Hand, foot and mouth disease
Your health expert: Dr Adrian Raby, General Practitioner
Content editor review by Julia Ebbens, December 2022
Next review due May 2026
Hand, foot and mouth disease is a common childhood viral illness. It causes blisters on your hands and feet, and ulcers in your mouth. While it may be unpleasant, it’s generally mild and you usually recover within a week or two.
It has no relation to foot and mouth disease, which only affects cattle, sheep and pigs.
About hand, foot and mouth disease
Hand, foot and mouth disease is most common in children under 10, especially those under four. But people of any age can get it, including adults. However, most adults will have had contact with the disease as a child and are immune. In the UK, it’s most common in the late summer and early autumn.
Causes of hand, foot and mouth disease
Hand, foot and mouth disease is usually caused by a group of viruses known as the coxsackieviruses. The most common cause of the disease is coxsackie virus A16.
Another virus called enterovirus 71 (EV71) can occasionally cause a more severe form of hand, foot and mouth disease but this isn’t common in the UK. These viruses are very easily spread. The infection often spreads through groups of children in nurseries and schools. Viruses pass from one person to another through coughing or sneezing and from direct contact with fluid from blisters. They’re also passed on in an infected person’s poo – so you can spread it if you don’t wash your hands properly after going to the toilet.
You are most contagious while you still have blisters and mouth ulcers – which usually last for seven to 10 days. But you can continue to pass the virus in your poo for up to 2 months, so you may still be mildly infectious during this time. You may also be infectious for a few days before the rash appears, which makes the spread of the infection even harder to control.
Symptoms of hand, foot and mouth disease
Symptoms usually appear three to seven days after becoming infected (this is the incubation period). Symptoms generally last for around seven to 10 days.
For the first few days, you may feel generally unwell with:
- a fever
- a sore throat
- a cough
- loss of appetite
- pain in your abdomen (tummy)
These early symptoms are similar to many other viral infections. But within a few days, you may start to develop symptoms more typical of hand, foot and mouth disease, including:
- blisters or ulcers in your mouth
- spots or blisters on your hands and feet
Mouth ulcers and blisters usually develop within a couple of days after you start feeling unwell. They’re most common on the roof of your mouth, the inside of your cheek and your tongue, which can make eating and drinking painful.
Spots and blisters on your hands and feet tend to develop soon after the blisters in your mouth. They tend to come up on the backs of your hands, the sides of your fingers, and the heels of your feet. Although less common, they may also appear on the palms of the hands and soles of the feet. Blisters often ulcerate (break down) and crust over. They can also be painful or itchy.
The rash tends to be more widespread in younger children and babies. And they are more likely to get the rash on the buttocks and groin. Older children may just have spots and blisters in and around their mouths.
Hand foot and mouth blisters on hand and mouth ulcers
You won’t need to see your GP if symptoms are mild because you can usually manage them at home. If you or your child becomes more unwell though, contact your GP surgery for advice.
Seeking help for hand, foot and mouth disease
You don’t usually need to see your GP for hand, foot and mouth disease, especially if you know it’s been going round your child’s school or nursery. But if your child is becoming more unwell or if you’re not sure what’s causing their symptoms, contact your GP surgery for advice.
Your GP will usually be able to tell if you have hand, foot and mouth disease by checking the spots or blisters on your body and ulcers in your mouth.
Under 18 GP Appointments
We now offer GP appointments for children aged between 1 and 18 via our remote video service (UK wide) and face to face appointments at selected centres. Please note that these appointments cannot be booked online so please call 0330 822 3072 for more information or to book. Lines are open Monday to Friday 8am to 8pm, Saturday and Sunday 9am to 5pm. We may record and monitor our calls. Available from £49.
To book or to make an enquiry, call us on 0343 253 8381∧
Self-help for hand, foot and mouth disease
There isn't any specific treatment for hand, foot and mouth disease. The infection usually clears up on its own after around seven to 10 days. Antibiotics won’t work because the infection is caused by a virus, not bacteria. There are a number of things you can do to help relieve your symptoms.
- Make sure you drink enough fluids to prevent dehydration.
- If you have painful mouth ulcers, stick to soft foods such as soup or yoghurt.
- If you need pain relief or have a high temperature, take over-the-counter painkillers such as paracetamol or ibuprofen.
- You can use teething gels such as Dentinox in babies older than 5 months.
- You can use dental mouth gels containing lidocaine in children over 4 years old or mouth sprays containing benzydamine to soothe painful mouth ulcers.
- Adults and children over 13 can use mouthwashes containing benzydamine. There is also choline salicylate gel (for example, Bonjela) that teens and adults over the age of 16 can use.
Always read the patient information that comes with your medicine. If you need any advice about what types of medicines to use for your or your child’s symptoms, you can check with a pharmacist.
Complications of hand, foot and mouth disease
Hand, foot and mouth disease is usually a mild infection. But occasionally it can lead to more serious problems.
