Hand, foot and mouth disease - Symptoms 

Symptoms of hand, foot and mouth disease 

Mouth ulcers

Mouth ulcers are painful round or oval sores that form in the mouth, most often on the inside of the cheeks or lips

The symptoms of hand, foot and mouth disease usually develop between three and five days after initial exposure to the infection. This is known as the incubation period.

Early symptoms of hand, foot and mouth disease include:

  • a high temperature (fever)  usually around 38-39°C (100.4-102.2°F)
  • loss of appetite
  • cough
  • abdominal pain
  • sore throat

Occasionally, hand, foot and mouth disease can cause vomiting, particularly if it is caused by the enterovirus 71 strain.

These early symptoms can last 12-48 hours.

Mouth ulcers

After one or two days, red spots develop inside the mouth, particularly around the tongue, gums and inside of the cheeks.

At first, the sores are about the size of a small button. They then rapidly develop into larger yellow-grey mouth ulcers surrounded by a red ring of tissue. You would normally expect to see 5-10 ulcers in the mouth.

The ulcers can be very painful and can make eating, drinking and swallowing difficult, which may cause a young child to dribble excessively.

The ulcers should pass within five to seven days.

Skin rash

Soon after the mouth ulcers appear, you will probably notice small red spots on your child’s skin.

The most common places for the spots to develop are on the fingers, palms of the hand, soles of the feet and occasionally the buttocks and groin.

The spots are around 2-5mm in size, with a darkish-grey centre and a "rugby-ball" shape.

These are usually painless and non-itchy, although they can turn into small blisters, which are sometimes painful and tender. It is important not to burst any blisters, as this can spread the infection.

The skin rash and any blisters can last up to 10 days.

When to seek medical advice

Most cases of hand, foot and mouth disease do not require medical attention as the symptoms will pass within seven days, without the need for treatment.

However, if you're unsure whether your child does have hand, foot and mouth disease, you can contact your GP or NHS 111 for advice.

You should also contact your GP if:

  • your child is unable or unwilling to drink any fluids
  • your child is showing signs of dehydration, including not passing as much urine as normal
  • your child’s symptoms have not improved or worsen after seven days 
  • your child has additional symptoms, such as a change in mental state, seizures (fits) and changes in personality and behaviour

Page last reviewed: 10/03/2014

Next review due: 10/03/2016

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Comments

The 18 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Peggy78 said on 01 February 2014

Just to correct Suze75: Whilst specific 'antibacterials' may have no effect on viruses there are many antimicrobial products and household chemicals which both kill bacteria and inactivate certain viruses.

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Suze75 said on 14 October 2013

Just to correct Jessasor (below) - this is a viral disease (not bacterial) so there is absolutely no point "antibac"ing everything your child has touched! Antibacterial products don't kill viruses any more effectively than normal soap.

Also, the virus can be transmitted for weeks afterwards according to my nursery and my GP - hence there is no point having a long exclusion becuase it would just be unworkable.

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Bimbee said on 09 September 2013

I agree that this is not mild in adults. I think it was picked up at school and has lasted for about 8 weeks, mostly affecting my mouth, but also my digestive system. It is a miserable and unpleasant affliction.

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N3tts said on 21 August 2013

Definitely not mild in adults!! I'm on day 4 and am still struggling to eat or drink. Ulcers are blisters are still appearing and are very very painful (nothing seems to ease the pain either :( ). My daughter had a very mild form last week she showed no symptoms other than a couple of white spots on her tongue and wouldn't eat anything crunchy. Can be contracted more than once; my daughter had a very bad case last year and was very nearly hospitaliased (however I never caught it that time). Not a nice illness for adults or children.

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Caztone said on 12 August 2013

I can honestly say this is the worst illness any of my children have ever had,she started off with a temperature and was then misdiagnosed with tonsillitis,the pain she has been in because of the mouth ulcers is unreal,we were able to give her a spray in her mouth to relieve the pain but its been difficult for her

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Jessasor said on 30 July 2013

I work in a nursery that is currently having an outbreak of hand, foot and mouth and am just looking to give some advice to the parents on here.

