Check out the PedsDocTalk YouTube Video: Hand-Foot-Mouth Symptoms and Treatment in Kids for more details and guidance on hand, foot, and mouth, how you get it, what the symptoms are, what is the treatment, when to see a clinician, complications, and how to reduce the spread at home.
What is Hand, Foot, Mouth Disease?
Hand, foot, mouth (HFM) is the name of the clinical syndrome caused by a group of viruses known as Enteroviruses, most commonly the Coxsackievirus. It is a common viral infection that typically affects infants and young children, most commonly in kids younger than 4 years of age. Older children and even adults can more be affected, but this is more rare. Likely adults getting HFM are those who haven’t been exposed to that particular strain of HFM as a child or their immunity has waned like it does with many viruses. Most adults who get it report that their symptoms are bothersome — more bothersome to them than their child. Even so, it does improve on its own, and you can treat it the same way you treat your child.
What are hand, foot, and mouth symptoms?
Symptoms usually start 3-6 days after exposure. Hand, foot, and mouth is termed HFM because it classically affects the hands, feet, and mouth. It typically causes sores or ulcers in the back of the mouth that usually cause throat pain and sometimes feeding refusal. Fever can occur, but not always. HFM causes a blistery rash that classically involves the palms of the hands and soles of the feet. The rash is not itchy and not typically painful, although less common strains of coxsackievirus can sometimes cause the rash to be uncomfortable. The rash can also be present on the legs, arms, and buttocks. Interestingly, for younger kiddos—the first sign of hand foot and mouth can be a rash in the diaper area, it often appears like a horrible diaper rash that came out of nowhere. Parents are putting diaper creams on these sores thinking it’s a diaper rash and its not improving and then—we see the small sores around the mouth or hands or feet days later.
Rarely, lesions can be seen on the face or trunk but some strain that cause HFM can cause this.
Symptoms are typically self-limited and children usually feel better after 3-4 days.
How do you get Hand, Foot, and Mouth Disease?
Hand foot and mouth is highly contagious and often spreads quickly through childcare settings. It spreads from person-to-person contact and by touching contaminated surfaces. Contact with respiratory droplets, kissing, sharing utensils, sharing toys, touching infected surfaces, and then touching your eyes/mouth spreads the virus. It tends to peak during in spring, summer and early fall.
What is the treatment for Hand, foot, and mouth disease?
Because HFM is caused by a virus, treatment is focused on managing symptoms and helping relieve any discomfort your child has. Focus on hydration and soft foods. Avoid spicy, acidic, or citrus foods. Cold drinks, milkshakes, and popsicles are great to help provide comfort and help with hydration. If your child isn’t drinking well, I’d recommend giving pain medication, like Tylenol or Motrin and offering liquids by syringe. This can alleviate the pain so they want to drink and maybe eat.
The blisters do not require any special treatment. They will go away on their own in time. You can continue using any ointments you typically use for your child’s skincare routine. If a rash is present in the diaper area, you can use zinc oxide ointment for symptomatic relief if needed, but do remember the rash will go away in time and not because of the ointments. The rash should start to improve within 3-4 days and go away within 7-10 days.
When to seek medical care?
It’s best to see the clinician if you are unsure of the diagnosis. If there is a question, it’s best to get clarity to make sure no other intervention is needed to help your little one recover. It’s also best to see your clinician if you’re concerned your child is dehydrated. If they are refusing all liquids despite the recommendations I discussed, or if they are not making tears or have stopped urinating, it’s important to seek care. Finally, if the fever persists for more than 5 days and/or your child appears to worsen see your clinician for guidance on the next steps.
If you know the diagnosis and your child is hydrated, there is no need to bring them in. Keep them hydrated and monitor their symptoms.
still have more questions about hand, foot, and mouth disease?
For example, when can your child go back to childcare or school? Are there any complications? Do their fingernails really peel off? How can I contain and prevent the spread at home?
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