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Jeremy Lopez

Hand, Foot, and Mouth Disease: Symptoms and Care

Hand, foot, and mouth disease is a common viral illness that causes a fever, mouth sores, and a rash on the hands and feet, most often in children under five.

Hand, Foot, and Mouth Disease: Symptoms and Care
Children's HealthHand-Foot-Mouth Diseasesymptom-check
Written By: DocAi Health Editorial Team
Last Updated: 2026-08-24
Medically Reviewed By: DocAi Health Medical Review Team
Medical Disclaimer: This article is for general informational and educational purposes only and is not medical advice. It does not create a doctor-patient relationship and is not a substitute for professional diagnosis or treatment by a qualified healthcare provider. Never disregard or delay seeking professional medical advice because of something you have read here. If you think you may have a medical emergency, call 911 or your local emergency number right away. Health information can change and this guidance is general and US-focused, so consult a licensed clinician in your own country about your specific situation.
Hand, foot, and mouth disease is a common viral illness that causes a fever, mouth sores, and a rash on the hands and feet, most often in children under five. It is caused by a virus called coxsackievirus and usually clears on its own within seven to ten days with rest, fluids, and pain relief at home. The illness looks alarming when the rash and mouth ulcers first appear, but most children recover without any lasting effects. This article covers what the rash and mouth sores actually look like, how the illness spreads through a household or daycare, what helps at home, and the specific signs that mean it is time to call a doctor.

What Causes Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease is caused most often by coxsackievirus A16, part of a group of viruses called enteroviruses. A related virus, enterovirus 71, can also cause it and is more often linked to severe cases, though this is uncommon in the United States. The virus spreads through saliva, fluid from blister sores, mucus, and stool, and it travels easily in places where young children share toys, close contact, and unwashed hands, which is why daycare and preschool outbreaks are so common.
A child is contagious in the first week of illness even before the rash shows up, and the virus can keep shedding in stool for weeks after symptoms resolve. That long stool-shedding window is one reason handwashing after diaper changes and after bathroom use matters even once your child looks completely well again.

Early Symptoms and Timeline

Symptoms usually start with a fever, often in the 101°F to 103°F (38.3°C to 39.4°C) range, along with a sore throat, reduced appetite, and general fussiness. This early phase can look like any other viral illness for a day or two before the more recognizable signs appear.
One to two days after the fever starts, painful sores typically develop in the mouth, usually on the tongue, gums, and the inside of the cheeks. These start as small red spots and turn into shallow ulcers that can make eating, drinking, and even swallowing saliva uncomfortable. A skin rash follows or appears around the same time, most often on the palms of the hands, soles of the feet, and sometimes the buttocks or knees. The rash can look like flat red spots, small bumps, or fluid-filled blisters, and it is not usually itchy, which is one way parents distinguish it from other childhood rashes.

What the Rash and Mouth Sores Look Like

The skin lesions tend to be small, gray or skin-colored blisters ringed with a thin red border, concentrated on the palms and soles rather than spread across the whole body. This distribution is one of the more reliable clues, since many other viral rashes in children spread more broadly across the trunk. If you are trying to tell this rash apart from chickenpox, a drug reaction, or a heat rash, the DocAI Health guide to common childhood rashes walks through how location and texture differ across the most frequent causes.
The mouth sores are usually the most uncomfortable part for a young child, more so than the skin rash itself. They can make a toddler refuse food, refuse the bottle or cup, and drool more than usual because swallowing hurts. Watching how much your child is drinking matters more during this illness than watching the rash, because dehydration from painful swallowing is the most common complication that actually needs medical attention.

Caring for Your Child at Home

Most cases of hand, foot, and mouth disease are managed entirely at home. Offer cool, soft, bland foods and drinks that do not sting the mouth sores. Cold items like ice pops, yogurt, milk, and diluted juice tend to be tolerated better than acidic juices, citrus, or salty and spicy foods, which can make the sores burn.
For fever and mouth discomfort, acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) can help, but always follow the dose printed on the product label for your child's current weight and age, and check with your pediatrician or pharmacist before giving any fever or pain medication to an infant. Ibuprofen is generally avoided in infants younger than six months unless a doctor has directed otherwise.
Keep offering small sips of fluid frequently rather than large amounts at once, since a child in mouth pain will often refuse a full cup but accept a spoonful or a popsicle. A humidifier in the bedroom and keeping your child comfortable and rested through the fever days both help, though there is no medicine that shortens the course of the virus itself, since antibiotics do not work against it.

How Long It Lasts and When Your Child Can Return to Daycare

The fever usually breaks within two to three days, and the mouth sores and rash typically fade over seven to ten days total. Many schools and daycares use a fever-free, blister-free standard rather than a fixed number of days, so check your specific program's policy and confirm with your pediatrician when your child is ready to return, since the virus can still shed in stool well after visible symptoms are gone.

Preventing Spread at Home

Because the virus spreads through saliva, blister fluid, and stool, frequent handwashing is the single most effective prevention step, for both the sick child and everyone caring for them. Avoid sharing cups, utensils, and towels during the illness, clean toys and high-touch surfaces regularly, and wash hands carefully after diaper changes even after the rash has faded. There is no vaccine for hand, foot, and mouth disease in the United States, so these everyday hygiene habits are the main defense, especially in households with more than one young child.