Unfortunately there is no treatment/cure for this but what I will recommend is:
-keeping shoes/socks on
-regular hand washing of yourself and child as well as regular baths/showers
-antibac everything and I mean everything they could have even breathed near
-allow your child to have ice cubes or cold water regularly

These are the tips we give parents and we often see the children back in about 3-5 days with no more symptoms. And as long as none of the blisters are filled with liquid you are ok to send them back to nursery/school providing they feel better as they are no longer infectious :) hope this helps.

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Demonspark said on 01 July 2013

I'm a 38 year old adult and have had hand foot and mouth for the last 11 days. The blisters aren't getting any better at all. My doctor keeps telling me another couple of of days in isolation, but there doesn't seem to be any guidelines as to whether after 11 days, I can get back to living my life - blisters or not!

They're driving me crazy and hurt, if I'm still contagious after 11 days and it's a common illness, is there any point in continuing to isolate myself?

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Bs mum said on 11 November 2012

i totally agree with everyone on how bad this can be, my daughter had when she was about 18 months old, i went back and back and back to the GP because she was so ill she didne eat for over a week and didnt drink for 5 days (very scary) eventually the GP referred us to hospital where the nurse very roughly tried to clean her nose where there was a massive blister as if i just hadnt bothered when in fact it was impossible because she was in so much pain, she was very dehydrated and weak and eventually ended up on masses of antibiotics and painkillers(prescribed) and cream which eventually got rid of it but its taken a year to get here eating acidic foods such as fruit etc because she had been in so much pain before it scared her off. we were very unimpressed by how laid back medical staff where when confronted with an 18 month old who hadnt had a drink for 5 days!

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SarahW2 said on 29 August 2012

I have had this 4 times now, the first 3 times were all within 6 or 7 months. I also think the info on this plays down the severity of it. My 11 month old daughter recently had it and her first symptom was when her temperature went from normal to 39.7 degrees c in a matter of about 10 minutes - it was after she went to bed too so if I hadn't checked on her I may not have noticed and don't know what might have happened to her. She was still very asleep until I got her up for Calpol and a strip down, tepid flannels and so on. Having had it myself I would say I've rarely had something that's made me feel so ill and the rash is not just non itchy, every tiny spot does feel like there is a splinter in it and it has left me with some nerve damage I think as I am now still extremely sensitive to heat on my fingertips 2 years on from the last infection with spots. Also I had a period during one infection with this and bled for 2 whole weeks instead of the normal few days so I can certainly see why miscarriages could happen. If you or your kids get this you have my every sympathy and if you have young kids keep a close eye as the temperature strikes quickly and without warning and you can pick this infection up from just about anywhere.

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nrtm said on 21 May 2012

I have just been diagnosed with this disease and yes, it is really painful! I caught it from my 3 year old daughter who, last week, had a really painful ulcer on her tongue and virus-like symptoms (tiredness, lethargy, aching). Today I developed ulcers on my tongue and in my mouth, which are really painful. I have also developed painful blisters, as in the photo, on my hands. The doctor said it's really rare for adults to catch the disease so reading the comments on here have made me feel like Im not the only one! I have been prescribed a mouth wash and strong painkillers to relieve the symptoms of the ulcers.

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GrannyS said on 04 April 2012

I am so relieved to find these comments as I felt as if I was being pathetic! I'm 63 and this is a really, really uncomfortable, unpleasant disease.I work with small children and in 40 years have never come across this before!! The initial fever was sudden and the ensuing symptoms very uncomfortable- particularly in the mouth( can't tolerate anything warm and difficulty swallowing) and on the feet ( feels as if I'm walking on splinters). On day 5 the spots are still appearing - even under my nails -hence fingertips are very sensitive and throbbing. GP a bit dismissive " haha - there's no treatment...." I only visit the surgery once every 3 or 4 years when desperate so wasn't impressed! Sympathy to all fellow sufferers.

