What is Hand, Foot, and Mouth Disease? Symptoms & Treatment

Hand, foot, and mouth disease (HFMD) is a contagious viral infection typically seen in children under five, characterised by fever, painful mouth sores, and skin rashes. It tends to spread rapidly among children, particularly in September when schools and nurseries reopen across Türkiye. The illness is usually mild and resolves on its own within one to two weeks with proper home care. Closely monitoring your child's general condition and ensuring they stay hydrated are the most important keys to getting through this period comfortably.

At a Glance

• It is usually caused by a virus called Coxsackievirus.
• While most common in children under 5, it can also affect adults.
• Fever, sore throat, and rashes on the palms and soles are the most prominent features.
• There is no specific medication or vaccine; treatment focuses on relieving symptoms.
• Dehydration is the most common complication, as mouth sores make swallowing painful.

What is Hand, Foot, and Mouth Disease?

Hand, foot, and mouth disease is a common infection caused by viruses from the Enterovirus family, most frequently Coxsackievirus A16. It gets its name from the physical signs of the disease: characteristic lesions that appear on the hands, feet, and around the mouth. In the community, it is generally known as a simple childhood rash illness. Although it can sometimes be confused with other eruptive diseases like chickenpox or measles, the locations of the rashes are quite distinctive.

The disease can occur year-round, but in countries with a temperate climate like Türkiye, there is a noticeable spike in cases during late summer and early autumn. The gathering of children in enclosed spaces, nurseries, and schools—especially around September—accelerates the spread of the virus. The illness is generally benign and heals without leaving permanent damage in children with a normal immune system. However, in rare cases, particularly in immunocompromised individuals or when different virus strains (such as Enterovirus 71) are involved, it can take a more severe course.

Causes and Risk Factors

The primary cause of the illness is direct or indirect contact with a virus-infected person. The virus enters the body through the mouth or nose and begins to multiply in the digestive and respiratory tracts. The biggest risk factor is age. Children under five are the most vulnerable group because their immune systems have not yet fully encountered this family of viruses. However, older children and even adults can catch the disease, particularly if they are caring for an infected child.

School and nursery environments offer ideal conditions for the disease to spread. It ranks high among common school illnesses because children frequently share toys, may not pay enough attention to hand hygiene, and engage in close physical contact. Furthermore, crowded playgrounds, shared toilets, and poorly ventilated classrooms are environmental factors that increase the risk. If one child in a family falls ill, the likelihood of it spreading to siblings or parents at home is quite high.

Symptoms of Hand, Foot, and Mouth Disease

The incubation period of the disease usually lasts three to six days from the moment the virus enters the body. The initial symptoms are generally non-specific and resemble a simple cold. You might notice your child has a mild fever, loss of appetite, sore throat, and general fatigue. One or two days after this initial phase, the characteristic signs of the illness begin to emerge.

Hand, foot, and mouth disease symptoms typically develop in the following order:

• Mouth Sores (Herpangina): First, small red spots appear inside the mouth, on the tongue, gums, and the inner cheeks. These spots quickly turn into painful, fluid-filled blisters and ulcers. The pain from these sores is the main reason a child might refuse to eat or drink.
• Skin Rashes: Shortly after the mouth sores, red rashes appear on the palms, soles of the feet, and sometimes on the buttocks and legs. A rash in children with this condition is usually not itchy, but it can be painful to touch once it forms into blisters.
• Restlessness and Sleep Problems: Especially in babies and toddlers, extreme fussiness, constant crying, and difficulty falling asleep are observed due to pain and fever.

Transmission and Prevention

The disease is highly contagious and spreads through contact with an infected person's saliva, nasal discharge, faeces, or the fluid inside the skin blisters. Coughing and sneezing scatter virus-laden droplets into the air. Additionally, because the virus can survive in faeces for weeks, the risk of transmission is high when changing a baby's nappy or during toilet training. Touching virus-contaminated surfaces (door handles, toys, tables) and then bringing hands to the mouth or eyes is also a common way to catch it.

The most effective way to protect against the virus is strict hand hygiene. Teaching children proper handwashing habits at an early age protects them not just from this disease, but from many other infections. For more detailed information on this topic, you can review our article titled School-Age Hygiene: How to Teach Children Handwashing Habits. Frequently disinfecting shared toys and keeping sick children home from school or nursery until their symptoms have completely cleared are critical steps to stop the spread.

How is it Diagnosed at the Hospital?

The diagnosis is mostly made through a clinical examination. After listening to your child's symptoms, a paediatrician will conduct a physical exam. The typical sores in the mouth and the characteristic rashes on the palms and soles are usually enough for the doctor to make a diagnosis. The appearance and location of the rashes are the most important clues for distinguishing the disease from chickenpox or allergic reactions.

