Sore throats
WHAT IS A SORE THROAT?
A sore throat can be an uncomfortable condition. In most cases, a sore throat is nothing to worry about and will get better on its own, but it can cause symptoms such as pain when swallowing and a dry, scratchy throat. These symptoms can vary in severity depending on the cause of the sore throat.
TYPES & CAUSES OF SORE THROATS
From a sore throat and tonsilitis to strep A and glandular fever, we’re here to help you effectively manage and ease the symptoms associated with the different types of sore throat.
A sore throat is very common and can cause irritation and pain when swallowing. They’re often nothing to worry about but can be a little uncomfortable. Sore throats can make it hard to swallow when you eat and drink and may affect your ability to get a good night’s sleep, as well as generally making you feel unwell.
Sore throats are usually caused by viruses like a cold or the flu, from smoking or occasionally they may be caused by bacteria. They can also be caused by:
• Tonsilitis – an infection of the tonsils at the back of your throat
• Strep throat – a bacterial throat infection
• Laryngitis – when your voice box or vocal cords become irritated or swollen
• Glandular fever – a viral infection
You can find more information on these conditions under the types of sore throats section.
While your sore throat may be causing dryness and irritation, you may also experience the following symptoms:
• A dry, scratchy throat
• Redness in the back of your mouth
• Bad breath
• A mild cough
• Swollen and red tonsils
• Swollen glands in your neck
Symptoms of a sore throat usually clear up on their own within a week, however, speak to your GP if your sore throat doesn’t improve after a week or you often get sore throats. A severe or long-lasting sore throat could be a bacterial infection like strep throat.
You should get advice from 111 if:
• You’re worried about your sore throat
• You have a sore throat and a very high temperature, or you feel hot and shivery
• You have a weakened immune system, for example, because of diabetes or chemotherapy
You should call 999 if you or your child:
• Have difficulty swallowing or breathing
• Are drooling – This can be a sign of not being able to swallow
• Are making high-pitched sounds as you breathe (called stridor)
• Have severe symptoms that are getting worse quickly
If your sore throat is causing you pain and discomfort, there are a few things you can do to help alleviate symptoms:
• Drink plenty of water (aim for six to eight glasses), and avoid very hot drinks
• Eat cool, soft foods such as yoghurts
• Avoid smoking and smoky places
• Suck lozenges, hard sweets, ice cubes or ice lollies (don’t give anything small to young children as this poses a choking hazard)
• Try gargling with warm, salty water (children should not try this)
If you have a high temperature or you don’t feel well enough to do your day-to-day activities, try to stay at home and avoid contact with other people until you feel better.
If you have a mild sore throat, trying the above tips should help soothe it. You can also visit your local Boots pharmacy and speak to a member of the pharmacy team for advice on sore throat remedies. They may suggest:
• Pain relief such as ibuprofen or paracetamol, if suitable for you. Always read the label.
• Medicated lozenges containing a local anaesthetic, antiseptic or anti-inflammatory medicine
• Anaesthetic sprays – although there isn’t much evidence to support these working, some people may find them helpful
These can all be bought from retailers without a prescription.
Antibiotics aren’t usually prescribed for a sore throat because they’re unlikely to relieve sore throat pain or speed up your recovery. They’re only prescribed if your GP thinks you have a bacterial infection like strep throat.
Just like adults, sore throats in children are often caused by viral illnesses such as colds or the flu. Your child's throat may be dry and sore for a day or two before a cold starts. Children with a sore throat may also experience:
• Pain in the throat and discomfort when swallowing
• Being less active or having less energy than usual
• A mild cough
• A high temperature (fever) of 38°C or more – this could be a sign of a throat infection
• Dry and scratchy throat
• Redness at the back of the throat
• Swollen glands – Feel your child’s neck for any swelling – If the glands are inflamed, this could be what is causing a sore throat
Most sore throats get better on their own after a few days, however, if your child has a sore throat for four days or more, has a high temperature or is feeling generally unwell, speak to your GP or call 111 for advice. Seek immediate medical advice if your child has a sore throat and any of the following symptoms:
• Red, swollen tonsils
• White patches or pus on the back of the throat
• Swollen lymph nodes in the neck
• Blood in saliva
• A rash on the skin
• A hoarse voice
• Showing signs of dehydration
If your child can’t swallow fluids or saliva, is drooling or has any difficulty breathing, go to A&E or call 999 immediately as they'll need urgent treatment in the hospital. Ways to help ease a sore throat include:
• Keeping them hydrated
• Ensuring they get plenty of rest
• Giving them cool or soft foods such as mashed potato, soups and smoothies
• Sucking on an ice lolly, ice cubes or hard sweets (don’t give anything small to young children as this poses a choking hazard)
• Avoiding smoking around your child or taking them to smoky places
You may also want to consider pain relief such as:
• Calpol Fastmelts from the age of six years – these contain paracetamol to relieve sore throat pain and dissolve in the mouth without water. Always read the label
• Age-appropriate paracetamol or ibuprofen, if suitable for them
Do not give paracetamol to babies younger than two months old, unless it is prescribed by a doctor. Always read the label of each product for an age-appropriate dose. Discover sore throat, cough and cold remedies for children.
