Hand Foot and Mouth Disease

What Is It?

Hand foot and mouth disease (HFMD) is a common childhood illness caused by the coxsackievirus.  The virus causes painful red blisters most commonly to hands, feet, diaper area, as well as inside and around the mouth.  The blisters are typically accompanied by or preceded by a fever (over 100.4 F), but not always.

The Rash

  • The infection is called “hand foot and mouth” disease, because it is classically present in these areas of the body. That being said, the rash is often present elsewhere on the body, such as the arms, legs, abdomen, and in the diaper area.
  • The rash usually starts with flat, red spots on the body.

  • Over the course of a day or two, the flat spots become raised, and then turn into blisters (small, and full of clear fluid). This is typically when the rash is the most painful.

  • From there, the blisters open up (also painful), and then scab over.

  • Your child is contagious until the blisters have all scabbed over. The whole process usually takes 5-10 days from the first day of the flat, red spots.

Is It Contagious?

  • HFMD is extremely contagious.  It is typically spread through saliva, mucus, feces, and fluid from the blisters.  As discussed above, your child is contagious until all the blisters have scabbed over.
  • Adult caregivers also get HFMD from their children. Usually, this just manifests as mild viral symptoms (malaise, cough, congestion), but developing sores on the skin or in the mouth does happen as well.
  • Do your best to maintain good hygiene in the home (frequent hand washing, cleaning of surfaces), and keep your infected child away from other kids.


  • Your child’s body will beat this virus in 10-14 days, hopefully sooner! There is no medicine to cure the virus from the body, nor is there a vaccine to prevent it.


  • We don’t treat the rash with ointments or salves because open air will speed the healing process.


  • Tylenol (all ages) and Motrin (if older than 6 months) will help manage the pain in the mouth and on the body.
  • Cold, soft foods (popsicles, smoothies) with help soothe the mouth and throat.
  • Avoid citrus and spicy liquids.
  • Can try "Magic Mouthwash" which is a homemade treatment you can give your child to help with mouth ulcers. The instructions can be found here: Magic Mouthwash


  • The primary danger with HFMD is that a child will completely refuse liquids (due to pain) and develop dehydration as a result.
  • Tylenol and motrin will reduce the pain with drinking, and help keep them hydrated.
  • Push non-citrus fluids (breast milk, formula, water), and mark down the time of day your child urinates.
  • Please don’t worry if your child won’t eat solid foods. This is normal, and will pass when the mouth blisters scab over.

Reach out to Modern Pediatrics if…

  • Concerns for dehydration - child is not having urine output at least every 8 hours
  • Symptoms are not improving after 14 days
  • Any signs of respiratory distress
  • Your child has a fever for more than 72 hours in a row
  • If anything else is worrying you!