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rellenk said on 23 January 2012

My daughter had this november 2010, I was so worried about her, she had a really high temperature and a sore throat intially, I went to the docs with this and she had a few spots in her mouth, she ended up having tonsillitis as well as hfmd, her mouth was full of ulcers her hands arms legs and feet were also covered and I had to carry her everywhere as she was in so much pain, she didn't eat for a week, I took her to so many surgeries because I wasn't given any decent information of how to treat it or make her more comfortable. I don't know how schools and the health service can play this down, this is highly contagious disease and children should be kept off school for the whole duration. My daughter ended up having three weeks off school.

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gall6 said on 10 January 2012

my 10 yr old son presented with a 104 temp, followed by a totally ulcerated mouthy 24 hrs later. rushed him to drs who gave me mouthwash and no explanation of why he had a whole mouth rather one or two mouth ulcers. That night rushed him to A&E after spots appears (like the photo) on hands,feet lower limbs ,chin and neck. they knew straight away it was hand.foot,mouth. My son is crying all the time in so much pain, his mouth is so sore. Have now been given augmentin antibiotics and given paracetamol/ibuprofen, plus bought anbesol along side corsodyl mouthwash. Mums, follow your instincts, if your child in that much pain - go and get more advice.
Ans ywa Vickhj - I agree, this is painted as a generally mild illness, which isn't so in all cases. I just wish I could take my little boys pain away from him!

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root66 said on 31 December 2011

I have just got over the worst of this, after catching from my 20 month old granddaughter. rash was really itchy and I was not as careful as I could have been and ended up with spots all up my arms over my face and head and genital area and was unable to eat my Christmas dinner as my throat was so sore. Mine ended up getting infected with a staphylococcal infection and needed antibiotics.I am still unsure about the hand foot and mouth diagnosis as I have found no link between the two unless it was a different strain?! but not very nice

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heppyjed said on 11 December 2011

I am 66 and have caught this from my 3 year old grandson. The condition is not mild for me. It is very unpleasant and like flu. I have got over the fever and headaches and now have blisters round my mouth after 4 days and mouth ulcers and a raging sore throat. I keep having to lie down and struggle to keep going. I have found gargling with soluble asprin, taking paracetomol and bongela for the mouth ulcers helpful.

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feelingrough said on 26 October 2011

After looking after my grandaughter who had a very bad nappy rash and rash around her mouth I developed a very painful ulcer on my tongue more of a sore .I was so tired spent the day in bed the next day I developed tiny red sores on my fingers which went on to develop into bigger painful blisters.Each day I had more ulcers in my mouth my doctor diagnosed hfmd he gave me steroid tablets which are slowly helping.I am on day four and now have a sore throat with a hoarse voice .It certainly is'nt mild in adults I am finding it hard to eat it feels like my tongue is swollen and it brings tears to my eyes to put any food into my mouth.Help I want to feel better!

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teresave said on 18 September 2011

I am in Florida, USA, and am so grateful to have found this site and the comments. I am 44 years old and have no idea ho or where I caught this. After two days of wishing I could either chop off my hands or take a cheese grater to them I finally went to the doctor. The itching and pain was so bad that I could no longer feel the keys on the keyboard, and the typing had become extremely painful as it just made everything worse. Unfortunately, my job requires great deal of typing. The doctor also found lesions in my throat which, although not painful now, does explain the earlier (mild) sore throat. After a couple days of nonstop Benedryl plus Lydocaine as a topical anesthetic life is now improved. So long as I don't touch anything it is down to a fairly mild tingling. Typing, even this short amount, still sets off the painful itch cycle, so I will go apply more Lydocaine. I am just grateful to finally see other adults with this disease, and that I am not alone in feeling a very itchy rash. I was starting to feel a little insane / lack of belief in the diagnosis as everything said child disease and non-itchy rash.

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Vickijh said on 22 July 2011

like most of the other people on here, my symptoms have been far from mild! Not had many of the spots but have had an extremely painful mouth and have only been able to drink warm milk and eat madeira cake for nearly a week-the only things that could find that didn't make my mouth and throat worse! I wonder if its a different strain of the virus or something because it doesn't seem as mild as the nhs etc makes it out to be

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