Under the new NHS service, Pharmacy First,32 our pharmacists are now equipped to provide additional support for sore throats for people in England.
No appointment is needed, and we can offer additional advice and treatment, including certain prescription-only medicines where appropriate, for individuals aged 5 and over who live in England. It's a convenient option to address minor health concerns without the need for a GP visit. When you approach our pharmacy team, they may:
• Ask about your symptoms
• Give advice on how to manage sore throat symptoms effectively
• Recommend certain treatments for a sore throat, if appropriate
• Refer you to another healthcare professional, such as your GP, for further support or advice if they feel this is necessary
Under the Pharmacy First service, individuals aged 5 years and over can access additional advice and treatment for sore throats at our pharmacies. However, certain exclusions apply, including pregnant women under 16.
Visit your local Boots pharmacy today for reliable advice on managing sore throat symptoms.
Tonsilitis is inflammation of the tonsils, which are two small, soft glands that sit at the back of the throat. It’s most common in children, although teenagers and adults can get it too.
It’s usually caused by a viral infection, such as the common cold or the flu virus (influenza). However, it can sometimes be caused by a bacterial infection, typically a strain of bacteria called group A streptococcus bacteria.
These types of infections spread easily, so it’s important to avoid public places until symptoms have cleared up. It’s also recommended to regularly wash your hands with soap and water (especially before eating and after going to the toilet) and coughing or sneezing into a tissue and dispose of it straight away to avoid passing the infection to others.
Initially, tonsilitis can feel like a bad cold or the flu and can cause symptoms such as:
• Red and swollen tonsils
• A sore throat
• Problems swallowing
• A high temperature (fever) of 38°C or above
• Coughing
• A headache
• Feeling sick
• Earache
• Feeling tired
Some people may experience more severe symptoms including:
• Swollen, painful glands in your neck (feels like a lump on the side of your neck)
• White, pus-filled spots on your tonsils
• Bad breath
Symptoms of tonsilitis usually clear up within three to four days but see your GP if:
• Your symptoms last longer than four days
• You keep getting throat infections
• Your symptoms are severe or you are worried about them
Get advice from 111 or call 999 urgently if:
• You're unable to eat or drink due to the pain
• You have pus-filled spots on your tonsils
• You have difficulty breathing
Although there’s no specific treatment for tonsilitis, there are a few things you can do to help alleviate the symptoms, including:
• Drink cool drinks to soothe the throat
• Get plenty of rest
• Gargle with warm, salty water (not suitable for children)
• Consider paracetamol or ibuprofen, if suitable for you
• Consider lozenges or a throat spray, speak to a member of the pharmacy team for advice about products which may be suitable for you
If you have a severe case of tonsillitis that doesn't clear up on its own, visit your GP. They may swab your throat to test for bacteria and will usually wait for the test results before considering treatment. If the infection is confirmed to be bacterial, they may prescribe a course of antibiotics. If the infection is viral, it will usually clear up on its own. In rare cases, some people may have surgery to remove their tonsils. This is usually if you have severe tonsillitis that keeps coming back. Find more information on tonsillitis.
Strep A is a common type of bacteria, known as group A streptococcus (GAS), which is found in the throat or on the skin. It can cause infections of the throat that range from mild to severe. GAS infections commonly show as a mild sore throat, known as strep throat, and are most common in children, although adults can sometimes get them.
Symptoms of strep A include:
• Flu-like symptoms, such as a high temperature, swollen glands or an aching body
• A sore throat (strep throat or tonsillitis)
• Severe muscle aches
• Nausea and vomiting
• A rash that feels rough, like sandpaper (scarlet fever)
• Scabs and sores (impetigo)
• Pain and swelling (cellulitis)
Strep A is highly contagious. If you’re concerned about your child’s symptoms, contact your local Boots pharmacy and one of our pharmacists will be able to provide advice about symptoms and recommend suitable products, if appropriate. However, if your child has symptoms that indicate they may have scarlet fever, impetigo, or cellulitis or their symptoms are severe, contact your GP or call 111 for advice as soon as possible.
