A sore throat can make it painful to eat and even talk. It brings scratchiness and irritation to the throat that can become worse when swallowing.

Common causes include a viral infection, such as a cold or the flu, or bacteria. Most sore throats are not serious, but severe symptoms can make it difficult to breathe.

How a person deals with a sore throat depends on the severity and the cause. Usually, home remedies can soothe the discomfort until it goes away. Sometimes, however, it needs medical treatment.

Find out more about the causes and symptoms and how to deal with them.

Viruses and bacteria are two common causes of sore throats.

Viruses

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A sore throat can be uncomfortable, but it is not usually serious.

Many sore throats are due to viral infections, such as:

If symptoms are severe, the person should see a doctor. However, a doctor will not prescribe antibiotics for a virus.

Bacteria

"Strep throat" is a common type of throat infection that results from exposure to a strain of streptococcus bacteria.

Symptoms include:

  • a fever greater than 101°F
  • white patches on the throat
  • swollen or tender glands in the neck area

The person may need antibiotics to fight the infection and prevent complications. In children, untreated strep throat can increase the risk of rheumatic fever or kidney inflammation.

Strep throat accounts for 20–30 percent of sore throats in children and 5–15 percent in adults, according to the Centers for Disease Control and Prevention (CDC).

Other common causes of a sore throat include:

  • allergies
  • irritation caused by dry heat, pollutants, or chemicals
  • reflux, when stomach acids come up into the back of the throat
  • cold air

More severe but less common conditions that can involve a sore throat include:

Epiglottitis is a rare but potentially dangerous throat infection in which inflammation and swelling of the epiglottis can close the airway, making it difficult to breathe. It is a medical emergency.

People who are most at risk of frequent sore throats include:

  • children aged 5–15 years
  • people with allergies
  • people with weakened immune systems
  • people who have come into contact with chemical irritants
  • people who have long-lasting or frequent sinus infections
  • people whose tonsils are large or irregularly shaped

Anyone with ongoing or severe symptoms should see a doctor, as they may have an underlying condition that needs further treatment.

The symptoms of a sore throat can vary depending on the exact cause.

Common signs and symptoms include:

  • a scratchy sensation in the throat
  • pain in the throat area that becomes worse when swallowing or talking
  • difficulty swallowing
  • sore or swollen glands in the neck or jaw area
  • swollen red tonsils
  • a hoarse or muffled voice
  • coughing, sneezing, and a runny nose
  • a fever

In children

Sore throats are common in every age group, but they are most common among children aged 5–15 years, according to the CDC.

Strep throat is more common in children than in adults. The exact symptoms depend on the age, but, in addition to a sore throat, they may include:

  • a fever
  • tender, swollen lymph nodes in the neck
  • being cranky
  • a reduced appetite
  • swollen tonsils with signs of pus
  • small red spots on the roof of the mouth
  • a headache
  • abdominal pain, nausea, and vomiting, especially in children

Before the age of 3 years, strep throat is uncommon, and symptoms tend to be less severe.

A doctor may prescribe antibiotics for a strep throat, to prevent future complications.

Viral infections are the most frequent cause of a sore throat in children. These will not respond to antibiotics, but a doctor may prescribe treatment to relieve the discomfort.

The symptoms of epiglottitis include:

  • a severely sore throat
  • difficulty swallowing and breathing
  • a high pitched sound on breathing in
  • drooling
  • skin that looks blue, due to a lack of oxygen

If a child has these symptoms, they need immediate medical attention.

In the past, epiglottitis was common, but since routine Haemophilus influenza type b (Hib) vaccinations began in 1985, its yearly incidence in children has fallen by 99 percent to fewer than 1 in every 100,000 children, according to a report published in 2016.

In adults

Bacterial and viral infections are also common in adults. The symptoms and treatment are similar to those for children.

Epiglottitis causes the same symptoms in adults as for children. It needs emergency medical attention.

It is rare, but the annual incidence in adults has risen since 1986 from one in every 100,000 people to around 2–3 adults every100,000.

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A doctor will carry out a physical examination and try to find the cause.

Most sore throats go away on their own within 5–10 days, and home treatment is usually enough.

Sometimes, however, medical treatment is necessary.

The American Academy of Otolaryngology, Head, and Neck Surgery suggest that a person should see a doctor if they have:

  • a severe and persistent sore throat that does not go away
  • difficulty breathing, swallowing, or opening the mouth
  • swelling in the face or neck
  • a fever of 101°F or above
  • blood in the saliva or mucus
  • a lump in the neck
  • hoarseness that lasts over 2 weeks
  • earache
  • a rash

Taking a swab

If a doctor suspects that a sore throat is bacterial, they will often start by taking a throat swab for testing in the lab to determine if a strep infection is present.

