A sore throat is one of the most common everyday symptoms. It may feel scratchy, raw, dry, swollen or painful when swallowing. Sometimes it comes with a cough, blocked nose or hoarse voice. Other times it feels more severe, with swollen tonsils, fever, tender neck glands or white spots at the back of the throat.
Most sore throats are caused by viral infections and improve on their own within about a week. But not every sore throat is the same. Some are caused by tonsillitis, strep throat, glandular fever, allergies, reflux, smoking, dry air or irritation. A smaller number need medical assessment, especially if symptoms are severe, persistent, one-sided, or linked with breathing or swallowing difficulty.
This guide explains common causes of sore throat, what may help at home, when a pharmacist can advise, and when to contact a GP, NHS 111 or 999.
Important: Seek urgent help if you have difficulty breathing, cannot swallow saliva, are drooling, have severe swelling, a stiff neck, confusion, a non-blanching rash, or feel seriously unwell.
What causes a sore throat?
A sore throat is usually a sign that the lining of the throat is irritated or inflamed. This can happen because of infection, allergy, dryness, acid reflux, voice strain or exposure to smoke and pollution.
The most common causes include:
- common cold and other viral infections
- flu or COVID-like illnesses
- tonsillitis
- strep throat or scarlet fever
- glandular fever
- hay fever and post-nasal drip
- acid reflux or GORD
- dry indoor air
- smoking, vaping or smoky environments
- voice strain from shouting, singing or talking for long periods
The NHS says sore throats are very common and usually get better by themselves within a week. Self-care such as drinking water, resting, avoiding smoky places and using warm salty gargles can help soothe symptoms. NHS sore throat guidance gives further practical advice.
Viral sore throat: the most common cause
Most sore throats are viral. This means antibiotics will not usually help, because antibiotics treat bacterial infections, not viruses.
A viral sore throat often comes with symptoms such as:
- runny or blocked nose
- cough
- sneezing
- hoarse voice
- mild fever
- headache
- tiredness
- general aches and pains
With a viral illness, the sore throat may be worst for the first two or three days, then gradually improve. A cough or blocked nose may last longer.
If coughing is one of your main symptoms, you may also find our guide to cough in adults useful. For children, see coughs and colds in children.
Tonsillitis
Tonsillitis means inflammation of the tonsils, the two soft lumps at the back of the throat. It can be caused by viruses or bacteria. It is common in children and teenagers, but adults can get it too.
Symptoms can include:
- a sore throat
- pain when swallowing
- red, swollen tonsils
- white spots or pus on the tonsils
- fever
- swollen glands in the neck
- bad breath
- ear pain
NHS guidance says tonsillitis usually gets better on its own after a few days, although it can last longer. Rest, cool drinks, suitable pain relief and warm salty gargles may help symptoms. See the NHS page on tonsillitis for more detail.
Antibiotics are not always needed. A GP may consider them if a bacterial infection is likely, symptoms are severe, or you are at higher risk of complications.
Strep throat and scarlet fever
Strep throat is caused by group A streptococcal bacteria. It can cause a sudden sore throat, fever, swollen glands and painful swallowing. It is less likely to cause a cough or runny nose than a viral cold.
Scarlet fever is also caused by group A strep. It often begins with flu-like symptoms, including a high temperature, sore throat and swollen neck glands. A rash usually appears 12 to 48 hours later and may feel rough, like sandpaper. The NHS has a clear overview of scarlet fever symptoms.
You should contact a GP or NHS 111 if you or your child has a sore throat with a high temperature and a sandpaper-like rash, or if scarlet fever is suspected. Scarlet fever is usually treated with antibiotics to reduce the risk of complications and help stop it spreading.
Glandular fever
Glandular fever can cause a very sore throat, fever, swollen glands and extreme tiredness. It is most common in teenagers and young adults, but it can affect people at other ages too.