It can sometimes be difficult to tell if your child has strep A, but always trust your instincts and either make an urgent appointment with your GP or call 111 if they:
• Are unwell or they’re getting worse
• Aren’t feeding or eating as much as usual
• Are very tired or irritable
• Have fewer wet nappies than usual or are peeing less than usual, or showing other signs of dehydration
• Are under three months old and have a temperature of 38°C, or are three to six months old and have a temperature of 38°C or higher
Sometimes Strep A can be serious. You must call 999 or go to A&E if your child:
• Is having difficulty breathing – they might make grunting noises, or you may notice their tummy sucking under their ribs
• Pauses when they breathe
• Has blue or grey skin, tongue or lips – on black or brown skin this may be easier to see on the palms of the hands or soles of the feet
• Is floppy and will not wake up or stay awake
Most strep A infections are mild and can be treated with a course of antibiotics. It’s recommended to stay away from work, school or nursery for 24 hours after taking antibiotics to help stop the infection from spreading. In rare cases when strep A is serious (known as invasive group A strep, iGAS), treatment in a hospital with antibiotics is needed.
Some people may be more at risk of strep A, particularly those with a weakened immune system, open sores and wounds or having certain viral infections, such as a cold or the flu.
Strep A can easily be passed from one person to another. To reduce the risk of spreading infection, try to:
• Avoid close contact with someone infected with strep A
• Teach your child to wash their hands properly, with soap and water for at least 20 seconds at a time
• Cover the mouth and nose with a tissue when coughing or sneezing
• Bin used tissues as quickly as possible and wash hands after, if possible
Find more information on Strep A.
Laryngitis is when your voice box (the larynx) or vocal cords in the back of the throat become irritated or swollen. In most cases, laryngitis usually clears up on its own within a week or two. Typically, laryngitis is caused by an infection from a virus like the flu. You can protect yourself from the flu by having a flu vaccination, a Winter Flu Jab Service1 is available at Boots.
It can also be caused by:
• Allergies to things like dust and fumes
• Acid reflux (where acid from your stomach travels up your throat)
• Coughing over a long period of time
• Always clearing your throat
• Damage to your larynx from straining your voice
Laryngitis can come on suddenly, with symptoms being at their worst in the first three days. Symptoms of laryngitis include:
• A hoarse voice
• Difficulty speaking and sometimes losing your voice
• An irritating cough that doesn’t go away
• Constantly needing to clear your throat
• A sore throat
Children may also experience the following:
• A high temperature (fever) of 38°C or above
• Lack of appetite
• Having difficulty breathing – This is due to children having narrower windpipes and larynx swelling, however, this is rare
Laryngitis is also linked to other illnesses such as a cold or the flu, meaning you may notice other symptoms. You normally only need to see your GP for laryngitis if your symptoms are severe, they last longer than two weeks or you keep getting laryngitis. However, call 111 if you or your child find it painful or difficult to swallow and call 999 or go to A&E if you or your child are having difficulty breathing. As laryngitis generally goes away on its own, there are a few dos and don’ts which can help ease your symptoms, as well as reduce your risk of getting laryngitis and spreading it to others.
Do:
• Try to speak as little as possible
• Keep the air moist by using a humidifier or inhale steam – central heating and air conditioning can make the air dry
• Gargle with warm salty water (children should not try this)
• Avoid smoky and dusty places
• Raise your head with pillows when you sleep to help relieve acid reflux
• Wash hands with soap and water before eating and after using the toilet
• Avoid having close contact with people who have respiratory infections, such as a cold or flu
Don’t:
• Smoke, if you do smoke
• Talk too loudly or whisper – these can strain your vocal cords
• Drink too much caffeine or alcohol as these can cause dehydration
• Clear your throat regularly, try swallowing instead
You can also visit your local Boots pharmacy for advice from one of our pharmacy team members. They can give advice and recommend an appropriate treatment, including:
• Pain relief such as paracetamol or ibuprofen, if suitable for you
• Throat lozenges for the pain
In some cases, if your laryngitis has been caused by an infection, your GP may suggest some antibiotics. Speak to your GP if you think you have laryngitis, your symptoms are severe or they last longer than two weeks..
