Hand, foot, and mouth disease is a common illness that causes fever, mouth sores, and a rash on the hands and feet. Children under 5 years old are more likely to get hand, foot, and mouth disease (HFMD), especially during the spring, summer, and fall.
A few different viruses cause HFMD, and the illness spreads easily through an infected person's bodily fluids and feces. Most people have mild symptoms that go away after a week, but the illness can be very uncomfortable. In rare cases, usually outside the U.S., people can have neurological complications.
HFMD treatment involves managing and relieving symptoms at home. Typically you have to let the illness run its course, but some over-the-counter medications can help you or your child feel better.
Hand, Foot, and Mouth Disease Symptoms
Hand, foot, and mouth disease is named after its two main symptoms: mouth sores and a rash on the hands and feet. Because it's a viral illness, you would likely have flu-like symptoms too.
HFMD symptoms are usually mild and last seven to 10 days, but sometimes adults who get HFMD don't have any symptoms. Depending on how severe your HFMD infection is, you or your child may have the following signs and symptoms.
Flu-like Symptoms and Fever
After you catch the virus, you can start to develop flu-like symptoms in about three to five days, including:
- Loss of appetite or thirst
- Sore throat
- Fatigue or a general feeling of being unwell
Mouth sores often appear a day or so after a fever. These look like small, red dots on the tongue, inside the cheeks, or roof of the mouth. These sores can also turn into painful blisters.
Mouth sores and a sore throat can make swallowing, eating, and drinking painful. Some signs your child is experiencing mouth pain from HFMD include:
- Refusing to eat or drink
- Only drinking cold fluids
- Drooling excessively
A rash from HFMD usually appears on the palms of the hands and bottoms of the feet, but you can also get it on your arms, legs, and buttocks. This rash can look like:
- Flat, red spots
- Slightly raised red spots
- Blisters with a red base
- Blisters that pop, ooze fluid, and scab
What Causes Hand, Foot, and Mouth Disease?
Over a dozen enteroviruses, a group of viruses that usually cause mild illness, cause HFMD. In the U.S., coxsackievirus A16 is the most common virus that causes mild HFMD, while coxsackievirus A6 causes more severe illnesses. These viruses spread through infected bodily fluids.
Some ways you or your child may contract HFMD from an infected person include:
- Touching feces
- Having contact with fluids like saliva and snot
- Breathing in respiratory droplets from a cough or sneeze
- Kissing, hugging, or sharing utensils
- Touching surfaces that contain an infected person's feces, snot, or spit
- Having contact with fluid from blisters and scabs
People with the virus are typically contagious during the first week of illness. However, sometimes people can still spread HFMD a few days or weeks after they're sick. Researchers have found HFMD viruses can linger in feces six weeks after a person recovers.
Babies and children under 5 are more at risk of contracting and spreading the virus, especially at daycares and schools. It's rare for adults and older kids to get the illness unless they have a weakened immune system.
The highest risk for HFMD may also be during the summer and fall when the viruses that cause the disease are most active.
How Is Hand, Foot, and Mouth Disease Diagnosed?
A healthcare provider can typically diagnose HFMD with a quick physical examination. They will also consider risk factors like your age and if you are around small children. Given the risk associated with young age, symptoms like a rash on the hands and feet and mouth sores are usually clear signs of HFMD in children.
Sometimes a healthcare provider will swab the throat, mouth sores, or skin sores and complete laboratory testing to detect an HFMD-causing enterovirus. However, laboratory testing for HFMD is rare.
Treatments for Hand, Foot, and Mouth Disease
Unfortunately, there's no cure for HFMD. Treatment typically involves relieving uncomfortable symptoms and staying hydrated. Most people recover on their own in seven to 10 days.
Consult a healthcare provider before trying any at-home remedies for symptom relief, especially for young children. Some treatments to manage HFMD symptoms at home may include:
- Taking over-the-counter fever and pain reducers like acetaminophen or ibuprofen (children should avoid aspirin)
- Drinking cold fluids, eating popsicles, or sucking on ice chips to prevent dehydration
- Taking liquid ibuprofen-containing medications to coat mouth sores and relieve pain
- Applying prescription or over-the-counter ointments to calm skin rashes
If your child has HFMD, it's especially important to see a healthcare provider if your child:
- Has a weakened immune system
- Is younger than 6 months
- Is not drinking enough fluids
- Has signs of dehydration
- Has symptoms that don't get better after 10 days
- Has severe symptoms
While rare, HFMD is linked to pregnancy complications. Call your healthcare provider if you're pregnant and think you may have been exposed to HFMD.
How to Prevent Hand, Foot, and Mouth Disease
Currently, there is no approved vaccine to help prevent HFMD (although there are a few in clinical trials). The best way to avoid HFMD is to help stop the spread of bodily fluids containing the contagious virus.
Here are some ways you can help prevent catching or spreading HFMD:
- Wash your hands with soap and water for 20 seconds.
- Use an alcohol-based hand sanitizer when you can't wash your hands.
- Frequently disinfect touched surfaces and toys.
- Don't touch your mouth, nose, and eyes.
- Avoid kissing or hugging people with HFMD.
Hand, Foot, and Mouth Disease Complications
Dehydration is the biggest concern with HFMD because mouth sores can make drinking painful. However, you can prevent dehydration by drinking enough liquids.
More severe complications from HFMD are rare but can include:
- Fingernail and toenail loss: A research review reported children losing fingernails or toenails a few weeks after having HFMD. The nails typically grew back on their own. Still, there isn't enough evidence to prove HFMD directly causes nail loss.
- Viral meningitis: People with HFMD can contract this viral infection which affects tissues that cover the brain and spinal cord. Viral meningitis can cause fever, headache, stiff neck, or back pain. Most people recover on their own, but meningitis can cause severe illness (especially in young babies) that may require hospitalization.
- Encephalitis: A study of HFMD cases in Japan, China, and Southeast Asia found enterovirus 71 can cause severe symptoms like brain swelling, also called encephalitis. This can lead to neurological issues, brain damage, and paralysis.
There are a few reports of pregnant people getting HFMD and having complications like stillbirth. However, the connection is unclear. What is known is that HFMD is not usually harmful to a birth parent or baby.
Living With Hand, Foot, and Mouth Disease
HFMD usually doesn't cause severe or life-threatening illness in children or adults. Most folks will get better in seven to 10 days, and research has shown even people who take up to 21 days to recover don't have complications.
Still, HFMD is often extremely uncomfortable, and it can be tough to watch young children deal with painful sores and rashes. Under your healthcare provider's guidance, your best bet is to stay on top of drinking fluids and administer pain relievers to stay more comfortable.
The good news is that while there isn't a specific treatment or vaccine for HFMD available in the U.S., there are a few different HFMD vaccines and antiviral medications in the clinical trial phase. So we may see a vaccine or HFMD-specific treatment in the future.
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