Hand, Foot and Mouth Disease

Overview

Hand, foot and mouth disease is a common viral illness that usually affects young children. It causes a rash with blisters on the hands, feet, and inside the mouth. The illness is usually mild and clears up on its own within a week to 10 days.

Yes, hand, foot and mouth disease is very common, especially in young children who go to nursery, preschool, or other childcare settings.

It mainly affects children under 5 years old, but older children, teenagers, and adults can also get it.

Symptoms

Common symptoms

• Fever
• Sore throat
• Feeling tired and irritable
• Loss of appetite
• A rash of small, red spots on the palms of the hands and soles of the feet that may turn into blisters
• Painful sores or blisters inside the mouth (on the tongue, gums, and inside the cheeks)

Symptoms in children

• Fussiness and crying more than usual
• Drooling because it hurts to swallow
• Refusing to eat or drink
• Trouble sleeping

Symptoms in older adults

• Same symptoms as children, but often more severe sore throat and tiredness
• Rash may be less noticeable or appear as red spots without blisters
• Sometimes joint pain

Causes

Main causes

• Infection with a virus from the enterovirus group, most commonly coxsackievirus A16
• The virus spreads through contact with infected droplets from coughs or sneezes, fluid from blisters, or infected poo

Risk factors

• Attending daycare, nursery, or preschool where children are in close contact
• Not washing hands often enough
• Living in a large family or crowded setting
• Weakened immune system (rare, but can increase risk of severe illness)

When to see a doctor

See a doctor urgently if:

• If your child shows signs of dehydration (dry mouth, no tears, not peeing as much as usual)
• If fever lasts more than 3 days despite using fever-reducing medicines
• If your child is very drowsy, confused, or has a stiff neck

Book a routine appointment if:

• If you are not sure whether it is hand, foot and mouth disease or something else
• If symptoms are getting worse instead of better after a few days
• For advice on managing pain and keeping your child comfortable

Diagnosis

Doctors usually diagnose hand, foot and mouth disease by looking at the rash and sores and asking about symptoms. No special tests are needed for most cases.

Tests that may be done

• In rare or unclear cases, a doctor may take a swab from the throat or a blister to send to a lab for testing.
• Blood tests are not usually needed unless there are concerns about other illnesses.

What to expect at your appointment

The doctor will examine your child – looking at the rash, inside the mouth, and checking temperature and signs of dehydration. They will ask about symptoms and how your child is feeling.

Treatment

There is no specific medicine to cure hand, foot and mouth disease. Treatment focuses on relieving symptoms and making sure your child stays hydrated and comfortable until the virus clears.

Self-care at home

• Offer plenty of fluids: water, milk, cool soft drinks, ice lollies, and soup. Avoid acidic drinks like orange juice that can sting.
• Provide soft, cool foods like yoghurt, mashed potatoes, and smoothies. Avoid salty or spicy foods.
• Give paracetamol or ibuprofen (check the correct dose for your child's age and weight with your pharmacist or doctor) to reduce fever and pain.
• Let your child rest as much as they need.
• Keep blisters clean and dry to prevent infection. Do not pop them.

Medical treatments

For severe mouth pain, a doctor may recommend a mouthwash or gel that numbs the area. In hospital, if a child becomes very dehydrated, they may be given fluids through a drip.

Living with this condition

Keep your child at home away from nursery, school, or play dates until the blisters have dried up and they feel better (usually about a week). Wash hands often and clean toys and surfaces to stop the virus spreading to others in the house.

Lifestyle tips

• Practice good hand hygiene – wash hands with soap and water after changing nappies, after using the toilet, and before eating.
• Avoid close contact like kissing or hugging while the rash is present.
• Disinfect shared items like cups, utensils, and towels.

Diet and exercise

Offer small, frequent sips of cool fluids. Soft, bland foods are best. Avoid hard, crunchy, or acidic foods. Gentle play is fine if your child feels up to it, but rest is important.

Mental health and emotional wellbeing

The illness can be uncomfortable and upsetting for children because of the mouth sores and feeling unwell. Offer extra cuddles, distract with stories or quiet games, and be patient. Most children feel better within a few days.

Prevention

You can reduce the risk by washing hands regularly with soap and water, especially after changing nappies or contact with an infected person. Clean shared toys and surfaces often. Avoid sharing cups, utensils, and towels. There is no way to completely prevent it because it spreads easily.

Complications

If left untreated

• Dehydration – if a child refuses to drink because of mouth pain, they may become dehydrated.
• Viral meningitis – very rarely, the virus can cause inflammation of the lining around the brain and spinal cord. This usually resolves on its own without lasting problems.
• Secondary bacterial infection – if blisters get scratched and become infected, they may need antibiotic treatment.

Long-term outlook

Hand, foot and mouth disease is almost always a mild illness that goes away on its own. Children recover fully within 7 to 10 days. Serious complications are very rare, and a full recovery is the expected outcome.

Find support

International organisations

• World Health Organization (WHO) ↗
• Centers for Disease Control and Prevention (CDC) ↗

Local organisations

• NHS (UK) ↗ · United Kingdom
• Healthline (US) ↗ · United States

Helplines

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