Hand, Foot and Mouth Disease

Hand, foot and mouth disease, (HFM) is a common and contagious viral illness that mostly affects young children. While it is usually mild, HFM can cause discomfort for kids and concern for parents.

At Banner Children’s, we’re here to help. Learn what causes HFM, how to care for your child and when to call your doctor.

What is hand, foot and mouth?

HFM disease is usually caused by the coxsackie virus, a type  of nonpolio enterovirus. Other strains of enteroviruses can also cause HFM.

The illness gets its name from the blister-like rash on the hands and feet and painful mouth sores.

Why is hand, foot and mouth common among children?

HFM often affects children under age 5 because their immune systems are still growing. Kids also tend to play in close contact and share toys, which makes it easier for viruses to spread.

Older children and adults can also get HFM – even if they've had it before – because different viruses can cause it. 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 were exposed, contact your health care provider. Complications are rare but possible.

How does hand, foot and mouth disease spread?

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

• Direct contact: HFM can spread through saliva, blister fluid, poop and mucus. Kissing, hugging, sharing utensils or cups and changing diapers can spread the virus. 
• Coughs and sneezes: Tiny droplets from coughs or sneezes can carry the virus. Breathing them in may lead to infection. 
• Contaminated surfaces: The virus can survive for hours on surfaces like toys, doorknobs or counters. Touching these can spread the illness.  

What are the symptoms of hand, foot and mouth?

Symptoms usually appear three to six days after exposure. This is called the incubation period.

HFM often starts with a fever, sore throat, upset stomach and loss of appetite. The rash usually appears one to two days after the fever begins.

• Mouth sores: Often appear in the back of the mouth but can also affect the tongue, gums, lips or outside the mouth. Sores may look like flat pink spots, bumps or blisters. 
• Skin rash: Blisters may appear on the hands, feet, bottom or thighs. 
• Nail peeling: Nails may peel a few weeks after the rash. This is harmless and the nails grow back normally.  

How is hand, foot and mouth diagnosed?

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

How is hand, foot and mouth treated?

There is no specific medicine to treat HFM. It usually clears up on its own within 7 to 10 days. You can help your child feel better by: 

• Giving plenty of fluids like water, popsicles or ice chips to prevent dehydration 
• Offering soft foods like mashed potatoes, yogurt or soup 
• Avoiding hot, spicy or acidic foods 
• Using over-the-counter pain relievers like children’s acetaminophen or ibuprofen (for children 6 months or older)—never give aspirin 
• Letting them rest at home 
• Using warm salt water rinses (for children old enough to rinse and spit) 

What are possible complications of hand, foot and mouth?

Serious complications are rare but may include: 

• Dehydration 
• Secondary skin infections 
• Viral meningitis 
• Viral encephalitis 

Call your child’s provider if they have a high fever, severe mouth pain, signs of dehydration or symptoms that last more than 10 days.

When can my child go back to school or daycare?

Let your child’s school or daycare know they have HFM. Most children can return once their fever is gone, blisters are dry and they feel well enough to participate. Some centers may have different return policies. 

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

No. Foot-and-mouth disease affects farm animals and cannot be spread to humans. It is different from hand, foot and mouth disease.

Are there ways to prevent hand, foot and mouth?

To help prevent the spread of HFM: 

• Teach your child to wash their hands often 
• Disinfect toys, counters and shared surfaces 
• Don’t share utensils, cups, towels or toothbrushes 
• Keep your child home when they are sick 
• Avoid close contact with anyone who is sick 

Our expert specialists

Banner Children’s caring team is here to support your family. Most children with hand, foot and mouth disease recover quickly at home. If you have questions or need medical care, schedule a visit with one of our pediatric providers.