Symptoms may include:
- a severe sore throat
- swollen glands in the neck and sometimes elsewhere
- high temperature
- extreme fatigue
- headache
- swollen tonsils
- a rash in some people
Glandular fever usually improves over time, but the tiredness can last for weeks or longer. The NHS notes that symptoms can include a high temperature, swollen glands, sore throat, headache and tiredness. You can read more about glandular fever.
If you have a severe sore throat with marked fatigue and swollen glands, especially if symptoms are lasting longer than a usual cold, speak to a GP. If fatigue is a major ongoing symptom, you may also find our guide to fatigue and constant tiredness helpful.
Hay fever, allergies and post-nasal drip
Not all sore throats are infections. Hay fever and allergies can irritate the throat, especially when mucus runs from the back of the nose down into the throat. This is called post-nasal drip.
An allergy-related sore throat may come with:
- sneezing
- itchy nose, eyes or throat
- clear runny nose
- blocked nose
- cough from throat irritation
- symptoms that worsen outdoors, around pollen, dust or pets
If symptoms are seasonal, pollen-related or worse in spring and summer, see our guide to hay fever symptoms and treatment. For children, see spring allergies in children.
Acid reflux and throat irritation
Acid reflux can also cause a sore throat. This happens when acid from the stomach travels up towards the throat, irritating the lining. Some people have obvious heartburn. Others mainly notice throat symptoms.
Reflux-related throat symptoms can include:
- burning in the chest or throat
- sour or bitter taste in the mouth
- hoarse voice
- throat clearing
- cough, especially at night
- a feeling of a lump in the throat
- worse symptoms after meals or when lying down
If this sounds familiar, read our guide to heartburn, acid reflux and GORD.
Dry air, smoking and voice strain
A dry, scratchy throat can happen after sleeping with your mouth open, spending time in heated indoor air, using air conditioning, shouting, singing, vaping or being around smoke.
This type of sore throat may feel worse in the morning or after heavy voice use. It may improve with fluids, voice rest, avoiding smoke, and keeping the air less dry. If hoarseness lasts more than three weeks, especially if you smoke or have other symptoms, speak to a GP.
What helps a sore throat at home?
For most mild sore throats, self-care is enough. The aim is to keep comfortable, stay hydrated and give the throat time to recover.
Things that may help include:
- drink plenty of water
- rest where possible
- eat soft or cool foods if swallowing is painful
- avoid smoking, vaping and smoky places
- try warm drinks, such as tea with honey, if suitable
- suck ice lollies, ice cubes or lozenges if safe for your age
- gargle with warm salty water if you are an adult
- use suitable pain relief, such as paracetamol or ibuprofen, if you can take them
Children should not gargle salty water if they may swallow it or choke. Do not give young children hard sweets or lozenges because of choking risk. Honey should not be given to babies under 1 year old.
If you are taking other medicines, are pregnant, have asthma, stomach ulcers, kidney disease, liver disease, or are unsure which pain relief is suitable, ask a pharmacist.
Do antibiotics help a sore throat?
Most sore throats do not need antibiotics. Many are caused by viruses and will improve on their own. Taking antibiotics when they are not needed can cause side effects and contributes to antibiotic resistance.
Antibiotics may be considered when a bacterial infection is likely, symptoms are severe, there is scarlet fever, or someone is at higher risk of complications. A GP may use your symptoms, examination findings and sometimes tests to decide.
It is reasonable to ask, “Is this likely to be viral or bacterial?” and “What symptoms should make me come back?” rather than expecting antibiotics automatically.
When to see a pharmacist
A pharmacist is often a good first step for a sore throat, especially if symptoms are mild to moderate and you do not have red flags. They can advise on pain relief, throat sprays, lozenges, allergy medicines, reflux treatments and whether you may need a GP appointment.
In some parts of the UK, pharmacies can also provide advice and treatment for certain common infections through NHS services. Availability depends on where you live and your symptoms.
For more on this route, see our guide to when to see a pharmacist instead of a GP.
