Hand, Foot and Mouth Disease

Hand, foot and mouth disease, or HFM, is a common, contagious viral illness that affects young children. While it is usually mild, HFM can cause discomfort for children and be worrisome for parents.

At Banner Children’s, we’re here to help. We share all you need to know about this common condition and how to manage it when your child is sick.

What is hand, foot and mouth?

HFM is an illness usually caused by the coxsackie virus, which belongs to a group of viruses called nonpolio enteroviruses. In some cases, other types of enteroviruses can cause HFM.

The disease gets its name from the blister-like rash that forms on your child’s hands and feet and painful sores that develop inside or around the mouth.

Why is hand, foot and mouth common among children?

HFM usually affects young children under the age of 5. This is because their immune systems are still growing. When kids play close to each other or touch the same things, it makes spreading the virus easier.

Older children and adults can also catch HFM – even if they had it already – because several different viruses and strains can cause the illness. While you might be immune to one specific virus, you can still catch other strains.

If you are pregnant and think you have HFM or have been exposed to it, contact your health care provider. Complications are rare but possible.

How is HFM spread?

The virus spreads through close contact with people who are infected:

• Direct contact: HFM can spread through contact with an infected person’s saliva, fluid from blisters, feces (poop) and nasal mucus. Activities like kissing, hugging, sharing utensils and cups and changing diapers can spread the virus.
• Coughs and sneezes: HFM can spread through tiny droplets that are made when an infected person coughs or sneezes. Breathing in these droplets can lead to illness.
• Contaminated surfaces: HFM can survive on surfaces for several hours. It can spread when someone touches these objects or surfaces (such as toys, doorknobs or countertops).

What are the symptoms of hand, foot and mouth?

The symptoms of HFM typically appear three to six days after your child has been exposed to the virus. This is called the incubation period.

HFM often begins with a fever, sore throat, stomachache and loss of appetite. The telltale rash on the hands, feet and mouth usually appears one to two days after the fever.

Mouth sores: Sores usually appear in the back of the mouth but may also be on the gums, tongue, inner lips and around the mouth. The sores may appear as flat pink spots, tiny bumps or blisters.

Skin rash: Blisters can appear on the palms of the hands and soles of the feet but also on other areas of the body, like your child’s bottom and thighs.

Nail peeling can happen, but it is harmless. The skin will grow back and look normal in a few months.

How is hand, foot and mouth diagnosed?

Your child’s health care provider can diagnose HFM during a physical exam. They’ll check your child’s mouth and body for blisters and rashes and ask about other symptoms. 

How is hand, foot and mouth treated?

Because it is caused by a virus, there is no specific treatment for HFM. It usually goes away within a week to 10 days.

You can keep your child comfortable until the illness is gone by following these tips:

• Stay hydrated: Suck on ice chips or popsicles, eat ice cream, and drink cold water.
• Eat soft, plain foods: Swallowing may be uncomfortable, so offer soft foods like mashed potatoes, yogurt and warm soup. Avoid hot, acidic or spicy food.
• Give pain relievers: Your child can take over-the-counter pain relievers like children’s strength ibuprofen (if 6 months of age or older) and acetaminophen to ease pain and discomfort. Check with your child’s provider for the right dose. Aspirin shouldn’t be given to children.
• Gargle with salt water: Swishing with warm salt water may be soothing if your child can rinse and spit without swallowing.
• Get rest: Your child should remain home and rest until the virus is gone.

What are possible complications of hand, foot and mouth?

Complications for HFM are rare but include dehydration, secondary infections, viral meningitis and viral encephalitis.

Call your child’s health care provider if your child has a high fever, severe mouth pain, signs of dehydration or if symptoms get worse or continue for longer than 10 days.

When can my child go back to school or daycare?

Notify your child’s school or daycare center and let them know your child has HFM. Usually, your child can safely return when their blisters have dried up, they are fever-free, and they feel well enough to participate. However, your child’s school or daycare center may have other rules.

Is hand, foot and mouth disease the same as foot-and-mouth disease?

No, these two illnesses are very different. Foot-and-mouth disease (FMD) is a viral infection found in farm animals and can’t be spread to humans.

Are there ways to prevent hand, foot and mouth?

To reduce the risk of HFM, here are some things you can do to prevent it:

• Teach your child to wash their hands regularly.
• Disinfect frequently touched surfaces and objects.
• Avoid sharing personal items like utensils, cups, towels and toothbrushes.
• Keep your child home when they don’t feel well.
• Avoid close contact with those who are sick.

Our expert specialists

Banner Children’s caring staff is here to help treat, diagnose and guide you through every phase of your child’s life.

Most children with hand, foot and mouth disease recover quickly and can be treated at home. If you want to know more about medical care, schedule an appointment with one of our pediatric specialists.