Can a Child Get Hand, Foot, and Mouth Disease More Than Once

Yes. Because several different viruses can cause hand, foot, and mouth disease, having it once does not protect your child from getting it again from a different strain later. Repeat cases are common in children who attend daycare or preschool, where new exposures happen regularly across a school year.

Rare but Serious Complications

Most children recover with no problems at all. In a small number of cases, the fingernails or toenails can loosen and shed several weeks after the illness, a harmless and temporary side effect called onychomadesis that resolves as the nail regrows. A more serious but rare complication is when the virus spreads beyond the skin and mouth to affect the brain, its lining, or the heart, which is why the emergency signs above focus on neurological changes like a stiff neck, severe headache, seizures, or sudden weakness rather than the rash itself. Severe dehydration from refusing fluids is by far the more common reason children with this illness end up needing medical care.

When to Seek Medical Care

When to Seek Urgent or Emergency Care

Hand, foot, and mouth disease is usually mild, but the mouth pain can drive a young child to refuse fluids to the point of dehydration, and in rare cases the virus can affect the brain or heart. This guidance is in addition to, not a replacement for, the general disclaimer above.

Emergency, call 911 or go to the emergency room immediately if:

  • Your child has not urinated in 8 hours or more, has a dry mouth, sunken eyes, or is unusually drowsy or hard to wake, which can signal severe dehydration
  • Your child develops a stiff neck, a severe headache, or repeated vomiting along with the fever, which can signal a rare complication affecting the brain or its lining
  • Your child has a seizure, sudden weakness, trouble walking, or jerking movements they cannot control
  • Your child is struggling to breathe, is breathing very fast, or has bluish lips or skin
  • A fever in an infant younger than 3 months reaches 100.4°F (38°C) or higher
  • Your child seems limp, unresponsive, or extremely lethargic even after the fever comes down

See a doctor soon (same-day or next available appointment) if:

  • Your child is drinking noticeably less than usual and you are worried about dehydration, even if urination has not stopped completely
  • The fever lasts longer than 3 days or climbs above 104°F (40°C)
  • Mouth sores are so painful your child refuses almost all food and liquids for more than a few hours
  • The rash spreads widely, looks infected with increasing redness, warmth, swelling, or pus, or your child develops new pain around the fingernails or toenails in the weeks after
  • Your child has a weakened immune system or a chronic medical condition
  • Symptoms have not started improving after 10 days
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Frequently Asked Questions

How long is hand, foot, and mouth disease contagious?

A child is most contagious during the first week of illness, often before the rash even appears, through saliva, blister fluid, and nasal secretions. The virus can also keep shedding in stool for several weeks after the child looks completely well, so ongoing handwashing after diaper changes and bathroom trips still matters after symptoms fade.

Can adults catch hand, foot, and mouth disease from their child?

Adults can catch it, though it is far less common than in young children because most adults built immunity to some strains during their own childhood. When adults do get it, the fever and rash are often milder, but mouth sores can still make eating uncomfortable for several days.

What can my child eat with mouth sores from hand, foot, and mouth disease?

Cold, soft, bland foods tend to be tolerated best, such as yogurt, milk, ice pops, applesauce, and diluted water or milk-based drinks. Avoid citrus, tomato-based foods, salty snacks, and anything crunchy or spicy, since these can sting the open sores and make a child refuse fluids altogether.

Is hand, foot, and mouth disease the same as foot and mouth disease in animals?

No, they are unrelated illnesses caused by completely different viruses. Foot and mouth disease affects livestock like cattle and pigs and does not spread to humans, while hand, foot, and mouth disease is a human illness, most often in young children, caused by coxsackievirus or a related enterovirus.

Does hand, foot, and mouth disease always cause a rash on the hands and feet?

Most children develop the classic rash on the palms and soles, but some cases are milder and show only mouth sores with little or no visible skin rash. The rash can also appear on the buttocks, knees, or elbows in some children, so the pattern varies more than the name suggests.

Can I give my baby ibuprofen for hand, foot, and mouth disease fever?

Ibuprofen is generally avoided in infants younger than six months and should not be given without your pediatrician's direction, since dosing and safety depend on your baby's age and weight. Acetaminophen is more commonly used in young infants, but always confirm the correct product and timing with your pediatrician or pharmacist first.

How is hand, foot, and mouth disease diagnosed?

Most cases are diagnosed by a clinician simply examining the mouth sores and the rash pattern on the hands and feet, along with the recent fever history. Lab testing is rarely needed and is usually reserved for more severe or unusual presentations, or when a doctor wants to confirm the specific virus involved.

Should I keep my child home from daycare with hand, foot, and mouth disease?

Yes, most pediatricians and daycare programs recommend keeping a child home while there is a fever and while blisters are still fresh and open, since this is when the child sheds the most virus through saliva and close contact. Check your specific program's return policy, since some use a fever-free standard rather than a fixed number of days.
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