Hand, foot and mouth disease: Causes, symptoms and treatment

Daycare, the playground, school – kids have a lot of opportunities to get sick. And as a parent or caregiver, you’ve probably gotten pretty good at telling the difference between a mild bug, allergies and something more serious. So how about something that starts out like the flu, then a rash? One possibility is that it’s hand, foot and mouth disease, which tends to be mild, but still needs to be handled appropriately.

Below, we cover what you need to know about hand, foot and mouth disease, including telltale symptoms, how to manage them and when to talk to a doctor.

What is hand, foot and mouth disease?

Hand, foot and mouth disease (HFMD) is a generally mild, yet highly contagious viral infection. It’s most common in children under 5 years old, but older kids and adults can catch HFMD as well.

The cause of hand, foot and mouth disease (and how it spreads)

HFMD can be caused by a few different strains of enterovirus – in the United States, coxsackievirus A16 is the most common cause of HFMD. It can spread through both direct and indirect contact with an infected person’s bodily fluids or stool, including through coughing, sneezing and shared objects.

Identifying symptoms of hand, foot and mouth disease

As mentioned above, HFMD often starts with flu-like symptoms in kids – which can include fever, tiredness, a sore throat and reduced appetite. After a couple of days, small sores or blisters may develop on or in your child’s mouth, which can make swallowing painful and may lead to drooling. Sores may also occur elsewhere on the body, and in some cases, a skin rash may appear.

If you think that your child may have a case of HFMD, getting a diagnosis can help. HFMD usually gets better on its own, but other conditions can cause similar symptoms, and not all cases of HFMD present with all of its possible symptoms. A diagnosis ensures that you get the right recommendations for treatment or symptom management.

What hand, foot and mouth looks like

HFMD got its name for a reason. In addition to the mouth, its telltale sores most often appear on the palms of the hands and the soles of the feet. They can also spread to the arms, legs, torso, face and buttocks. They typically look like flat or raised red spots, depending on whether they blister and whether the blisters pop.

When hand, foot and mouth disease symptoms need immediate care

Most cases of HFMD are mild and get better on their own. However, it’s important to talk to a doctor as soon as possible if:

• Your child has a lot of trouble drinking liquids
• Your child’s symptoms don’t improve after 10 days, or their fever lasts longer than three days
• Your child has a very high fever, extreme tiredness, or widespread sores or blisters
• Your child is under 6 months old or has a weakened immune system

How long hand, foot and mouth disease lasts

HFMD typically has a 3-6 day incubation period before symptoms appear. Once symptoms appear, they tend to last for 7-10 days. HFMD is most contagious during the first week. However, after symptoms have resolved, the virus can continue to live in the nose, mouth and lungs for a few weeks and in stool for several months – meaning that it’s still possible to catch it, although the risk is lower.

How to prevent hand, foot and mouth disease from spreading

Good hygiene is key to preventing the spread of HFMD. In particular:

• Make sure everyone in your household washes their hands after coughing, sneezing, blowing their nose, or using the bathroom
• Make sure you and any other caregivers wash your hands before and after caring for your child
• If your child has blisters, keep them clean and uncovered, and discourage your child from touching them
• Frequently clean shared surfaces or toys, and avoid sharing objects
• Avoid or limit close contact with anyone who’s infected
• Avoid touching your eyes, nose and mouth

For hand, foot and mouth disease, treatment means symptom management

There’s no specific cure for HFMD. So after a diagnosis, treatment involves keeping your child comfortable and hydrated until their symptoms have improved. You can do this with:

• Over-the-counter pain medication – Acetaminophen and ibuprofen can help with pain and reduce fever. Follow all instructions on the label, and any from your child’s doctor. Do not give your child aspirin, as it has been linked to Reye syndrome, a serious condition that affects the liver and brain.
• Cold food and drinks – Cold food and drinks (like smoothies and popsicles) can temporarily numb throat and mouth soreness, and keep your child’s energy and hydration up.
• Avoiding hot, spicy or acidic food and drinks – These kinds of foods and drinks can make the pain from mouth sores worse.
• Saltwater rinses – If your child can swish liquid around their mouth without swallowing, frequent rinses with saltwater can help relieve pain and inflammation.
• Antihistamines – If your child complains of the rash itching, ask their doctor about giving them an antihistamine like Zyrtec.

Wondering if your child has hand, foot and mouth disease? Get a diagnosis

Even though HFMD is often mild, getting an expert’s diagnosis can ensure that your child gets the kind of care that they need. It’s also an opportunity to get professional recommendations for keeping your child as comfortable as possible while they recover.