- Dehydration is the most common complication. Blisters in your mouth might make drinking painful – so you may not drink enough. Young children may find it easier to drink through a straw. Ice lollies can be a useful way to increase hydration.
- Blisters on your skin can become infected, especially if you scratch them. If one or more areas of your skin becomes very red and you develop a high temperature, see your doctor. You may need antibiotics for a secondary bacterial infection.
Young children are especially prone to dehydration. Signs that you or your child may be dehydrated include feeling thirsty, having a dry mouth and not passing urine as often. You should contact your doctor if you think your child is dehydrated because if it’s severe, babies or young children may need to go to hospital to have fluids through a drip.
More serious complications are much rarer, and are generally related to a more severe type of hand, foot and mouth disease caused by enterovirus 71 (EV71). Most people in the UK won’t have this form of the disease.
If you or your child become more unwell or don’t get better after a week or so, contact your doctor for advice.
Pregnancy
Doctors don’t think hand, foot and mouth disease will cause any risk to your developing baby if you get it when you’re pregnant. But it makes sense to try and avoid close contact with anyone with any infection, especially if you’re getting close to your due date.
If you get hand, foot and mouth disease within three weeks of being due to give birth, you could pass the infection to your new-born baby. So if you have symptoms such as a rash when you’re pregnant, talk to your midwife or GP for advice.
Prevention of hand, foot and mouth disease
Hand, foot and mouth disease spreads very easily. To reduce your risk of catching or spreading it, you should:
- wash your hands thoroughly with soap and water before you eat and after going to the toilet
- cover your mouth and nose when you cough or sneeze – use a tissue and wash your hands afterwards
- clean surfaces that may have been in contact with saliva or faeces with cleaning products containing bleach. (If you use bleach on a changing mat, rinse it off afterwards.)
- dispose of used tissues and nappies properly after changing your baby
- wash soiled clothing, towels, and bedding on a hot machine wash with laundry bleach
- don’t share cups, utensils or towels with people who are infected
- the virus is contained in the spots and blisters, so don’t deliberately squeeze or pierce them
- try to avoid contact with other people – particularly pregnant women – as much as you can while you have symptoms
- remember that the virus can be found in poo for a number of weeks after you’ve had the infection so take extra care after using the toilet
Hand, foot and mouth disease is a common childhood viral illness, especially in children under 10 and those under four. But people of any age can get it, including adults.
It causes blisters on your hands and feet, and ulcers in your mouth. But, it is generally mild and you usually recover within a week or two.
Hand, foot and mouth disease is usually caused by a group of viruses known as the coxsackieviruses. The most common cause of the disease is coxsackie virus A16.
Another virus called enterovirus 71 (EV71) can occasionally cause a more severe form of hand, foot and mouth disease but this isn’t common in the UK. See our causes of hand, foot and mouth disease section for more information.
These viruses are very easily spread. They pass from one person to another through coughing or sneezing and from direct contact with fluid from blisters. They’re also passed on in an infected person’s poo – so you can spread it if you don’t wash your hands properly after going to the toilet. See our prevention of hand, foot and mouth disease section for more information.
While it may be unpleasant, it’s generally mild and you usually recover within a week or two. Serious complications are rare, and are generally related to a more severe type of hand, foot and mouth disease caused by enterovirus 71 (EV71). Most people in the UK won’t have this form of the disease. See our complications of hand, foot and mouth disease section for more information.
The main difference between chickenpox and hand, foot and mouth disease is where you get the blisters.
With hand, foot and mouth disease, you tend to get blisters on your hands and feet, and blisters or ulcers in your mouth.
With chickenpox, you’ll usually get spots all over your body, face, scalp, arms and legs.
Children should really stay home if they feel unwell. But official guidance is that they don’t need to be kept away from nursery or school if they feel well. Different childcare providers may have their own rules though, so you should check with your child’s nursery or school.
It’s possible, although most adults are immune to the viruses that most commonly cause the disease.
If you get hand, foot and mouth disease, you become immune to the specific virus that caused it. This means you won’t get that particular virus again. However, there are several different viruses that cause hand, foot and mouth disease. Even if you’re immune to one, you could become infected with another – and you may then develop hand, foot and mouth disease again.
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- Hand, foot and mouth disease. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last updated November 2015
- Hand-foot-and-mouth disease. BMJ Best Practice. bestpractice.bmj.com, last reviewed September 2020
- Oxford Handbook of General Practice. (5th ed). Oxford Medicine Academic. academic.oup.com, published June 2020
- Dentinox teething gel. Electronic Medicines Compendium. medicines.org.uk, last updated September 2018
- Hand, foot and mouth disease. Patient. patient.info, last updated July 2015
- Benzydamine hydrochloride. NICE British National Formulary for Children. bnfc.nice.org.uk, accessed October 2020
- Choline salicylate. NICE British National Formulary for Children. bnfc.nice.org.uk, accessed October 2020
- Chickenpox. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last updated August 2018
- Hand, Foot, and Mouth Disease. Center for Disease Control and Prevention. cdc.gov, last reviewed July 2015
