Hand, Foot and Mouth Disease: Symptoms, Causes, Treatment & Prevention
Illustration of common hand, foot and mouth disease features, including palm blisters, mouth sores and a rash on the soles.
Hand, foot and mouth disease (HFMD) is a common, contagious viral infection that mainly affects infants and young children, although teenagers and adults can also get it. It typically causes fever, painful sores inside the mouth and a rash or small blisters on the hands and feet. Most people recover without specific treatment within 7 to 10 days, but painful mouth sores can make drinking difficult and lead to dehydration.
HFMD is caused by enteroviruses, including coxsackieviruses. It spreads through close contact with an infected person, respiratory secretions, blister fluid, stool and contaminated surfaces. There is no specific antiviral medicine for ordinary HFMD; care focuses on fluids, comfort and monitoring for warning signs.
Hand, Foot and Mouth Disease: Key Facts
Several enteroviruses, commonly coxsackievirus A16; other types such as coxsackievirus A6 and EV-A71 can also cause illness.
Children under 5 years are most commonly affected, but people of any age can become infected.
Fever, sore throat, painful mouth ulcers and spots or blisters on palms and soles; buttocks or other areas may also be affected.
Most cases improve on their own in about 7 to 10 days.
Keep the person drinking enough, because mouth pain can reduce fluid intake.
Handwashing, cleaning shared surfaces and avoiding close contact while unwell help reduce spread.
What Is Hand, Foot and Mouth Disease?
HFMD is an infection caused by viruses in the enterovirus group. It is common in childcare settings and among young children who share toys, surfaces and close contact. The infection is usually mild, but symptoms can be uncomfortable, particularly when mouth ulcers make swallowing painful.
The name describes the areas commonly affected: the hands, feet and mouth. However, the rash may also appear on the buttocks, legs, arms or around the diaper area. Not every infected person develops all the classic symptoms, and adults may have mild symptoms or none at all.
Hand, Foot and Mouth Disease Symptoms
Symptoms often begin around 3 to 6 days after exposure, although the timing can vary. The illness may start with general symptoms before mouth sores and the skin rash become noticeable.
A raised temperature may be one of the first signs, sometimes with tiredness or reduced appetite.
A child may complain of throat discomfort, become irritable or seem less active than usual.
Small red spots can develop into blisters or ulcers on the tongue, gums, inner cheeks or other parts of the mouth.
Flat or raised red spots and small blisters may appear on palms, fingers, soles and toes.
Spots can also occur on the buttocks, knees, elbows, arms or diaper area.
Mouth pain may cause a child to refuse food or fluids, increasing the risk of dehydration.
How the Rash and Mouth Sores May Look
The rash can look different depending on the virus, skin tone and stage of illness. It may appear as small red or darker spots, raised bumps or fluid-filled blisters. Mouth lesions may begin as red spots and become painful ulcers. The rash is often seen on the palms and soles, but its distribution is not identical in every person.
Some children have more widespread lesions, particularly with certain strains such as coxsackievirus A6. A rash alone cannot confirm HFMD; a clinician considers the pattern, age, fever and mouth findings.
Stages and Timeline of HFMD
| Period | What may happen | What to watch |
|---|---|---|
| After exposure | Symptoms commonly begin about 3 to 6 days later. | A person may not know exactly when exposure occurred. |
| Early illness | Fever, sore throat, tiredness or reduced appetite may appear. | Monitor temperature, activity and fluid intake. |
| Mouth and skin phase | Painful mouth sores and a rash on hands, feet or other areas may develop. | Watch for refusal to drink and fewer wet nappies or urination. |
| Recovery | Most people improve within 7 to 10 days. | Seek medical advice if symptoms worsen or are not improving. |
| After symptoms improve | The virus may continue to be shed in stool for weeks. | Continue careful hand hygiene, especially after toileting or diaper changes. |
This is a general guide, not a fixed timetable. Some people have mild symptoms, while others take longer to recover.
What Causes Hand, Foot and Mouth Disease?
HFMD is caused by several enteroviruses. Common causes include coxsackievirus A16 and coxsackievirus A6; enterovirus A71 (EV-A71) can also cause HFMD and has been associated with rare but serious neurological complications in some outbreaks.
Having HFMD once does not protect a person against every virus that can cause it. Because different enterovirus types circulate, reinfection can occur.
How Does HFMD Spread?
The viruses can spread when they enter another person's body through the eyes, nose or mouth. Transmission can happen through:
- Respiratory droplets and secretions: saliva, mucus or droplets released when an infected person coughs, sneezes or talks.
