Differin (Adapalene) for Seniors: What to Know
Read More
Hand, Foot, and Mouth Disease: Symptoms, Treatment, and Prevention
Medically reviewed by Oghenefejiro Okifo | MD , Harvard Medical School | Henry Ford Hospital - Detroit, MI on March 3rd, 2024. Updated on June 25th, 2026
Key Takeaways
Non-polio enteroviruses, primarily Coxsackievirus A16 and Enterovirus 71, cause HFMD, which affects 90% of cases in children under 5 but can occur in adults with more severe symptoms.
An initial fever of 101-103 degrees F appears 3-6 days after exposure, followed by painful mouth ulcers, then the characteristic blister rash on the hands and feet 1-2 days later.
The contagious period extends from initial fever through blister healing, typically 7-10 days, with viral shedding in stool continuing for several weeks after recovery.
Pain management focuses on acetaminophen or ibuprofen for fever, while cold foods like popsicles and avoiding acidic drinks help with mouth pain; aspirin should never be given to children.
Complications are rare but include viral meningitis in about 1 in 1,000 cases and nail loss 4-6 weeks after infection, particularly with Coxsackievirus A6 strains.
Hand, foot, and mouth disease (HFMD) is a common viral infection that primarily affects children under 5, though adults can get it too. It causes fever, painful mouth sores, and a blister rash on the hands and feet. Most cases clear up on their own within 7-10 days without prescription treatment.
What Causes Hand, Foot, and Mouth Disease?
HFMD is caused by viruses belonging to the non-polio enterovirus group, with the most common being Coxsackievirus A16 (CVA16) and Enterovirus 71 (EV-A71). These viruses spread easily through close contact, especially among children in daycare settings and schools.
Symptoms of Hand, Foot, and Mouth Disease
HFMD symptoms typically appear in two stages:
Early symptoms (1-2 days): Fever Sore throat Painful blisters inside the mouth or on the tongue Feeling unwell (malaise) Loss of appetite Fatigue Crankiness
Later symptoms (3-7 days): Rash that turns into blisters on hands, feet, knees, elbows, or buttocks Painful sores in and around the mouth Swollen lymph nodes in the neck
Diagnosing Hand, Foot, and Mouth Disease
A doctor can usually diagnose HFMD by examining the sores and rashes on the patient's body. In some cases, they may take a throat swab or a sample of poop or blood for lab testing to confirm the diagnosis.
Treating Hand, Foot, and Mouth Disease
There is no specific treatment for HFMD, as it is caused by a virus and antibiotics are not effective. However, you can ease the symptoms with:
Over-the-counter pain relievers like ibuprofen or acetaminophen (avoid aspirin in children)
Numbing mouth sprays
Cold treats such as ice pops, yogurt, or smoothies to soothe a sore throat
Anti-itch lotion, such as calamine, for rashes
When to See a Doctor for Hand, Foot, and Mouth Disease
Most children with HFMD recover fully at home without a doctor visit. However, there are situations where medical attention is important.
Dehydration is the most common complication to watch for. Painful mouth sores can make it hard to swallow, so children may refuse to drink. Signs of dehydration include a dry mouth, no tears when crying, fewer wet diapers than usual, and unusual sleepiness or irritability. If your child cannot keep fluids down or has not urinated in 8 hours, call a doctor.
In rare cases, HFMD can lead to more serious complications. Viral meningitis occurs in roughly 1 in 1,000 cases and causes a stiff neck, severe headache, and sensitivity to light. Encephalitis, an inflammation of the brain, is even rarer but more serious. Both are more commonly associated with Enterovirus 71 than with Coxsackievirus A16. Seek emergency care immediately if your child has a seizure, loses consciousness, is confused, or has difficulty breathing.
Nail loss is another uncommon complication, typically seen 4-6 weeks after infection, especially with Coxsackievirus A6 strains. The nails usually grow back on their own without treatment.
Adults with HFMD should also see a doctor if symptoms are severe or prolonged. Pregnant women who are exposed to HFMD near their due date should contact their provider, since infection close to delivery can occasionally be passed to the newborn.
Red flags that warrant prompt medical attention
Contact a doctor or seek urgent care if you notice any of the following:
High fever above 103°F that does not come down with medication
Signs of dehydration in a child, such as no tears, dry mouth, or very dark urine
Symptoms that worsen after day 3 or do not improve after 10 days
A rash that looks infected, with increased redness, warmth, or pus
Stiff neck, severe headache, or sensitivity to light in a child over 6 months
Any neurological symptoms such as unusual weakness, shakiness, or confusion
For healthy children with mild symptoms and good fluid intake, home care is usually all that is needed. Our AI doctor can help you assess symptoms and decide whether an in-person visit makes sense.
Preventing the Spread of Hand, Foot, and Mouth Disease
To reduce the risk of spreading HFMD, follow these guidelines:
Wash your hands frequently, especially after changing diapers or wiping a child's nose
Teach children to cover their mouth and nose when sneezing or coughing
Clean and disinfect surfaces and shared items like toys and doorknobs
Avoid close contact with infected individuals, such as hugging, kissing, or sharing cups and utensils
Keep children with HFMD out of school or daycare until their fever is gone and mouth sores have healed
HFMD spreads most easily in the first week of illness, but viral shedding in stool can continue for several weeks after recovery, so good hygiene practices should continue even after symptoms resolve.
Takeaways
Hand, foot, and mouth disease is a highly contagious viral infection that primarily affects infants and young children. While it can be painful, it is not a serious condition and usually clears up on its own within 1-2 weeks. By understanding the symptoms, treatment options, and prevention methods, you can help manage the disease and reduce its spread.
Frequently Asked Questions
HFMD is most contagious during the first week of illness, when fever and blisters are active. The virus can still be shed in stool for several weeks after symptoms disappear, so regular handwashing remains important even after recovery. Children should stay home from school or daycare until their fever is gone and mouth sores have healed.
Yes, adults can get HFMD, though it is much more common in children under 5. Adults who contract it often have milder symptoms or no symptoms at all, but they can still spread the virus. In some cases, adults experience more severe symptoms than children, particularly if their immune system is weakened.
Cold, soft foods are the most soothing for painful mouth ulcers. Good options include ice pops, cold water, yogurt, smoothies, and applesauce. Avoid acidic foods and drinks like citrus juice, tomatoes, and soda, as these can irritate sores and make pain worse. Staying well hydrated is the most important priority, especially for young children.
There is no vaccine for HFMD available in the United States. A vaccine against Enterovirus 71 has been approved in China, but it is not widely available elsewhere. Prevention relies on frequent handwashing, avoiding close contact with infected individuals, and disinfecting commonly touched surfaces.
Yes, it is possible to get HFMD more than once. Different strains of enterovirus cause the disease, and immunity after infection is strain-specific. Getting infected with Coxsackievirus A16 does not protect you from Enterovirus 71 or other strains. Repeated infections tend to be less severe as some partial immunity builds over time.
The Bottom Line
Most cases resolve within a week with supportive care, but maintaining hydration is crucial since mouth pain often prevents adequate fluid intake. Keep children home until fever-free for 24 hours and practice thorough handwashing since the virus survives on surfaces for days. If you're concerned about symptoms or need guidance on managing pain and hydration, Doctronic can provide quick answers and peace of mind.