Glandular fever is a viral throat infection that typically affects teenagers and young adults. It can make you feel generally unwell and last for several weeks. For most people, glandular fever gets better on its own without treatment, but symptoms can be very unpleasant, including:
• A very high temperature
• Feeling hot and shivery
• A severe sore throat
• Swelling glands on either side of your neck
• Extreme tiredness or exhaustion
• Tonsillitis that’s not getting better
If you have any of these symptoms, speak to your GP. However, if you have difficulty swallowing, severe stomach pain or difficulty breathing, call 999 or go to A&E. Your GP may do a blood test to confirm it’s glandular fever and to check for the Epstein-Barr virus (EBV) which causes glandular fever. Glandular fever is spread through the saliva of someone who carries the infection, so you can get it through kissing (it’s known as the ‘kissing disease’), sharing food utensils and exposure to coughs and sneezes.
There’s currently no treatment for glandular fever, however, there are a few self-help things you can try doing at home to help ease your symptoms while you recover, such as:
• Resting and getting plenty of sleep
• Drinking plenty of fluids to avoid dehydration
• Consider pain relief like paracetamol or ibuprofen, if suitable for you
• Avoiding alcohol – your liver may be weak during your infection
Someone with glandular fever is infectious for up to seven weeks before symptoms start to appear. To help reduce the risk of glandular fever spreading, avoid kissing others and sharing cutlery, cups or towels with those who are infected. You should also wash your hands regularly for at least 20 seconds with soap and warm water, as well as regularly wash bedding and clothing that may have saliva on them.
You should feel better within two to three weeks but some people may feel extremely tired for months after. Try to gradually increase your activity when your energy starts to come back. Keep in mind that glandular fever can sometimes cause your spleen to swell so it’s best to avoid heavy lifting, sports or any activities that might increase your risk of falling as this may damage your spleen. Speak to your GP for advice if you’re unsure.
Thyroiditis is the inflammation and swelling of the thyroid gland, causing unusually high or low levels of thyroid hormones in the body. The thyroid is a butterfly-shaped gland that sits in the neck and is responsible for producing hormones that control the body’s metabolism and growth. There are several types of thyroiditis.
Hashimoto's thyroiditis
Hashimoto’s thyroiditis is caused by the immune system attacking the thyroid gland, which damages it and makes it swell. As the thyroid becomes more damaged over time, it’s unable to produce enough of the thyroxine (T4) thyroid hormone, which can cause an underactive thyroid and cause symptoms such as tiredness, weight gain and dry skin. The swollen thyroid may also cause a lump to form (goitre) in your throat.
Symptoms can vary from person to person but it’s important to see your GP if you think you have Hashimoto’s thyroiditis.
Postpartum thyroiditis
Postpartum thyroiditis is a relatively uncommon condition that affects people who have recently given birth, particularly those with type 1 diabetes or those who have had postpartum thyroiditis before. It’s caused by the immune system attacking the thyroid gland within six months of giving birth, triggering a temporary rise in thyroid hormone levels and symptoms of an overactive thyroid gland. After a few weeks, the gland becomes depleted of the thyroid hormone which can lead to symptoms of an underactive thyroid gland such as tiredness, low mood and weight gain. If you think you have postpartum thyroiditis, speak to your GP.
De Quervain's (subacute) thyroiditis
De Quervain's thyroiditis is a painful swelling of the thyroid gland which is thought to be caused by a viral infection, such as mumps or the flu.
It's most commonly seen in women aged 20 to 50 and can cause symptoms such as a high temperature and pain in the neck, jaw or ear. The thyroid gland can also release too much thyroid hormone into the blood which can lead to symptoms of an overactive thyroid gland. You may want to consider pain relief such as paracetamol to help manage the pain, if suitable for you. If this doesn’t help, you may be prescribed an anti-inflammatory medicine. If you think you have De Quervain's thyroiditis, speak to your GP.
Acute or infectious thyroiditis
This type of thyroiditis is often caused by a bacterial infection. It's quite rare and is usually associated with a weakened immune system (in adults) or a problem with the development of the thyroid (in children). Acute or infectious thyroiditis can cause symptoms such as pain in the throat, generally feeling unwell, swelling of the thyroid and sometimes symptoms of an overactive or underactive thyroid gland. However, these symptoms usually improve once the infection is treated with antibiotics.
If you think you have acute or infectious thyroiditis, speak to your GP.
Drug-induced thyroiditis
Some medicines can damage the thyroid and cause symptoms of an overactive or underactive thyroid gland. The symptoms are usually short-lived and may get better after you stop taking the medicine if agreed with by your doctor. You may experience pain around the thyroid, however, you can help ease this discomfort by considering pain relief such as ibuprofen, if it’s suitable for you. If you think you have thyroiditis, speak to your GP. You can also check the health of your thyroid by using the Boots Online Doctor Thyroid Home Test Kit.5 This test works by checking your blood for TSH (thyroid stimulating hormone) and T4 (thyroxine) which may indicate a problem with your thyroid gland. You can find more information on The British Thyroid Foundation.
