Here's the difference between a sore throat and strep

Every year, tens of millions of Americans pay a visit to their primary care doctor hoping to get relief from unpleasant symptoms associated with an illness or infection. Some such symptoms include a stuffy nose or low-grade fever that are associated with the common cold; itchy or watery eyes as occur with seasonal allergies; or nausea, chills and diarrhea, as are frequently experienced when one has the flu. 

Sore throats are another common ailment people experience throughout the year - but more often during fall and winter months. While a sore throat can be a side effect of many other illnesses, it's the most telling symptom of strep throat - contributing to more than 5 million physician visits a year in the United States, per the Centers for Disease Control and Prevention. 

What does strep throat look like? 

The first thing to understand is that strep throat isn't a virus the way many other seasonal ailments are but is instead a contagious bacterial infection. It causes inflammation and discomfort by affecting the throat and tonsils, "which are the lymph nodes in the back of your mouth," says Dr. Jason Nagata, a pediatrician at UCSF Benioff Children’s Hospital in San Francisco. 

Though strep throat is most common in children ages 5-12, Nagata says, "it can affect people of all ages." He explains that someone experiencing strep throat usually has a fever and throat pain, or a "scratchy" discomfort that is exacerbated when talking or swallowing. 

Beyond the pain and discomfort associated with strep throat, one of the most frustrating aspects of the infection is that, to many people, it looks very similar to a sore throat. This is one reason a throat culture or rapid test "is needed to confirm it," says Dr. Melissa Zheng, an otolaryngologist at Mayo Clinic in Arizona. 

Still, the infection has some distinct symptoms, notes Dr. David Levine, a pediatrician and the Chief of General Pediatrics at the Atlantic Health System’s Goryeb Children’s Hospital in New Jersey.  For one, "the throat will often be red with swollen tonsils, sometimes with pus on them," he says. And the pain associated with strep throat is usually more intense than the pain associated with a typical sore throat. 

Nagata explains that the lymph nodes on your neck may also be tender to touch and that you may develop tiny, red spots on the roof of your mouth. "With some strains of the bacteria, a rash may also develop," he adds. "The rash typically starts on the neck and chest but can spread to other areas of the body." 

The fever associated with strep throat may also be more pronounced than someone dealing with a typical sore throat - "and some people may also have a headache and stomach pain," says Zheng. 

What causes strep throat? 

Strep throat is caused by the bacteria Streptococcus pyogenes, or group A streptococcus. "These bacteria are contagious and can be spread through droplets when someone coughs or sneezes or through sharing food or drinks," says Nagata.

It's also possible to become infected by touching a surface that has the bacteria on it - such as a counter, doorknob, or toilet handle - then touching your nose, eyes or mouth.

Can strep throat go away on its own?

No matter how you become infected, strep throat won't just go away on its own like viruses do. As a bacterial infection, it requires antibiotics. "Unless someone is allergic, penicillin is the drug of choice," says Levine. Amoxicillin is also commonly used. He explains that within 24 hours of starting antibiotics, the infected person "is no longer contagious and should be fever-free soon after."

Even once symptoms begin to subside, however, "it's important to take the full course of prescribed antibiotics," says Zheng. 

Until the antibiotics kick in and clear the infection up, there are things that can minimize the pain and discomfort associated with strep throat. These include throat sprays, cough drops, lozenges, humidification, and gargling saltwater.