In most cases, laboratory tests like blood tests, throat cultures, or stool analyses are not needed. However, in rare instances where the diagnosis is uncertain, the symptoms are very severe, or outbreaks are being investigated, your doctor may request a laboratory analysis by taking a swab from the throat or a stool sample to determine the virus type. If the child shows signs of dehydration, blood and urine tests may be performed to check kidney function and electrolyte balance.

Treatment Methods and Home Care

There is no specific antiviral medication or antibiotic treatment for hand, foot, and mouth disease. Because antibiotics only work against bacterial infections, they are not used for this viral illness. The main goal of treatment is to relieve the symptoms and keep the child comfortable while their immune system fights off the virus. The recovery process usually takes seven to ten days.

The most important thing to watch out for during home care is ensuring your child gets enough fluids. Since swallowing will be painful due to the mouth sores, you should avoid acidic, tomato-based, or overly salty foods like orange juice. Instead, opt for soft, cool foods that will soothe the throat, such as cold milk, ayran, yoghurt, plain ice cream, or cold soups. To manage fever and pain, you can use paracetamol or ibuprofen syrups as recommended by your doctor. You should avoid applying any creams or ointments to the rashes without your doctor's advice.

Possible Complications and Risk Groups

Although the disease usually passes without issue, the most common complication is dehydration. Children who refuse to drink water due to severe mouth pain can quickly become dehydrated, especially in hot weather. If not addressed in time, this condition may require hospital admission and intravenous fluid supplementation.

In very rare cases, the virus can reach the central nervous system, leading to serious conditions like viral meningitis (inflammation of the membranes surrounding the brain) or encephalitis (brain inflammation). Furthermore, a few weeks after the illness, children may experience peeling or loss of fingernails or toenails; this is temporary, and the nails will eventually grow back healthily. To learn more about other common childhood viral diseases affecting the respiratory tract, you can also check out our article What is RSV? Symptoms in Babies and Children.

When to See a Doctor

If your child's general condition is good and they are able to consume fluids, you can monitor the process at home. However, certain warning signs require immediate medical attention. You should observe your child closely and consult your doctor right away if you notice any of the following symptoms:

• If your child has not urinated for more than eight hours, or if a baby's nappies remain completely dry (a sign of severe dehydration).
• If the fever lasts longer than three days and cannot be controlled despite fever-reducing medication.
• If your child exhibits excessive sleepiness, difficulty waking up, or unresponsiveness to their surroundings.
• If you observe a stiff neck, severe headache, or persistent vomiting.

If your child is struggling to breathe, their skin is turning blue, they lose consciousness, or they experience a febrile convulsion (seizure), you must call 112 immediately or go to the nearest emergency department without losing any time.

Diagnosis and Treatment at BHT CLINIC

When you observe symptoms of hand, foot, and mouth disease in your child, you can visit our Paediatrics department for an accurate diagnosis and safe follow-up. Our specialist doctors will conduct a detailed examination of your child, assess the severity of the illness, and provide you with the most suitable home care plan.

Our emergency department, providing 24/7 service, is by your side for urgent situations like high fever or severe dehydration that may develop outside of regular working hours. Bringing a record of your child's temperature measurements from the last 24 hours and a list of medications they are taking will help the process move faster when you arrive at the hospital. For the sake of your child's health, you can book an appointment to consult with our specialists without delay.

Frequently Asked Questions

Does hand, foot, and mouth disease cause itching?

The rashes are usually not itchy, but they can cause mild itching or discomfort in some children. When the blisters pop or become irritated, the feeling of pain may override any itchiness.

Can the disease spread to adults?

Yes, the virus can infect adults too. Because adults generally have stronger immune systems, they often experience the disease asymptomatically or very mildly. However, adults caring for a sick child must pay extra attention to hand hygiene.

When can I send my child back to school or nursery?

Your child can return to school once their fever has completely subsided, no new rashes or blisters are forming, and their general energy levels have returned to normal. This process usually takes 7 to 10 days from the onset of symptoms.

Does hand, foot, and mouth disease leave scars?

The rashes and blisters associated with the disease typically do not leave permanent scars on the skin once healed. Preventing the child from picking at the blisters and keeping them free from infection is important to avoid scarring.

Can someone who had the disease get it again?

Yes, they can. Because there are multiple virus types (different strains of Coxsackie and Enterovirus) that cause the illness, it is possible to get sick again with a different virus type even if immunity has been built against one.

This article is for informational purposes only; please consult your doctor for diagnosis and treatment.