Hand, Foot and Mouth Disease
Mouth ulcers, spots on the hands and feet, and a child who won’t eat. Hand, foot and mouth disease spreads quickly through childcare and usually clears by itself in 7 to 10 days. The main job is keeping your child drinking.
What it is: a viral infection, usually from a coxsackievirus. It is not related to foot-and-mouth disease in animals. It mostly affects children under 10, but adults can catch it too, usually with milder symptoms.
Symptoms: it often starts with a sore throat, fever and going off food. A few days later come mouth ulcers and a spotty rash on the hands and feet, sometimes the bottom and groin, which can turn into small blisters. Symptoms usually begin 3 to 7 days after catching it.
How it spreads: through coughs, sneezes, blister fluid and poo. People are most infectious in the first 5 days of symptoms, but the virus can stay in poo for several weeks. You can catch it more than once.
Nails: some children lose a fingernail or toenail a few weeks later. It grows back.
The treatment ladder
There’s no cure and antibiotics don’t work. Treatment is about comfort and fluids while the virus runs its course.
- Step 1 · Self-careCool drinks and soft foodOffer cool drinks often, and soft foods such as yoghurt. Avoid acidic drinks like fruit juice, and hot, salty or spicy food, which sting.
- Works
- Doesn’t shorten the illness, but helps prevent dehydration, the main risk
- Cost
- Free
- How long
- 7 to 10 days
- Watch for
- Peeing less than usual can be a sign of dehydration.
Ice blocks: finally, medically endorsed.
- Step 2 · PharmacyPain relief and mouth gelsParacetamol or ibuprofen can ease a sore mouth and fever. A pharmacist can suggest a mouth gel or spray that suits your child’s age.
- Works
- Eases pain enough to drink, which is what matters
- Cost
- About $5–15
- How long
- As needed
- Watch for
- Don’t give aspirin to children.
A comfortable mouth drinks more.
- Step 3 · GPA check for complicationsFor very young babies, severe symptoms, signs of dehydration, or if it isn’t better after 7 to 10 days. Usually diagnosed by looking, without tests.
- Works
- Picks up the rare child who needs more help, such as fluids in hospital
- Cost
- Often bulk billed for children; varies
- How long
- Same day if your child isn’t drinking
- Watch for
- Pregnant women who catch it should talk to their GP or midwife.
Most of the time the GP’s job is reassurance. That still counts.
Save your money
Popular, heavily marketed or often asked about, but the evidence is weak or says no.
- AntibioticsIt’s caused by a virus. Antibiotics don’t work.
- Popping the blistersLeave them to dry naturally. The fluid is infectious.
- Acidic drinks and spicy foodThey sting a sore mouth and put children off drinking.
What you can do
- Offer drinks little and often, and try ice blocks for older children.
- Wash hands well, especially after nappy changes and wiping noses.
- Don’t share cups, cutlery, towels or clothes.
- Clean toys and surfaces, as the virus can live on them.
- Childcare rules vary. In Australia, keep children home until the blisters have dried. NHS advice in the UK is to return once they feel well.
- For mouth ulcers that aren’t from a virus, see our mouth ulcers fact sheet.
See your GP if
- Your child is a young baby or seems quite unwell
- It isn’t getting better after 7 to 10 days
- Mouth ulcers are so sore your child can’t swallow
- You’re pregnant and have caught it or been in close contact
- Your child has eczema that flares or looks infected
See a doctor urgently if
- Signs of dehydration: few wet nappies or little wee, a dry mouth, or unusual sleepiness
- A fever of 38°C or more lasting 3 days or longer
- Jerky movements, trouble walking, or unusual drowsiness or irritability
- Fast breathing
Call 000 (Australia) or your local emergency number if your child is very hard to wake, struggling to breathe, has a fit, or seems seriously unwell. Serious complications are very rare.
Common questions
How long is hand, foot and mouth disease contagious?
People are most contagious in the first 5 days of symptoms, and can spread it a few days before symptoms start. The virus can stay in poo for several weeks, so keep washing hands after nappy changes.
When can my child go back to childcare?
In Australia, the advice is to keep children home until their blisters have dried up. UK advice is that they can return once they feel well. Check your centre’s rules.
Can adults get hand, foot and mouth disease?
Yes, though symptoms are often mild. If you’re pregnant and catch it, talk to your GP or midwife. Usually there is no risk to the baby.
Why are my child’s nails falling off?
Some children lose a fingernail or toenail a few weeks after the illness. It’s temporary, and the nail grows back.
Helpful resources
- healthdirect: Hand, foot and mouth diseaseSymptoms, spread and childcare advice. Free, Australia.
- NHS: Hand, foot and mouth diseaseHome care and when to get help. Free, UK.
- Fever in children fact sheetWhen a temperature needs a doctor. Free, from us.
Evidence and more information
maladywise.com/hand-foot-mouth/