UNC Health Care
Graphic of child with thermometer in mouth

What You Need to Know About Hand, Foot and Mouth Disease

Fever, reduced appetite, sore throat and a general feeling of being unwell—it seems like your child may be coming down with a cold.

But then, one or two days later, painful sores begin to develop in your child’s mouth, and flat red spots, sometimes with blisters, appear on the hands and feet.

It’s not a cold—it’s a common contagious infection called hand, foot and mouth disease (HFMD). Soma Susan Johnkutty, MD, a physician at UNC Pediatrics at Panther Creek, breaks down what you need to know to keep your child—and you—healthy.

What Is HFMD?

HFMD is a contagious infection caused by several viruses, most frequently a virus called coxsackievirus A16. The virus is spread through contact with an infected person’s nose and throat secretions, such as mucus from a sneeze, saliva or phlegm from a cough; blister fluid; or stool.

“Hand, foot and mouth disease is most common in children less than 5 years old,” Dr. Johnkutty says. “And we see it most frequently in the warmer months of the year, in summer and in early fall, before the weather starts turning cooler.”

Because it is easily transmitted, outbreaks of HFMD can happen anywhere groups of young children congregate and spend a lot of time with each other, such as day care centers or summer camps. But adults and older children are not immune—though less common, they can catch the infection, too.

Because HFMD is caused by more than one virus, sometimes HFMD can recur in a person who has already had it. For example, in recent years, cases of HFMD caused by a virus called coxsackievirus A6 have been on the rise, Dr. Johnkutty says. This version of the virus causes an atypical, more severe form of the illness, with more widespread spotting and blistering.

Health complications from HFMD are not common, Dr. Johnkutty says. But in rare cases, HFMD has been reported to occur with viral meningitis; encephalitis (inflammation of the brain); a polio-like paralysis; myocarditis (inflammation of the heart muscle); or fingernail and toenail changes.

Symptoms of HFMD

Symptoms of HFMD include:

  • Fever
  • Sore throat
  • Reduced appetite
  • Mouth sores and blisters (herpangina)
  • Rash of flat red spots that may blister on the hands, feet, knees, elbows, buttocks or genital area

It’s important to note that symptoms of HFMD usually appear in stages, rather than all at once, and not everyone will experience all of them, Dr. Johnkutty says.

Preventing HFMD

The best way to prevent HFMD is through good hand-washing habits, Dr. Johnkutty says. Both children and adults, especially those taking care of children, should wash their hands with soap and water often, for at least 20 seconds. Similarly, avoid touching your eyes, nose and mouth with unwashed hands, as well as close contact with someone with HFMD.

For caretakers or parents caring for a child with HFMD, avoid kissing, hugging and sharing utensils or dishware with your child in addition to regular hand-washing.

Treatment for HFMD

There is no cure for HFMD, which means treatment is focused on managing symptoms, Dr. Johnkutty says. In most cases, HFMD is not dangerous, and the symptoms usually go away on their own, in about seven to 10 days. Taking over-the-counter medications, such as Tylenol or Motrin, to reduce fever and staying hydrated can also help aid the recovery process.

Blisters on the hands and feet should be washed with lukewarm water and soap, and then patted dry. If a blister pops, a dab of antibiotic ointment and a bandage will help prevent infection.

Because HFMD mouth sores can make it painful to eat or drink, people who experience this symptom are more likely to become dehydrated. Make sure you drink or give your child plenty of cold fluids. For pain relief, eat cold foods, such as ice pops or ice cream, to soothe your or your child’s mouth and avoid items that are salty, crunchy, spicy or acidic, as these foods can cause pain when they come into contact with mouth sores.

In severe cases, a doctor may prescribe medication to help ease mouth sores, or a person may need to be hospitalized and treated for dehydration with intravenous fluids. Talk to your doctor about the treatment option that is best for you or your child.


Are you concerned about hand, foot and mouth disease in your household? Talk to your doctor or your child’s doctor. If you need a doctor, find one here.