When to contact a GP or NHS 111
Most sore throats improve within about a week. Contact a GP, NHS 111 or seek medical advice if:
- your sore throat is severe or getting worse
- symptoms have not improved after a week
- you keep getting sore throats
- you have a high temperature or feel hot and shivery
- you have swollen glands and extreme tiredness
- you have white spots or pus on the tonsils with fever
- you have a rash, especially a rough sandpaper-like rash
- you are dehydrated or struggling to drink
- you have a weakened immune system
- you are taking medicine that affects your immune system
- you are worried about a baby, young child, older adult or vulnerable person
NHS Inform advises seeing a GP if a sore throat lasts 3 to 4 weeks, because persistent symptoms may need further checks. NHS Inform’s sore throat guidance explains this in more detail.
If you need help arranging care, see our guide to how to get a GP appointment quickly in the UK.
When to call 999 or seek urgent help
Call 999 or seek emergency help if a sore throat comes with symptoms that suggest breathing problems, severe infection or another emergency.
Urgent warning signs include:
- difficulty breathing
- noisy breathing or stridor
- difficulty swallowing saliva
- drooling
- severe swelling of the mouth, tongue, throat or face
- blue lips
- confusion, extreme drowsiness or collapse
- a stiff neck with fever or severe headache
- a non-blanching rash that does not fade when pressed
- severe one-sided throat pain with trouble opening the mouth
Severe one-sided throat pain, muffled “hot potato” voice, drooling, difficulty opening the mouth or swelling around one tonsil can sometimes suggest a complication such as a quinsy, which needs urgent medical assessment.
Sore throat in children
Children often get sore throats with colds, coughs and viral infections. Many improve with fluids, rest and suitable pain relief. But children can become dehydrated more quickly than adults, and some infections need medical advice.
Get advice if your child:
- is under 3 months old and has a temperature
- is struggling to drink
- has fewer wet nappies or is peeing less than usual
- is unusually sleepy, floppy or hard to wake
- has a rash with fever
- has breathing difficulty
- has severe throat pain or cannot swallow
- has symptoms that are worsening or not improving
For related child health topics, see fever in children, coughs and colds in children and common rashes in children.
Could a sore throat be COVID, flu or another virus?
Yes. A sore throat can happen with COVID, flu and other respiratory viruses. Other symptoms may include fever, cough, runny nose, headache, muscle aches, fatigue, loss of appetite or feeling generally unwell.
If you have a fever, cough or feel unwell, avoid close contact with vulnerable people where possible, rest, drink fluids and follow current public health advice. Seek medical advice if symptoms are severe, you are at higher risk, or you develop breathlessness, chest pain, confusion or dehydration.
Our guides to fever in children, fatigue and cough in adults may be useful depending on your symptoms.
Can a sore throat cause ear pain?
Yes. Throat infections and tonsillitis can cause referred pain to the ears, even when the ear itself is not infected. This happens because the throat and ear share nerve pathways.
Ear pain with sore throat may also happen with colds, sinus problems, jaw problems or an ear infection. If ear pain is severe, there is discharge from the ear, hearing loss, dizziness, fever or symptoms are not improving, seek advice.
You may also find our guide to sinusitis symptoms and treatment useful if facial pressure, blocked nose or thick nasal discharge are part of the picture.
Can reflux cause a sore throat without heartburn?
Yes. Some people get throat symptoms from reflux without obvious burning chest pain. This is sometimes called silent reflux. It may cause throat clearing, hoarseness, cough, a sour taste, a lump sensation or a sore throat that is worse in the morning.
Helpful steps may include avoiding large late meals, reducing alcohol, raising the head of the bed if symptoms are worse at night, losing weight if appropriate, and speaking to a pharmacist about reflux medicines. If symptoms persist, see a GP.
How long should a sore throat last?
A simple viral sore throat often improves within 3 to 7 days. Some symptoms, such as cough or tiredness, may last longer. Tonsillitis can last around a week, sometimes longer.
If your sore throat is not improving after a week, keeps coming back, or lasts several weeks, get medical advice. Persistent symptoms should not be ignored, especially if they are one-sided, associated with a lump in the neck, voice changes, difficulty swallowing, unexplained weight loss or blood.
Quick self-check: what pattern do you have?