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Do not take more than 1 paracetamol-containing product at a time
LEARN MORE ABOUT SORE THROATS
FREQUENTLY ASKED QUESTIONS
If you have a sore throat, there are a few things you can try to help ease symptoms. These include:
• Drinking plenty of water (aim for six to eight glasses), and avoid very hot drinks
• Eating cool, soft foods such as mashed potato or yoghurts
• Avoiding smoking and smoky places
• Sucking lozenges, hard sweets, ice cubes or ice lollies (do not give children anything small as this poses a choking hazard)
• Trying gargling with warm, salty water (not recommended for children)
• Consider taking pain relief such as ibuprofen or paracetamol, if suitable for you
• Considering an anaesthetic throat spray – although there isn’t much evidence to support this, some people may find it helpful
Everyone is different and may experience a variety of symptoms and severity. If you’re concerned about your sore throat and trying the above methods hasn’t worked, speak to your GP for advice
Strep throat is a bacterial infection of the throat that can make it feel irritated and scratchy. It’s caused by a type of bacteria known as group A streptococcus (GAS), which is found in the throat or on the skin. It’s very contagious and can cause symptoms such as:
• A sore throat that starts suddenly
• Red and swollen tonsils
• Swollen or painful neck glands (lymph nodes)
• A high temperature of 38°C or more
If you think you or your child has strep throat, speak to your GP. They may prescribe you a course of antibiotics. Find more information on strep A and strep throat.
If your sore throat is caused by a viral infection, then no, you don’t normally need antibiotics. This is because they won’t usually relieve your symptoms or speed up your recovery. Antibiotics may only be prescribed by your GP if they think you could have a bacterial infection, such as strep A. Speak to your GP if you’re concerned about your sore throat or you think you have a bacterial throat infection.
Tonsil stones are white or yellow stones that can form at the back of the throat on the tonsils (the two soft masses at the back of the throat).
The tonsil stones are made up of minerals, such as calcium salts. They can also be caused by an accumulation of debris from surrounding cells and germs getting stuck in the crevices of the tonsils which then harden. You may be at greater risk of getting tonsil stones if you smoke, have poor oral hygiene or have recurrent tonsil infections such as tonsilitis.
They can either be hard or quite soft and can cause the following symptoms:
• A feeling of something being stuck at the back of your throat, or irritating it
• Bad breath
• A sore throat or discomfort when you swallow
• Difficulty swallowing
• A bad taste in your mouth
• An irritating cough
In most cases, tonsil stones can be removed at home without any medical treatment. Methods such as gargling warm salt water may help dislodge the stones. Alternatively, you may want to consider trying cotton swabbing which involves gently massaging around your tonsils with a cotton bud to push the stones loose. If they’re causing discomfort or keep triggering bacterial throat infections, speak to your GP.
Tonsilitis itself is not contagious, however, most of the infections that cause it are.
Most cases of tonsillitis are caused by a viral infection, such as the viruses that cause the common cold or the flu virus (influenza), but it can also be caused by bacterial infections. This means that tonsilitis is easily spread through coughing, sneezing and by coming into close contact with someone who has tonsilitis.
The best way to prevent tonsilitis from spreading from person to person is to:
• Stay away from public places, such as work, school or nursery until your GP says it's safe to return (this is usually after the symptoms have subsided)
• Cough and sneeze into a tissue and dispose of the tissue
• Wash your hands before eating, after going to the toilet and after coughing and sneezing. Do this with soap and warm water for at least 20 seconds
Strep A and scarlet fever are both bacterial infections.
Although strep A and scarlet fever share some symptoms such as a sore throat and a high temperature, the main difference between the two is that a rash appears on the skin with scarlet fever. The rash looks like small, raised bumps and starts on the chest and tummy, then spreads over the body anywhere between 12 and 48 hours of infection. This can cause skin to feel rough, like sandpaper.
Scarlet fever also causes a white coating on the tongue which peels, leaving the tongue red, swollen and covered in little bumps, known as ‘strawberry tongue’. Find more information on scarlet fever.
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5 Access to test kits is subject to an online consultation with a clinician to assess suitability. Subject to availability. Charges apply.
32 Supply of treatment is subject to a suitability assessment. In most stores in England only. Subject to availability and store opening hours. Charges may apply.
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