The Bottom Line

Hand, foot, and mouth disease (HFMD) is a common, contagious viral infection seen most often in children under 5. It causes painful mouth sores and a blister-like rash on the hands and feet. Most children recover fully within 7–10 days without any special treatment. The illness is caused by viruses called coxsackievirus A16 and enterovirus 71. Keep your child comfortable, watch for signs of dehydration, and call your doctor if symptoms seem severe.

What Is Hand, Foot, and Mouth Disease?

Hand, foot, and mouth disease (HFMD) is a viral illness that mostly affects young children. The most common cause is coxsackievirus A16, though a related virus called enterovirus 71 (EV-71) can also cause it. HFMD spreads easily in daycare centers and schools, especially during late summer and fall. An infected child can spread the virus through coughs, sneezes, and contact with stool — even for weeks after the rash is gone.

Despite the similar name, HFMD in people has nothing to do with foot-and-mouth disease in cattle. They are completely different illnesses caused by different viruses.

Signs and Symptoms

HFMD usually follows a predictable pattern:

  • Days 1–2: Fever, fussiness, reduced appetite, and a sore mouth. The incubation period (from exposure to first symptoms) is typically 3–6 days.
  • Mouth sores: Small red spots appear inside the mouth — on the tongue, cheeks, and gums — and turn into painful ulcers. These make eating and drinking uncomfortable.
  • Skin rash: Shortly after, a rash of small, flat or raised spots appears on the palms of the hands and soles of the feet, often on the sides and tips of the fingers and toes. These can look like tiny blisters. Unlike chickenpox, the spots are usually not itchy and are smaller and more uniform.
  • Buttocks and legs: The rash sometimes spreads to the buttocks, genitals, and lower legs.

Most symptoms clear up within 3–5 days. Mouth sores may linger for 7–10 days.

How Does It Spread?

HFMD spreads through:

  • Respiratory droplets from coughs and sneezes
  • Contact with saliva, blister fluid, or stool
  • Touching contaminated surfaces and then touching the mouth or face

The virus can remain in stool for several weeks, so good hand hygiene — especially after diaper changes — is very important even after your child feels better.

Treatment and Home Care

There is no specific antiviral medicine for HFMD. Treatment focuses on keeping your child comfortable:

  • Pain and fever: Give acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) as directed on the package. Do not give aspirin to children.
  • Fluids: Keep your child hydrated. Cold drinks, ice pops, and cold liquids can soothe mouth pain and prevent dehydration. Avoid acidic juices (orange, lemon) as these can sting sores.
  • Soft foods: Offer soft, bland foods like yogurt, mashed potatoes, and applesauce. Skip spicy, salty, or crunchy foods until mouth sores heal.
  • Oral pain relief: Your doctor may suggest a topical numbing gel for mouth pain, though over-the-counter pain medicine often works better.

Children may return to daycare or school once their fever is gone and they feel well enough to participate. Be aware that the virus can still be in stool for weeks.

When to See a Doctor or Go to the ER

  • Your child cannot swallow enough fluids and shows signs of dehydration (no tears, dry mouth, fewer wet diapers)
  • Your child has a high fever that does not respond to medicine
  • Your child has a seizure
  • Your child seems unusually drowsy, confused, or very difficult to wake
  • You notice rapid or labored breathing
  • Symptoms do not improve after 10 days

Serious complications are rare with the common coxsackievirus strain but can occur with enterovirus 71, which has been linked to neurological problems such as encephalitis and meningitis, particularly in the Asia-Pacific region.

Frequently Asked Questions

Can adults get hand, foot, and mouth disease?

Yes. Adults can catch HFMD, especially parents caring for sick children. Adults often have milder symptoms or none at all, but they can still spread the virus to others.

Will the rash leave scars?

No. The blisters from HFMD are shallow and heal cleanly without scars or permanent skin changes in most children.

Is there a vaccine for HFMD?

There is no vaccine available in the United States for the most common strains. An inactivated EV-71 vaccine is used in China to prevent severe disease from that particular strain. For now, the best prevention is careful hand washing.

How long is my child contagious?

Your child is most contagious during the first week of illness, but the virus can be shed in stool for weeks. Wash hands thoroughly — especially after diaper changes — to limit spread within your household.

References

  1. Paller AS, Mancini AJ. Hurwitz Clinical Pediatric Dermatology. 5th ed. Elsevier; 2016.
  2. Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Elsevier; 2016.
  3. Lott JP, Liu K, Landry M, et al. Atypical hand-foot-and-mouth disease associated with coxsackievirus A6. JAMA Dermatol. 2013;149(12):1419-1421.
  4. Centers for Disease Control and Prevention. Hand, Foot, and Mouth Disease (HFMD): Clinical Information. cdc.gov; 2024.

Trusted Resources

Always consult a board-certified dermatologist or your child's pediatrician for a diagnosis and treatment plan tailored to your child's specific needs.