Should Your Child See a Doctor?
- A viral infection that causes mouth ulcers and tiny blisters on the hands and feet
- Small painful ulcers in the mouth, especially on tongue and sides of mouth (in all children)
- Small, thick-walled water blisters (like chickenpox) or red spots located on the palms, soles, and webs between the fingers and toes (70%)
- 1 to 5 water blisters per hand or foot
- Small blisters or red spots on the buttocks (30%)
- Low-grade fever less than 102° F (39° C)
- Mainly occurs in children age 6 months to 4 years
- Coxsackie A-16 virus
- Not related to animal disease
Return to School
- Can return to child care or school after the fever is gone (usually 2 to 3 days). The rash is not contagious.
When to Call Your Doctor for Hand-Foot-Mouth Disease
Call Your Doctor Now (night or day) If
- Your child looks or acts very sick
- Signs of dehydration (e.g., very dry mouth, no tears, no urine in more than 8 hours)
- Stiff neck, severe headache or acting confused (delirious)
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
- You think your child needs to be seen
- Red, swollen and tender gums
- Ulcers and sores also present on outer lip
- Fever present for more than 3 days
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
Parent Care at Home If
- Probable hand-foot-mouth disease and you don't think your child needs to be seen
Home Care Advice for Hand-Foot-Mouth Disease
- Reassurance: Hand-foot-mouth disease is a harmless viral rash.
- Liquid Antacid for Mouth Pain:
- Use a liquid antacid 4 times per day.
- For younger children, put ½ teaspoon (2 ml) in the front of the mouth 4 times per day after meals.
- Children over age 4 can use 1 teaspoon (5 ml) as a mouthwash after meals.
- Soft Diet:
- Encourage favorite fluids to prevent dehydration.
- Cold drinks, milkshakes, popsicles, slushes, and sherbet are good choices.
- Avoid citrus, salty, or spicy foods.
- For infants, give fluids by cup, spoon or syringe rather than a bottle. (Reason: The nipple can cause pain.)
- Solid food intake is not important.
- Fever Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for fever above 102° F (39° C) or severe mouth pain.
- Contagiousness: Quite contagious but a mild and harmless disease. Incubation period is 3-6 days. Can return to child care or school after the fever is gone (usually 2 to 3 days). The rash is not contagious.
- Expected Course:
- The fever lasts 2 or 3 days.
- The mouth ulcers resolve by 7 days.
- The rash on the hands and feet lasts 10 days. The rash on the hands and feet may then peel.
- Call Your Doctor If:
- Signs of dehydration develop
- Fever present over 3 days
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.
- Adler JL, et al. Epidemiologic investigation of hand-foot and mouth disease. Am J Dis Child. 1970;120:309.
- Slavin KA and Frieden IJ. Picture of the month: Hand-foot-and-mouth disease. Arch Pediatr Adolesc Med. 1998;152:505-506.
- Thomas I and Janniger CK. Hand, foot, and mouth disease. Cutis. 1993;52:265-266
This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Copyright 1994-2015 Barton D. Schmitt, MD. All rights reserved.