Learn About Treating Hand, Foot, and Mouth Disease

What Is Hand, Foot, and Mouth Disease?

Hand, foot, and mouth disease (HFMD) is a viral infection that spreads easily from person to person. It typically affects young children under age 5, but older children and adults can catch it too. The disease gets its name from the distinctive rash that appears on the hands, feet, and inside the mouth. Unlike some serious infections, HFMD is usually mild and goes away on its own within 7 to 10 days without lasting complications.

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The illness is caused by viruses in the enterovirus family. The most common culprit is coxsackievirus A16, but other enteroviruses can also trigger the disease. In rare cases, a strain called enterovirus 71 can cause more severe symptoms. HFMD is not the same as foot-and-mouth disease found in animals, which is completely different and does not infect humans.

According to the Centers for Disease Control and Prevention (CDC), HFMD occurs worldwide. In the United States, outbreaks typically happen in summer and early fall, though the disease can occur year-round. The infection spreads through respiratory droplets when an infected person coughs or sneezes, through direct contact with the characteristic sores, and through contact with contaminated surfaces or stool.

Most cases appear in children who attend daycare or school, where close contact makes transmission more likely. Parents and caregivers can contract the virus from infected children, though they may have fewer symptoms or none at all. Understanding what HFMD is helps caregivers recognize it and take steps to prevent spreading it to others.

Practical Takeaway: HFMD is a common, usually mild viral illness that spreads easily among young children. Recognizing that it is a self-limited infection that typically resolves within 10 days can help reduce unnecessary worry, though medical guidance should always be sought when symptoms are severe or unusual.

Recognizing the Symptoms of HFMD

The symptoms of hand, foot, and mouth disease develop in stages over several days. Most people first experience general signs of illness, similar to a cold or flu. These initial symptoms include fever, sore throat, reduced appetite, and a general feeling of being unwell. The fever often reaches 101°F to 104°F (38.3°C to 40°C) and may last 3 to 4 days. Young children may be unusually fussy or lethargic during this phase.

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One to two days after the fever starts, the characteristic rash appears. Painful sores develop inside the mouth, typically on the inside of the cheeks, on the gums, and on the tongue. These mouth sores look like small red spots that develop into painful blisters. Eating and drinking become uncomfortable, which is why infected children often refuse food and may drool more than usual.

At the same time or shortly after mouth sores appear, a rash develops on the hands and feet. This rash consists of small, flat red spots or raised bumps, often with a grayish or whitish center. The rash on the hands typically appears on the palms and between the fingers. On the feet, it shows up on the soles and between the toes. Some children develop a rash on the buttocks or genital area as well. Unlike chickenpox, these spots do not usually itch.

Not all infected people show the typical rash pattern. Some may have only mouth sores, or only a rash on the hands and feet. Others experience very mild symptoms or no visible signs at all, even though they can still transmit the virus to others. Children under 2 years old sometimes have atypical presentations, making diagnosis trickier. Symptoms are usually most uncomfortable between days 2 and 4 of illness.

Practical Takeaway: Learn to recognize the sequence of symptoms—fever first, then mouth sores and rash on hands and feet. Keep in mind that not every infected child shows the classic presentation. If a child has these symptoms, it is reasonable to contact a healthcare provider for confirmation and guidance on managing discomfort and preventing spread.

How HFMD Spreads and Prevention Strategies

Hand, foot, and mouth disease spreads through multiple routes, which is why it is so common in group settings. The primary transmission route is respiratory droplets. When an infected person coughs, sneezes, or talks, tiny droplets containing virus particles travel through the air. These droplets can land on surfaces or be inhaled by nearby people. In childcare settings and schools, where children are in close quarters, respiratory transmission happens easily and frequently.

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Direct contact with sores also spreads the virus. If a caregiver touches an infected child's rash and then touches their own face or eyes, or if another child touches the sores and then puts fingers in their mouth, transmission occurs. This is particularly common when young children play together and touch each other. The virus can enter the body through breaks in the skin, mucous membranes in the eyes, nose, and mouth, and through the digestive tract.

A third route is fecal transmission, which surprises many people. The virus is shed in stool for several weeks, even after rash and other symptoms disappear. Poor handwashing after using the bathroom or changing diapers can transmit the virus. This is why thorough hygiene is especially important in homes with young children and in facilities caring for multiple children.

Prevention strategies focus on breaking these transmission chains. Regular handwashing with soap and water for at least 20 seconds is the most effective step. This should happen after using the bathroom, before eating, after playing outside, and after any contact with body fluids or sores. In settings where handwashing stations may not be immediately available, alcohol-based hand sanitizer (containing at least 60% alcohol) offers some protection, though soap and water is preferred when visibly soiled. Disinfecting frequently touched surfaces like doorknobs, toys, and countertops reduces environmental transmission. Using separate drinking cups and utensils for infected individuals and avoiding sharing food prevents direct contact transmission. Parents who work or attend school should keep infected children home for the first few days of illness, when they are most contagious.

Practical Takeaway: Understanding that HFMD spreads through multiple routes means implementing multiple prevention strategies. Regular handwashing is the single most important preventive step. When HFMD is present in a household or facility, intensified hygiene practices—particularly after diaper changes and bathroom use—significantly reduce transmission to others.

Managing Symptoms and Providing Comfort

Since HFMD is viral, antibiotics do not treat it. Recovery depends on the body's immune system fighting the infection. However, several strategies can make an infected person more comfortable while healing occurs. Pain management is a primary concern because mouth sores make eating, drinking, and swallowing painful. Over-the-counter pain relievers such as acetaminophen or ibuprofen can reduce discomfort and lower fever. Dosing should follow package instructions based on the person's age and weight. These medications typically provide relief for 4 to 6 hours and can be given every 4 to 6 hours as needed, following maximum daily doses.

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Nutrition and hydration require special attention. Painful mouth sores often cause children to refuse food and drink, raising concerns about dehydration. Offering cool, soft foods is more tolerable than hot or hard items. Good options include yogurt, applesauce, mashed potatoes, scrambled eggs, smoothies, ice cream, and pudding. Cold drinks like water, milk, or diluted juice are easier to consume than hot beverages. Popsicles provide both hydration and numbing relief to sore areas. Offering small, frequent feedings rather than large meals is often more successful. If a child drinks very little for more than 8 hours, urinates less frequently than usual, or shows signs of extreme drowsiness, dehydration may be present and medical guidance should be sought.

Topical treatments can provide localized relief for mouth sores. Some parents use milk of magnesia as a coating agent, while others apply salt water rinses to reduce inflammation. Commercial oral numbing products designed for teething pain may help, though these should be used cautiously and according to product instructions. Brushing teeth gently during illness is important for maintaining oral hygiene, but children may prefer soft toothbrushes or rinsing with salt water instead.

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