Hand foot and mouth disease: symptoms, treatment and how contagious it is

Hand foot and mouth disease, the symptoms, treatments, preventions and causes - get in the know about this very common childhood condition

Hand foot and mouth disease
(Image credit: Alamy Stock Photo)

Hand foot and mouth disease symptoms are usually pretty easy to spot. This is because, as its name suggests, the rash that it causes is normally confined to a person’s hands and feet. They may also experience ulcers in their mouths. Unfortunately, hand foot and mouth disease is very contagious, which is why it often spreads quickly in nurseries and schools.

The first signs of the condition can sometimes appear to be similar to the common cold, with a high temperature and sore throat.Although the condition does not look very pleasant, it usually clears up on its own within 7 to 10 days. NHS GP Thuva Amuthan (opens in new tab) says: "Hand, foot and mouth disease is caused by a virus. It is a common illness in childhood."

Medical researchers state that the cause of hand, foot and mouth disease is coxsackievirus A type 16, in most cases. However, the infection can also be caused by many other strains of coxsackievirus.

Hand foot and mouth disease symptoms

GP Dr. Amuthan, who is also the founder of Dr.Derme (opens in new tab) clinics, says: "Initially you may get a sore throat, high temperature or lose your appetite. Painful mouth ulcers then appear after a few days. These can make it difficult to eat or drink. Raised pink, red, or darker spots appear on your hands and feet as well as thighs and bottoms in some cases. They can be painful if they become a blister."

  • Hand foot and mouth disease spots - When a person has hand foot and mouth disease, spots usually appear on their hands and feet. These raised spots sometimes spread onto their thighs and bottom as well. The spots can look pink, red, or darker than the surrounding skin, depending on the skin tone.
  • Hand foot and mouth disease rash - The rash is quite distinctive. It is a series of spots mainly confined to the hands and feet. Although it may also spread to the thighs and bottom too. If you are unsure about the rash you should call your GP or the NHS 111. The NHS also has a helpful guide to rashes in babies and young children.
  • Hand foot and mouth disease blisters - The spots of hand foot and mouth disease will then turn into blisters These will appear grey or lighter than the surrounding skin and can be painful.
  • Hand foot and mouth disease sores - Sores can appear around the mouth area. This is an area often touched by young children, so it may be uncomfortable for them.
  • Hand foot and mouth disease on the tongue - Ulcers often appear in the mouth and on the tongue with hand foot and mouth disease. These can be painful and make it difficult to eat or drink.

The symptoms are usually the same in adults and children, but they can be worse in babies and children under 5.

It is important to make sure that your child stays hydrated, even if they don’t feel like eating or drinking. Try getting them to take sips of water through a straw if possible. If you think your child is dehydrated and they are not passing urine as often as usual, you should contact your GP.

You should also contact your GP if your child has a very high temperature, or feels hot and shivery. If the symptoms do not improve after 7 to 10 days, seek medical advice.

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How do you catch hand foot and mouth disease?

  • Being close to someone with the condition who coughs or sneezes
  • Being kissed or hugged by someone with it
  • Picking up toys or touching the same surfaces as the person with hand foot and mouth
  • Sharing crockery, utensils, or towels with someone
  • Coming into contact with a child’s faeces, for example when changing a nappy or wiping their bottom

Hand foot and mouth disease is very contagious. It is spread via coughs and sneezes and can also be picked up from surfaces that have been touched by someone with the infection. This is why it often spreads quickly in childcare settings, such as nurseries and schools. 

A person with hand foot and mouth disease is actually most contagious just before their symptoms appear, right up until they’re feeling better.

The fluid from the blisters caused by hand foot and mouth disease can also spread the infection.

In addition, the virus can live for up to four weeks in the stools of a child with hand foot and mouth. So making sure your little one washes their hands after going to the toilet is really important. Plus, make sure you wash your hands thoroughly after changing nappies.

Hand foot and mouth disease treatment

Hand foot and mouth disease treatment simply helps to relieve the symptoms of the condition. This is because it is not possible to take antibiotics or medicines to cure it. The symptoms will usually clear up on their own after about a week. However, as the rash and ulcers can be painful, you can apply a soothing gel, spray, or powder from the chemist to help ease the symptoms. You can also use a children’s paracetamol, such as Calpol, to help keep a temperature down.

Dr. Amuthan says: "Hand foot and mouth disease gets better by itself in 7 to 10 days in most cases. Rest, good hydration, and a soft diet are essential to your recovery. Simple analgesia like paracetamol can help with the pain and temperature."

For adults or older children, you can gargle with salt water to cleanse the mouth ulcers and relieve some of the discomforts. However, this is not recommended for small children in case they swallow it.