- Blister fluid: direct contact with fluid from skin blisters.
- Stool: contact with infected stool, especially during diaper changes or after using the toilet without proper handwashing.
- Contaminated objects: toys, door handles, utensils and frequently touched surfaces.
- Close personal contact: hugging, kissing or sharing cups and eating utensils.
Who Is at Higher Risk?
- Infants and children younger than 5 years.
- Children attending daycare, preschool or other group settings.
- People who have close household contact with an infected person.
- Anyone with frequent contact with contaminated toys, surfaces or diaper-changing areas.
Adults can get HFMD too. Some adults have mild symptoms or no obvious symptoms, but they can still contribute to transmission.
Is Hand, Foot and Mouth Disease the Same as Foot-and-Mouth Disease?
How Is Hand, Foot and Mouth Disease Diagnosed?
In most typical cases, a healthcare professional can diagnose HFMD by reviewing symptoms and examining the mouth, hands and feet. Laboratory testing is not usually needed for an uncomplicated, typical illness.
In unusual, severe or outbreak-related situations, a clinician or public health team may request a throat swab, blister sample or stool sample for laboratory testing. Do not try to diagnose a child from photographs alone, because other infections and skin conditions can cause similar rashes or mouth ulcers.
Hand, Foot and Mouth Disease Treatment
There is no specific medicine that cures routine HFMD, and antibiotics do not work against the viruses that cause it. Treatment is supportive: relieve pain and fever, maintain hydration and watch for complications.
1. Keep Fluids Going
- Offer frequent small sips of water or other suitable fluids.
- Cool drinks, chilled yoghurt or other soft, cool foods may be easier to tolerate.
- If drinking is difficult, offer small amounts often rather than expecting the child to drink a large amount at once.
- Ask a healthcare professional whether an oral rehydration solution is appropriate if intake is reduced or dehydration is a concern.
2. Choose Foods That Do Not Irritate Mouth Sores
- Offer soft foods such as yoghurt, porridge, mashed vegetables or other foods the child can swallow comfortably.
- Avoid very hot, spicy, salty or acidic foods and drinks if they make the sores sting.
- Do not force solid food; maintaining fluids is the priority during painful days.
3. Manage Fever and Pain Safely
Paracetamol (acetaminophen) or ibuprofen may help with pain or fever when appropriate for the person's age and medical history. Follow the product label and a clinician's or pharmacist's advice for the correct formulation and dose. Ibuprofen may not be suitable for some children, including those who are dehydrated or have certain medical conditions.
4. Care for the Skin
- Keep the skin clean and avoid scratching or picking at blisters.
- Do not deliberately burst blisters.
- Wash hands after touching affected skin and keep any broken areas clean.
- Seek medical advice if the skin becomes increasingly red, hot, swollen, painful or develops pus.
Warning Signs: When to See a Doctor
Contact a healthcare professional if a child is drinking poorly, passing urine less often, has a persistent or high fever, seems unusually unwell, has severe symptoms, has a weakened immune system, is younger than 6 months, or is not improving after about 7 to 10 days.
- Very sleepy, difficult to wake, confused or unusually floppy.
- Seizure, abnormal jerking movements, severe headache or stiff neck.
- Weakness, difficulty walking or unusual loss of coordination.
- Fast or difficult breathing.
- Signs of significant dehydration, such as very little urine, a very dry mouth, no tears when crying, sunken eyes or marked lethargy.
- Inability to swallow fluids or persistent refusal to drink.
Possible Complications
Most people recover fully. Complications are uncommon, but may include:
- Dehydration: painful mouth ulcers can make drinking difficult. This is a more common reason children need medical attention.
- Viral meningitis: rare inflammation of the membranes around the brain and spinal cord.
- Encephalitis or other neurological complications: very rare, but potentially serious; some enterovirus types have been linked to these complications.
- Nail changes: temporary nail shedding or nail changes have been reported after HFMD and usually recover, but other causes may need consideration.
How to Prevent Hand, Foot and Mouth Disease
Use soap and running water for at least 20 seconds, especially after diaper changes, toilet use, wiping noses and before preparing food.
Regularly clean and disinfect toys, tables, door handles, taps and other frequently touched objects.
Do not share cups, spoons, towels, toothbrushes or eating utensils during illness.
Use a tissue or elbow, dispose of tissues safely and wash hands afterwards.
Dispose of diapers safely and wash hands thoroughly after every change.