It can help to think about the pattern of your symptoms:
- Sore throat with cough, runny nose and sneezing: often viral or allergy-related.
- Sore throat with fever, swollen glands and no cough: tonsillitis or strep may be possible.
- Sore throat with rough rash: consider scarlet fever and seek advice.
- Sore throat with extreme tiredness and swollen glands: glandular fever may be possible.
- Sore throat worse after meals or lying down: reflux may be contributing.
- Sore throat with breathing or swallowing difficulty: seek urgent help.
Final thoughts
A sore throat is usually caused by a viral infection and improves with time, fluids, rest and simple symptom relief. But some sore throats need medical advice, especially if they are severe, persistent, linked with fever or rash, or make swallowing difficult.
Use a pharmacist for mild to moderate symptoms and advice on suitable treatments. Contact a GP or NHS 111 if symptoms are worsening, not improving, keep returning, or you are worried about a child or vulnerable person. Call 999 for breathing difficulty, drooling, severe swelling, confusion, collapse or other emergency signs.
For official guidance, see the NHS pages on sore throat, tonsillitis, scarlet fever and glandular fever.
Frequently asked questions about sore throats
How long does a sore throat usually last?
Most sore throats improve within about a week, especially when they are caused by a common cold or another viral infection. If your sore throat is severe, getting worse, keeps coming back, or has not improved after a week, it is sensible to seek medical advice.
Do I need antibiotics for a sore throat?
Not usually. Most sore throats are caused by viruses, and antibiotics do not work against viral infections. Antibiotics may be considered if a bacterial infection is likely, symptoms are severe, scarlet fever is suspected, or you are at higher risk of complications.
What is the fastest way to soothe a sore throat?
There is no instant cure, but drinking fluids, resting, avoiding smoke, using suitable pain relief, sucking lozenges if safe, and trying warm drinks may help. Adults may also find warm salty gargles soothing.
Can a sore throat be caused by allergies?
Yes. Hay fever and other allergies can cause throat irritation, especially when mucus drips from the back of the nose into the throat. Allergy-related sore throat often comes with sneezing, itchy eyes, runny nose or symptoms that worsen around pollen, dust or pets.
Can acid reflux cause a sore throat?
Yes. Acid reflux can irritate the throat and may cause soreness, hoarseness, throat clearing, cough, a sour taste or a lump-like feeling in the throat. Symptoms may be worse after meals or when lying down.
When should I worry about a sore throat?
Seek medical advice if your sore throat is severe, not improving, keeps returning, or comes with a high temperature, swollen glands, rash, dehydration, white spots on the tonsils, or extreme tiredness. Get urgent help if you have breathing difficulty, drooling, severe swelling, confusion, a stiff neck, or cannot swallow saliva.
Can a sore throat be a sign of tonsillitis?
Yes. Tonsillitis can cause a sore throat, painful swallowing, red or swollen tonsils, white spots, fever, swollen neck glands and sometimes ear pain. Tonsillitis can be viral or bacterial, so antibiotics are not always needed.
Can children go to school with a sore throat?
It depends on how unwell they are. If a child has only mild symptoms and feels well enough, they may be able to attend. Keep them at home if they have a high temperature, feel very unwell, are struggling to eat or drink, or have symptoms of a contagious illness such as suspected scarlet fever. Follow school or nursery guidance where relevant.
Can a sore throat cause ear pain?
Yes. Pain from the throat can be felt in the ear because the throat and ear share nerve pathways. Ear pain can also be caused by ear infection, sinus problems, jaw problems or dental problems, so seek advice if it is severe, persistent, or comes with hearing loss, discharge or dizziness.
What should I drink with a sore throat?
Water is a good choice. Warm drinks may feel soothing, and cool drinks or ice lollies can also help some people. Avoid alcohol and very irritating drinks if they make symptoms worse. Children and older adults should be encouraged to drink regularly to reduce the risk of dehydration.
This article is for general information only and should not replace medical advice. If you are worried about your symptoms or someone else’s, contact NHS 111, your GP, or call 999 in an emergency.