It is also important to make sure your child does not get dehydrated. Children can often stop eating and drinking because their mouths are so sore. Encourage your little one to sip fluids through a straw and avoid acidic drinks, like fruit juices. If you are unable to get your child to drink, contact your GP.

Some other ways to ease a hand foot and mouth disease symptoms include:

  • An ice lolly, ice chips or ice cream can relieve the sores in your child’s mouth
  • Eat soft foods like yoghurt and jelly. Avoid anything hot and spicy
  • Rinsing the mouth with warm, saltwater will soothe mouth ulcers and keep them clean
  • A bath with Epsom salts helps to flush out the toxins – and lavender oil has healing properties
  • Coconut oil is anti-viral, you can rub it directly onto the rash or pop a scoop of it into a bath to soothe their skin

You can also visit your local pharmacy for advice on soothing gels or powders.

How long is hand foot and mouth contagious?

Hand foot and mouth is very contagious and can start spreading a few days before symptoms begin. However, it is most likely to spread to others in the first five days after symptoms start.

Dr Amuthan says: "Coughs, sneezes, poo and any fluid from blisters can easily pass it onto others. You can be contagious a few days before you develop any symptoms. You are most contagious in the first 5 days. Children should stay at home whilst they are feeling unwell."

The best way to reduce the risk of getting hand foot and mouth is through good hygiene practices. These include:

  • Washing your hands often with soap and water
  • Using tissues to trap germs when you cough or sneeze and disposing of them immediately
  • Do not share towels or household items like cups or cutlery
  • Disinfect toys before sharing with other children
  • Wash soiled bedding and clothing on a hot wash

Hand foot and mouth disease quarantine period

Children should be kept off school or nursery while they are feeling unwell. However, as soon as they are feeling better they can go back to school or nursery. According to the NHS (opens in new tab), you do not need to wait until all of the blisters have healed, as at this stage they should no longer be contagious. Despite this, you should always inform your childcare provider immediately if your child has had hand foot and mouth. This is so that they can let other parents know that there has been a case in the setting.

According to this review (opens in new tab) of 16 studies in China, the infection spreads rapidly within childcare facilities, with an outbreak length of 4 to 46 days. Researchers stressed the importance of early notification of cases so that preventative measures to stop the spread can be put in place.

Also, some nurseries and schools have their own rules around hand foot and mouth and ask that children do not return until the rash has completely gone.

Can I get hand foot and mouth from my child?

Hand foot and mouth disease is highly contagious and it is possible for a parent to get it from a child. According to information from the National Institute for Health and Care Excellence (NICE): “Spread within families is common”. However, it also adds that some adults are immune following previous exposure during childhood.

If you think you have hand foot and mouth disease, follow the best hygiene practices of washing your hands often with soap and water and using tissues to catch germs when you cough and sneeze.

Do not share items like cutlery, crockery or towels with other members of the household.

Remember to stay hydrated and take paracetamol if you have a temperature. You can also speak to a pharmacist about gels or sprays to help with the itching if you are uncomfortable.

Hand foot and mouth disease pregnancy

Catching hand foot and mouth disease during pregnancy should be avoided if possible. Although there is usually no risk to the pregnancy or baby, it is best to avoid close contact with anyone who has the condition. If you do come into contact with someone with it you should speak to a GP or midwife.

This is because having a high temperature during the first three months of pregnancy can lead to miscarriage, although this is very rare. Also, getting hand foot and mouth disease shortly before giving birth can mean your baby is born with a mild version of it.

Dr. Amuthan says: "It is best to avoid close contact with anyone that has the disease if you are pregnant. Although very rare, having a high temperature in your first three months can lead to a miscarriage. Your baby can be born with a mild form of the disease if you get it just before giving birth."

If your child develops hand foot and mouth while you are pregnant, you should follow all of the best hygiene practices of regularly washing your hands, encouraging them to catch coughs and sneezes in tissues and not sharing items such as cutlery or towels.

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Emily-Ann Elliott
Emily-Ann Elliott

Emily-Ann Elliott is an experienced online and print journalist, with a focus on health, travel, and parenting. After beginning her career as a health journalist at The Basingstoke Gazette, she worked at a number of regional newspapers before moving to BBC News online. She later worked as a journalist for Comic Relief, covering stories about health and international development, as well as The Independent, The i, The Guardian, and The Telegraph. Following the birth of her son with neonatal meningitis, Emily-Ann has a particular interest in neonatal health and parental support. Emily-Ann has a degree in English literature from the University of Newcastle and has NCTJ and NCE qualifications in newspaper journalism.