Avoid kissing, hugging and close face-to-face contact while the person is feeling ill.
There is currently no widely available vaccine that prevents all viruses responsible for HFMD. Prevention relies mainly on hygiene and reducing exposure.
When Can a Child Return to School or Daycare?
Follow local school, childcare and public-health guidance. In general, a child may return when they have no fever, feel well enough to take part in normal activities and do not have uncontrolled drooling because of mouth sores. It is not always necessary to wait until every blister has disappeared, but local outbreak rules may differ.
Keeping a child away for weeks until all virus shedding has stopped is usually not practical and may not prevent spread. Continue careful handwashing and cleaning after the child returns, especially because virus can remain in stool for weeks.
Hand, Foot and Mouth Disease in Adults
Adults can develop HFMD after exposure to an infected child or another person. Some adults have no symptoms; others may experience fever, sore throat, mouth ulcers and a rash on the hands or feet. The appearance and severity can vary. Adults who are pregnant, immunocompromised or experiencing severe symptoms should contact a healthcare professional for individual advice.
HFMD During Pregnancy
Exposure to HFMD during pregnancy does not automatically mean there will be a problem. However, pregnant people who develop symptoms or believe they have been exposed should contact their maternity clinician or doctor for advice, particularly close to delivery. The clinician can consider gestational age, symptoms and individual health circumstances.
Frequently Asked Questions About Hand, Foot and Mouth Disease
Showing 6 of 6 questions
1. What are the common symptoms of hand, foot and mouth disease?
Common symptoms include fever, sore throat, painful mouth sores and a rash or small blisters on the palms and soles. Spots may also appear on the buttocks, arms or legs. Not everyone develops every symptom.
2. How long does hand, foot and mouth disease last?
Most people recover within 7 to 10 days. Symptoms can vary, but seek medical advice if the illness becomes worse, the child is not drinking adequately or recovery is not progressing.
3. Is hand, foot and mouth disease contagious?
Yes. The virus can spread through saliva and respiratory secretions, blister fluid, stool and contaminated surfaces. People are usually most contagious during the first week, but the virus may remain in stool for several weeks.
4. What is the treatment for hand, foot and mouth disease?
There is no specific antiviral treatment for routine HFMD. Care focuses on frequent fluids, soft foods, rest and age-appropriate pain or fever relief recommended by a healthcare professional. Antibiotics do not treat the viral infection.
5. When should a child with HFMD see a doctor urgently?
Seek urgent medical help if a child is difficult to wake, has a seizure, stiff neck, breathing difficulty, unusual weakness or signs of significant dehydration. Contact a clinician if the child is drinking poorly, passing less urine or symptoms are worsening.
6. When can a child return to school or daycare after HFMD?
Follow local school and public-health guidance. In general, a child can return when fever-free, well enough to participate and without uncontrolled drooling from mouth sores. It is not always necessary to wait until every blister has disappeared.
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Trusted Medical Sources and Further Reading
- US Centers for Disease Control and Prevention (CDC): About Hand, Foot, and Mouth Disease — symptoms, spread, prevention, treatment and return-to-school guidance.
- CDC: HFMD Symptoms and Complications — warning signs and uncommon complications.
- CDC: HFMD Causes and How It Spreads — enteroviruses and transmission routes.
- UK National Health Service (NHS): Hand, Foot and Mouth Disease — home care and when to seek medical advice.
- Mayo Clinic: Hand-Foot-and-Mouth Disease — overview and clinical features, updated December 2025.
- Pan American Health Organization / WHO: 2025 Epidemiological Alert — regional epidemiological context and causative enteroviruses.
Conclusion: Recognise Symptoms and Prevent Dehydration
Hand, foot and mouth disease is a common viral infection that usually causes fever, painful mouth sores and a rash on the hands and feet. Most people recover within 7 to 10 days with supportive care. Because mouth pain can make drinking difficult, maintaining hydration is one of the most important parts of home care.
Good hand hygiene, cleaning shared surfaces and avoiding close contact while unwell can reduce transmission. Seek medical advice if symptoms are severe, the child is not drinking or is passing less urine, or recovery is not progressing. Neurological symptoms, breathing difficulty or marked drowsiness require urgent medical assessment.
Medical disclaimer: This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Children with poor fluid intake, reduced urination, persistent fever or worsening symptoms should be assessed by a healthcare professional. Seek emergency care for seizures, severe drowsiness, stiff neck, breathing difficulty or other serious warning signs. Medication choice and dose must be appropriate for the person's age and health.
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