Hand, Foot and Mouth Disease in Children: Early Signs & Treatment

What is hand, foot and mouth disease?

Hand, foot and mouth disease (HFMD) is a common viral illness that affects babies and young children, especially under the age of five. It’s caused by a group of viruses known as enteroviruses, most often coxsackievirus A16 or enterovirus 71.

Despite the name, it’s not the same as foot and mouth disease in animals. In children, it usually causes a mild rash and small blisters on the hands, feet, and mouth.

Early signs and symptoms of hand, foot and mouth disease

The early symptoms of hand, foot and mouth disease can look like a cold or mild flu. The first signs often include:

• Fever and sore throat
• Runny or blocked nose
• Cough
• Tiredness or irritability
• Loss of appetite

These early signs typically appear 3-5 days after exposure, known as the incubation period.

Within a few days, small red spots or blisters may develop on:

• The palms of the hands
• The soles of the feet
• Inside the mouth (tongue, gums, or cheeks)
• Occasionally on the arms, legs, or bottom

Blisters may feel itchy or sore, especially in the mouth, and may make swallowing uncomfortable. A sore throat is also common at the start of the illness. 

Hand, foot and mouth in babies

Hand, foot and mouth in babies may cause fussiness, drooling, and reduced feeding due to mouth ulcers. Some infants may have fewer wet nappies because of mild dehydration.

If your baby is under three months old, feeding less than half their usual amount, or breathing fast, contact your GP or paediatrician promptly.

How do you get hand, foot and mouth disease?

HFMD spreads easily through coughing, sneezing, saliva, and contact with blisters or dirty nappies. It can also spread by touching contaminated toys or surfaces.

It is most contagious during the first week, but children can continue to spread the virus for up to two weeks.

Is hand, foot and mouth airborne?

Unlike chickenpox, hand, foot and mouth is not airborne, it spreads mainly through close contact.

How to prevent hand, foot and mouth:

• Wash hands regularly with soap and warm water
• Clean shared toys and surfaces often
• Avoid sharing cups or utensils
• Keep your child home during the contagious period

Comfort and relief tips for hand, foot and mouth

To provide comfort and relief from symptoms, you can:

• Offer cool drinks and soft foods to ease mouth soreness
  
• Use saline nasal spray to clear congestion
  
• Dress your child in loose cotton clothing to reduce itching
  
• Keep their nails short and clean to avoid scratching
  
• Encourage rest and quiet play
  

How to treat hand, foot and mouth disease

There’s no specific medicine for HFMD. It’s a viral infection that clears on its own. However, supportive care at home can make recovery easier.

How to treat hand, foot and mouth at home:

• Fluids: Offer water or milk regularly to prevent dehydration.
• Pain relief: Use paracetamol or ibuprofen for fever and mouth pain (follow dosing advice).
• Soothing foods: Offer yoghurt, smoothies, or soups to avoid irritation.
• Cool compresses: Soothe itchy blisters on the hands and feet.
• Rest: Let your child sleep and recover.

How to treat hand, foot and mouth in infants

In babies, keep feeds small and frequent, use saline drops to ease nasal congestion, and avoid hot or acidic foods. Contact your paediatrician if your baby shows signs of dehydration or difficulty breathing.

Can you go to school or nursery with hand, foot and mouth?

Children should stay home if they feel unwell or have a fever. Once they’re feeling better and the blisters have dried, they can return to school or nursery, usually after five to seven days.

If you’re unsure, check with your childcare provider or GP. It’s also a good idea to let the nursery know so they can disinfect toys and surfaces to prevent spread.

How long does hand, foot and mouth last?

Most children recover within a week to ten days.

The typical timeline of hand, foot and mouth disease is:

• Days 1-3: Fever, sore throat, and reduced appetite
  
• Days 3-5: Blisters appear on the hands, feet, and mouth
  
• Days 7-10: Rash fades and your child starts feeling better

Occasionally, mild peeling on the hands or feet occurs after recovery, this is normal.

How long is hand, foot and mouth contagious?

HFMD is most contagious in the first week, but the virus can stay in the body for up to two weeks. Practise good hygiene even after your child feels better to avoid spreading it to others.

Can you get hand, foot and mouth disease twice?

Yes, it’s possible to get hand, foot and mouth more than once, as different viruses can cause it. However, repeat infections are usually milder and shorter.

When to see a doctor for hand, foot and mouth disease

Call your GP or paediatrician if your child:

• Is under three months old
• Has a high fever that doesn’t settle
• Refuses to drink or feed
• Has fewer wet nappies
• Seems very tired or unresponsive
• Has blisters that look red or infected

Seek emergency care if your child:

• Has blue lips or tongue
• Is struggling to breathe
• Has long pauses between breaths

Hand, foot and mouth vs chickenpox

Although both cause blisters, they’re different infections:

• Location: HFMD affects hands, feet, and mouth; chickenpox covers the whole body.
  
• Itchiness: Chickenpox is typically itchier.
  
• Blisters: HFMD blisters rarely crust over.
  
• Contagion: HFMD spreads through touch; chickenpox spreads through the air.

How Kidswell Health can help

At Kidswell Health, our experienced Paediatric GPs and Paediatricians support families through common childhood illnesses, including hand, foot and mouth disease.

If you’re worried about your child’s symptoms, feeding, or rash, our doctors can assess your child quickly, in person or online, and provide expert reassurance and treatment advice.

💜 Book an appointment online or call 020 3011 1843 to speak with our team.

FAQs about hand, foot and mouth disease

What are the early symptoms of hand, foot and mouth?
Fever, sore throat, tiredness, and loss of appetite, followed by blisters within a few days.

How long does hand, foot and mouth last?
Usually 7-10 days. Mouth ulcers and blisters heal without scarring.

How long is hand, foot and mouth contagious for?
Most contagious in the first week; some children can spread it for up to two weeks.

Can hand, foot and mouth disease come back?
Yes, though later infections tend to be milder.

Can hand, foot and mouth be itchy?
Yes, mild itching or tingling is common, especially on the hands and feet.

Can you go to school or nursery with hand, foot and mouth?
Keep your child home until they feel well and the blisters have healed. This is usually after five to seven days.