There are a few ways to do this.

The doctor takes a sample by touching the back of the throat and tonsils with a cotton-tipped applicator. In the lab, someone will smear the sample in a culture dish. If strep bacteria is present, it will grow. This usually takes 24 hours.

A rapid strep test can provide results in minutes. Sometimes a doctor will recommend a culture test to confirm a negative result from a rapid strep test.

If the test is negative, the infection is due to a virus, and antibiotics will not help.

If the strep test is positive, the doctor can prescribe an antibiotic.

EBV test

If a doctor suspect EBV, they can recommend a blood test to confirm this. Find out more in our dedicated article.

Sometimes, a sore throat can happen for another reason, such as a tumor. If the problem does not go away, the doctor will do more investigations to find the cause.

The treatment will depend on the cause of the sore throat.

Bacterial infection: In the case of a bacterial infection, such as strep throat, a doctor may prescribe an antibiotic. People should always take the complete course, even if they feel better before finishing all the medication.

Viral infection: Sore throats due to a viral infection usually start to improve within 7 days and do not require medical treatment. Acetaminophen or mild pain relievers may help with the pain and fever. Children can use pediatric versions of these. A pharmacist can advise which ones to use and how much.

It is important always to follow the instructions on the medication and not to take more than they suggest.

A person with epiglottitis or may need to spend time in the hospital. In severe cases, they may need intubation to help them breathe.

If investigations reveal a tumor or another cause, the doctor will discuss appropriate treatment options with the individual.

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Warm honey and lemon or ginger tea can be a soothing home remedy.

A few home care strategies may help to relieve sore throat symptoms:

  • getting plenty of rest
  • drinking plenty of fluids to keep the throat moist and prevent dehydration
  • cold treats, such as popsicles, for children
  • gargling with warm, salt water or apple cider vinegar
  • lozenges or hard candy to soothe a sore throat and a cough for children over the age of 4 years and adults

Soothing drinks for a sore throat

Consuming warm liquids can help ease the discomfort.

Drinks that people use include:

  • warm lemon or water with honey
  • ginger tea
  • licorice root tea

Cautions for children

Honey is not safe for children aged under 1 year, due to the risk of botulism, a type of food poisoning.

Lozenges and hard candy can be a choking hazard and are not suitable for young children.

Alternative remedies

Some other home remedies may be useful, but they may not be safe for everyone.

Zinc acetate lozenges are available as an over-the-counter remedy.

A review of three studies published in 2015 concluded that dissolving tablets containing a high dose of zinc acetate in the mouth may relieve symptoms of a common cold in adults, including a sore throat.

However, more evidence is needed to show that it works and that it is safe in the long term. It can also have some adverse effects, including nausea and a bad taste in the mouth.

Zinc nasal sprays are also available, but some people have experienced a permanent loss of smell after using them. Children should not use these products.

Other remedies that people use include:

Some of these may be useful because of their possible anti-inflammatory properties. However, there is a lack of evidence to prove that many these treatments are effective or safe.

Some, such as vitamin C, will have no additional effect once a person has a cold.

However, a study published in 2017 concluded that extracts of clove, ginger, danshen, and Echinacea flower may reduce the inflammation that can occur with strep throat.

Click here to learn about 15 home remedies for a sore throat.

People should avoid unproven home remedies if they are:

  • aged under 18 years
  • pregnant
  • have certain health conditions

Always check with a doctor or health professional before taking any alternative remedies, to make sure they are safe to use and that they will not interact with another medication.

Some simple steps can help to prevent a sore throat.

To avoid the microbes that can cause a sore throat:

  • wash the hands often, including after sneezing and coughing
  • avoid touching your nose or mouth
  • do not share food, eating utensils, or drinking glasses
  • cough or sneeze into a tissue, throw it away, and immediately wash both hands
  • avoid touching public drinking fountains with your mouth
  • avoid close contact with people who are sick and stay away from people if you are sick
  • use alcohol-based hand sanitizers if soap and water are unavailable
  • avoid smoking or being near smoke

A sore throat can be uncomfortable, but most are not serious, and they usually go away quickly. Home remedies and over-the-counter medication can soothe the symptoms.

However, if symptoms are severe, persistent, or if a person has difficulty breathing, they should see a doctor. If it is strep throat, they will prescribe antibiotics.