take antibiotics for ten days, but follow the advice given by your doctor. While you may feel better, you should continue taking the prescription. The bacteria can still be active even if you feel fine.

Although there are concerns about antibiotic resistance, the CDC³ notes there has never been a report of group A strep penicillin resistance. Still, resistance to azithromycin and clarithromycin exists in some communities, which are essential penicillin alternatives.

You can alleviate the pain from strep throat by drinking plenty of water, gargling with warm salt water, using a humidifier, and taking honey. Over-the-counter anesthetic throat sprays or throat lozenges can also ease the pain. 

What are the side effects of strep throat medication?

You may have several side effects of antibiotics, including:

• Stomachache

• Vomiting

• Nausea 

• Diarrhea

• Loss of appetite

These side effects are typically mild. They should cease once you have finished the medication. Call your doctor if they are severe or persist.

Antibiotic allergies are uncommon. An allergic response can cause the following symptoms:

• Wheezing

• Breathing difficulty

• Rash

• Rapid heart rate

• Dizziness

These symptoms indicate anaphylaxis, which is an emergency. Seek urgent medical care.

Other sore throats don't require medication, so why is strep throat different?

Viruses cause most sore throats, and antibiotics cannot treat a virus. If you have a viral sore throat, you can manage the symptoms with painkillers and the throat remedies listed above.

Bacteria causes strep throat, and antibiotics can treat bacterial infections. Treatment for strep throat is crucial since complications can occur if left untreated.

How long does strep throat last?

Strep throat symptoms usually subside within a week.

With antibiotics

Your symptoms should improve quickly after antibiotics administration, frequently within a day or two. To eliminate the bacteria, take the antibiotic for the recommended period.

Without antibiotics

Even without treatment, strep throat can be self-limiting. However, there is an increased risk of transmission and complications without antibiotic treatment.

Complications may include:

• Kidney disease: Post-streptococcal glomerulonephritis

• Guttate psoriasis: A skin disorder causing red, scaly patches on the trunk and extremities

• Rheumatic fever: A heart-damaging inflammatory condition that can follow strep throat

• An abscess near the tonsils

• Scarlet fever

Can you get strep throat multiple times?

Yes. Some people are more likely to get strep throat, and failure to respond to the first round of antibiotic therapy is a typical cause of recurrence.

How can you prevent further cases of strep throat?

Frequently washing your hands is the best approach to prevent contracting or spreading group A strep. If you have children, teach them to properly wash their hands with soap and water and use an alcohol-based hand sanitizer.

This is crucial, especially after sneezing or coughing and before cooking or eating.

To maintain proper hygiene:

• Cover your mouth and nose with a tissue when you cough or sneeze.

• Place the used tissue in the trash can.

• If you don't have a tissue, cough or sneeze into your elbow rather than your hands.

• Wash your hands regularly.

• If soap and water are unavailable, use hand sanitizer.

Before taking antibiotics for 24-48 hours, most people with strep can still infect others. Until you take antibiotics for at least a day, you should stay away from school, work, and other public spaces.

Get a new toothbrush a few days before finishing the antibiotics. Without antibiotics, the bacteria could persist on the toothbrush and re-infect you. It’s best to keep your family's toothbrushes and utensils separate.

If strep cases recur in your family, check if anyone is a strep carrier. Despite having strep in their throats, carriers do not become ill from the infection. In some cases, treating them can prevent others from getting it.

Can you get strep throat without tonsils?

Even after having your tonsils surgically removed (tonsillectomy), it is still possible to contract strep throat. Some evidence⁴ suggests you may get strep throat less frequently.

When you get strep throat, group A strep bacteria attack your tonsils and throat. The bacteria can no longer infect your tonsils after a tonsillectomy, but they can still infect your throat. 

You can't get tonsillitis after a tonsillectomy, and a virus causes most cases of tonsillitis.

When to see your doctor

It's important to consult your doctor as soon as you notice strep throat symptoms to determine if you need antibiotics.

The doctor can perform a rapid strep test, analyze the results, and prescribe antibiotics. If the test is negative, but they still believe it to be strep throat, they can take a throat culture with a swab. It will take some time to receive the results. This is more frequently done for children since they’re more likely to get a rheumatic fever from untreated strep.

Adults typically do not have a throat culture if the rapid test is negative because they have a lower risk of developing rheumatic fever.

The lowdown

While strep throat usually resolves on its own in a week or so, antibiotics stop complications and reduce transmission to others. You should feel better quickly with antibiotics, and after taking the drug for 24 hours, you are no longer contagious to other people.

Ensure you take the antibiotics for the recommended duration, even if you feel better. Talk with your healthcare provider if you have any questions about your antibiotic regimen.