What Is Hand, Foot, And Mouth Disease?

Doctor examining little girl's hand
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Hand, foot, and mouth disease (HFMD) is one of those viruses that makes parents say “Ughhhh!” It involves blisters in the mouth, fingers, toes, feet, and buttocks. One possible complication is peeling fingernails (yes, really!), and it's also super-contagious.

No one wants to deal with HFMD, but the good news is that it is not considered medically serious. Most children will get it at some point or another, and will fare well.

Let’s take a look at what parents need to know about HFMD disease, including what symptoms to watch out for, what causes it, what treatment options are available, and what possible complications can arise.

What Is Hand, Foot, and Mouth Disease?

Hand, foot, and mouth Disease (HFMD) is a sickness usually caused by the coxsackievirus virus. It most commonly strikes kids under the age of 5, but older children and adults can be infected too. The most typical symptoms of HFMD disease are fever, sore throat, and blisters in the mouth, as well as on the hands and feet. Symptoms are usually mild, and supportive treatments like fever reducers and hydration are generally all that are needed. Most children have uncomplicated cases and make full recoveries.

Symptoms of Hand, Foot, And Mouth Disease

When you picture HFMD, you likely picture a child with telltale blisters in their mouths, hands, and feet. But there are other symptoms that children experience with the condition, and HFMD doesn’t always start with blisters.

Fever and sore throat are usually the first symptoms of HFMD, says Victoria Regan, MD, a pediatrician at Children’s Memorial Hermann Hospital in Houston. The symptoms then progress to sores in your child’s mouth, usually around their lips and gums, says Dr. Regan. Blisters also may appear on the palms of the hands and soles of the feet. “Some children may also get a blistery rash on their buttocks,” Dr. Regan adds.

What exactly do these blisters look like? “The rash may appear flat or might have slightly raised red spots that develop into blisters,” says Lisa Hoang, MD, a pediatrician with Providence Mission Hospital. Dr. Hoang says that the rash is generally not itchy. Symptoms are the worst for children during that first week, Dr. Hoang adds.

One of the most uncomfortable aspects of HFMD disease is that the sores that develop in the mouth can be painful, says Dr. Hoang. Some children will refuse to eat or drink because of how painful the sores are. Children may also drool more or only want to consume cold beverages.

Fevers associated with HFMD disease usually last about 3 days, and the blisters and rash usually are gone by 7-10 days.

Diagnosis

If you think your child may have HFMD disease, it can be helpful to visit the pediatrician for a concrete diagnosis. In most cases, your pediatrician will examine your child and diagnose the virus on sight, says Muzna Atif, M.D, pediatric hospitalist and medical director of inpatient pediatric hospitalist services at Pomona Valley Hospital Medical Center.

“Diagnosis is usually a clinical one, based on the typical appearance and location of rash,” says Dr. Atif. “Testing for confirmation is only necessary if diagnosis is uncertain and would affect management.” If more information is needed to confirm the diagnosis, it would involve getting a sample from your child’s throat, stool, or a blister and sending it off to be tested, Dr. Atif explains, adding that this is rarely necessary.

Causes

Hand, foot, and mouth disease is caused by a virus called coxsackievirus, which is part of the Enterovirus family. Various types of coxsackieviruses can cause HFMD, but coxsackievirus A16 and enterovirus A71 are most commonly involved. Because HFMD is a virus, it cannot be treated with antibiotics.

How Is HFMD Transmitted?

HMFD usually hits young children hardest, especially those between the ages of 5-7, says Dr. Atif. The virus usually strikes in the summertime or early autumn period, Dr. Atif adds.

The virus is also very easy to catch. “Since its transmission is by contact with oral and respiratory secretions, or fecal-oral, it is quite contagious,” Dr. Atif explains. That means kids can contract it through contact with the respiratory or fecal secretions of an infected person, or by touching surfaces that have the virus on it, such as toys or doorknobs. Water in a swimming pool that is not properly chlorinated can also be a source of infection.

HFMD frequently causes outbreaks in settings where young children make close contact. “Kids who go to preschool or daycare are at a higher risk of catching the virus because it spreads from person-to-person,” Dr. Hoang describes.

Treatment

Treatment for hand, foot, and mouth disease is usually focused on making your child feel more comfortable. “The management of HFMD is mainly supportive care,” says Dr. Atif. There are no specific antiviral treatments for HFMD.

If your child is experiencing pain from the blisters, this can be managed with pain relievers like acetaminophen and ibuprofen, Dr Atif explains. Of course, you should talk to your child's pediatrician about proper dosing of these medications based on your child’s age.

It’s important to rest and drink plenty of fluids while recovering, says Dr. Regan. She suggests avoiding acidic drinks like orange juice because they can make sores hurt more. According to the Academy of American Pediatrics (AAP), some pediatricians will recommend liquid remedies to treat mouth pain from blisters. You should only use a remedy recommended by your chid's pediatrician or healthcare provider, and stay away from using mouthwash.

Complications

Complications are rare with hand, foot, and mouth disease, says Dr. Hoang. “Most children get better within a week or so,” she explains. “Extremely rare complications include viral meningitis and encephalitis,” Dr. Hoang shares. But these types of complications are usually not something you need to worry about. Dr. Hoang advises parents to talk to their pediatrician if their child’s symptoms are not improved as expected or if new troubling symptoms emerge.

By far, the most common complication that kids may experience is dehydration, says Dr. Regan. “Children may find eating and drinking painful so they may refuse to eat or drink,” she says. “Offering small amounts of mild, non-acidic drinks and smooth foods like yogurt or ice cream may help coax your child.”

Perhaps one of the strangest complications that can occur is that sometimes your child’s fingernails or toenails will fall off a few weeks after recovering from HFMD. The CDC assures your child’s nails will grow back just fine.

A Word From Verywell

Hand, foot, and mouth disease is one of those annoying, miserable viruses that most children are fated to get at some point or another. The silver lining is that as unsightly and uncomfortable as the virus can be, there is really nothing for parents to worry about. The vast majority of kids recover with no complications or lasting effects. If you have any further questions about HFMD, please reach out to your child's pediatrician or healthcare provider.

6 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Pediatrics. Hand, Foot & Mouth Disease: Parent FAQs.

  2. Centers for Disease Control and Prevention. Complications of Hand, Foot, and Mouth Disease.

  3. Guerra AM, Orille E, Waseem M. Hand Foot And Mouth Disease. In: StatPearls. StatPearls Publishing. 2022.

  4. Centers for Disease Control and Prevention. Symptoms and Diagnosis of Hand, Foot, and Mouth Disease.

  5. Centers for Disease Control and Prevention. Causes & Transmission.

  6. Centers for Disease Control and Prevention. Treat Hand, Foot, and Mouth Disease.

By Wendy Wisner
Wendy Wisner is a lactation consultant and writer covering maternal/child health, parenting, general health and wellness, and mental health. She has worked with breastfeeding parents for over a decade, and is a mom to two boys.

Originally written by
Vincent Iannelli, MD

Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years.

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