Hand, Foot and Mouth Disease: What Parents Need to Know

Feel Prepared for Hand, Foot and Mouth Season

Red blisters and sores on your child's hands, feet and sometimes in their mouth are common signs of hand, foot and mouth disease (HFM). While usually mild, the virus can make little ones fussy and uncomfortable. It's also highly contagious, spreading quickly through daycares, schools and homes. Knowing how to ease your child’s symptoms and when to call the doctor can help you feel confident and prepared for hand, foot and mouth season.

What Causes Hand, Foot and Mouth Disease?

Hand, foot and mouth disease is caused by viruses in the enterovirus family, most often coxsackievirus A16. It spreads easily from person to person when someone coughs, sneezes or touches another person. Your child can catch it by coming into contact with an infected person’s blisters, bodily fluids or contaminated surfaces and then touching their own eyes, nose or mouth.

Is There a Hand, Foot and Mouth Disease Season?

“Hand, foot and mouth disease is something we mostly saw in kids 5 years and under, in late summer and early fall,” says Tina Scott-Mordhorst, MD, a pediatrician with Children’s Nebraska. “But since the COVID-19 pandemic, we’ve seen cases year-round — and in all ages, including smaller children and adults.”

What Symptoms are Common for Children?

Hand, foot and mouth disease typically starts as an upper respiratory infection, which seems like an ordinary cold.

“Then, kids often develop a rash on their hands, feet, buttocks, lips and mouth that lasts for about a week,” Dr. Scott-Mordhorst says. “The look of the rash can vary from blisters to red bumps that look like dots, and both can peel as the rash resolves. I also always try to warn parents about that since it can be a little alarming to see fingers and toes peeling after something like that.”

Symptoms may include:

• Rash or blisters on the hands, feet, buttocks, lips and mouth

• Skin peeling

• Mild fever

• Nasal congestion

• Runny nose

• Sore throat

Hand, Foot and Mouth Disease vs. Chickenpox: How to Spot the Difference

The rash associated with both hand, foot and mouth disease and chickenpox can look similar. This can make it hard to tell the difference. While a hand, foot and mouth disease rash can appear anywhere, you’re most likely to see it on the palms of your child’s hands, the soles of their feet or in their mouth. Chickenpox, on the other hand, is more commonly seen on the arms, legs and torso. If your child has a rash and you aren’t sure which condition they have, their pediatrician can help determine whether it’s hand, foot and mouth disease or chickenpox.

How Long is Hand, Foot and Mouth Disease Contagious?

One of the reasons hand, foot and mouth disease spreads so easily is that people are most contagious early on, before the tell-tale rash appears. However, it’s important to know your child will continue to be contagious even as the rash develops. Here’s a good rule of thumb: When the rash or blisters dry up, your child is less likely to spread the disease.

Can Adults Get Hand, Foot and Mouth from Kids?

Yes, children can pass along hand, foot and mouth disease to adults. It’s especially important to keep in mind that adults who are pregnant or have weakened immune systems are more at risk of developing long-term complications if they become infected. Adults who may be more at risk should avoid contact (like hugs and kisses), encourage good handwashing and disinfect frequently touched objects and surfaces.

Managing Hand, Foot and Mouth Disease at Home

While the disease can be uncomfortable for your child and tiring for you, most children recover at home in less than two weeks with no long-term issues.

According to Dr. Scott-Mordhorst, the best thing to do is to treat your child symptomatically. “If they have mouth sores, for example, pushing them to drink water and clear fluids will keep them hydrated (which is especially important for babies) and soothe the affected areas. And although kids tend to favor carbs and crunchy foods, soft and cool foods are likely your best bet. Then, if they’re older and still uncomfortable, you can try acetaminophen (Tylenol) and ibuprofen (Advil).”

When to Call the Doctor: What Parents Should Know

Hand, foot and mouth disease is caused by a virus, so antibiotics are not effective. Most children start feeling better within a week as symptoms clear up on their own.

Still, it’s not always easy to know when to call the doctor. You should contact your child’s provider if your baby is younger than 6 months or has any of the following symptoms:

• A fever that lasts more than three days

• A rash that spreads to the arms or legs

• A weakened immune system

• Changes to fingernails or toenails, such as lifting or coming off

• Painful mouth sores or swollen gums that make it hard to drink fluids

• Signs of dehydration

• Symptoms that last longer than 10 days

• Severe illness or unusual tiredness

If you have any questions or concerns, talk to your pediatrician. At Children’s Nebraska, we can help diagnose hand, foot and mouth disease and offer advice to help your child feel better.