Hand Foot and Mouth Disease: When to Visit a Pediatrician

As a parent, noticing unusual spots on your child’s hands, feet, or around their mouth, especially when paired with a fever or irritability, can be concerning. These could be signs of hand foot and mouth disease (HFMD), a common but often misunderstood viral illness affecting infants and young children. While HFMD is usually mild, it can make children extremely uncomfortable and is highly contagious. Left unmanaged, it may also lead to complications like dehydration or skin infections. Many parents try home remedies first, not realising when medical care becomes necessary. As a paediatrician, I see this infection frequently during school terms and monsoon months. In this blog, I’ll explain how to spot early hand foot and mouth disease symptoms, what care your child needs, and when to visit a doctor.

What Is Hand Foot and Mouth Disease (HFMD)?

Hand foot and mouth disease is a viral infection most often caused by the Coxsackievirus A16 or Enterovirus 71. It gets its name from the characteristic rash that appears on the hands, feet, and mouth, though it can also affect other areas like the buttocks or knees. While HFMD generally clears up on its own within 7–10 days, it can be uncomfortable and distressing, especially for toddlers who may not be able to express what they’re feeling.

Causes and How It Spreads in Children

HFMD spreads very easily, especially in environments where children are in close contact, such as daycares or schools. The virus is present in:

• Saliva and nasal secretions (from sneezing or coughing)
• Fluid from blisters
• Stool (especially during diaper changes)
• Contaminated surfaces like toys or utensils

Even before visible symptoms appear, infected children can unknowingly pass the virus to others.

Common Age Groups Affected

The illness most commonly affects children under the age of five. Their immune systems are still developing, and they often explore the world with their hands and mouths, making them more susceptible to transmission. That said, HFMD can also affect:

• Older children during outbreaks
• Teenagers in close-contact settings
• Hand, Foot and Mouth Disease in Adults, though typically with milder symptoms (we’ll cover this later)

Contagiousness and Precautions at Home/School

HFMD is most contagious during the first week of illness, but the virus can linger in the body for weeks after symptoms subside, especially in stool. That said, it is important to remember that hand foot and mouth disease treatment​ is easily available. You can consult a pediatrician near you online for quick intervention.  To prevent spreading the infection:

• Keep your child home from school or daycare until they are fever-free and blisters have dried.
• Encourage handwashing before meals and after bathroom use.
• Disinfect shared surfaces like doorknobs and toys.
• Avoid sharing towels, bedding, cups, or utensils.

If you’re unsure about returning to school, speak to your doctor or book an online consultation for personalised advice.

Hand Foot and Mouth Disease Symptoms to Watch For

The symptoms of HFMD appear in a predictable pattern but can vary slightly from child to child. The most recognisable signs usually show up 3–6 days after exposure, starting with general flu-like symptoms and followed by skin or mouth lesions.

Fever and Sore Throat

One of the first signs is a low to moderate fever, typically around 100–102°F, accompanied by:

• Sore throat
• Runny nose or congestion
• Lethargy or decreased activity
• Fussiness, especially in toddlers

This phase often resembles a cold, which can lead to delayed diagnosis.

Painful Sores in the Mouth

Within 24–48 hours, small red spots begin to form inside the mouth, especially:

• On the tongue
• Inside the cheeks
• On the gums

These spots develop into painful ulcers, making it difficult for your child to eat or drink. This is often when parents first notice a sudden refusal of food.

Rash on Hands, Feet, and Sometimes Buttocks

Shortly after mouth sores, a rash appears:

• On the palms and soles as red spots or blisters
• Sometimes on the buttocks, elbows, or legs
• The rash may be tender but not itchy

The appearance of both rash and mouth sores helps differentiate HFMD from other illnesses like chickenpox or measles.

Loss of Appetite and Irritability

Because mouth sores are painful, children may:

• Refuse food or drinks
• Cry when swallowing
• Appear more irritable or clingy
• Wake more frequently at night

Dehydration becomes a key concern at this stage.

Stages of Hand Foot and Mouth Disease

Like many viral illnesses, hand foot and mouth disease progresses through distinct phases. Recognising these stages helps you better support your child and plan for recovery.

Stage 1 – Early Cold-Like Symptoms

• Fever
• Mild sore throat
• Runny nose or congestion
• Tiredness and reduced appetite

This stage can easily be mistaken for a viral cold or flu.

Stage 2 – Rash and Blisters Appear

• Painful mouth ulcers develop
• Rash with red spots or fluid-filled blisters appears on hands and feet
• Irritability and fussiness peak
• Some children develop a rash on the buttocks or limbs

Stage 3 – Healing Phase and Recovery Timeline

• Mouth sores begin to heal
• Blisters dry and peel (no scarring)
• Appetite slowly returns
• Complete recovery within 7–10 days

Parents should continue to monitor hydration during this stage, especially if your child is still not eating normally. 

Hand Foot and Mouth Disease Treatment and Care

There is no cure for HFMD, but supportive care can go a long way in easing discomfort and preventing complications.

At-Home Relief Remedies

Here are gentle remedies that provide comfort:

• Cold liquids like water, coconut water, or cold milk help soothe mouth pain.
• Soft, bland foods such as khichdi, porridge, or mashed potatoes are easier to eat.
• Yogurt and ice pops can reduce oral inflammation.
• Keep your child cool and rested in a calm environment.

Avoid acidic foods like citrus fruits, tomatoes, and spicy dishes as they can aggravate ulcers. 

Medications to Ease Pain and Fever

Always speak with a doctor before giving medication. Commonly recommended:

• Paracetamol (acetaminophen) for pain and fever
• Ibuprofen if pain is moderate and the child is above 6 months old
• Topical oral gels may be prescribed to ease mouth ulcers temporarily

Avoid aspirin in children due to the risk of Reye’s syndrome. For personalised medication plans, consult a pediatrician.

What Not to Give or Do During Infection

• Don’t pop or scratch blisters
• Avoid force-feeding; focus on fluids
• Don’t send your child back to school until cleared by a doctor
• Never use unverified home remedies or adult mouth gels on infants

When to Visit a Pediatrician

While most children recover with home care, there are situations when medical help is essential.

Signs the Condition Is Getting Worse

Seek help if your child shows:

• A high fever persisting beyond 3 days
• Excessive drooling or refusal to swallow
• Rash that spreads rapidly or becomes infected
• Unusual drowsiness or lack of response

Dehydration, High Fever, or Prolonged Symptoms

Signs of dehydration include:

• No tears when crying
• Dry lips and tongue
• Sunken eyes
• Reduced urination (less than 3 wet diapers in 24 hours)

If you suspect dehydration, book an appointment or get help immediately.

When Hospital Care Might Be Needed

Though rare, some children with HFMD may require hospitalisation due to:

• Severe dehydration
• High, unrelenting fever
• Seizures or neurological symptoms (caused by Enterovirus 71)

Early intervention prevents complications. A quick online doctor consultation can help you make the right decision.

Hand Foot and Mouth Disease in Adults

Yes, adults can get HFMD too—though it’s often milder and more manageable.

How Symptoms Differ in Adults

• Low-grade fever or fatigue
• Mild sore throat or occasional mouth ulcers
• Rash that may not blister
• Most cases resolve without treatment

Still, adults can pass the virus to children even when asymptomatic.

Who’s at Risk and How to Prevent Infection

Those at risk include:

• Parents and caregivers
• Teachers, daycare staff
• Healthcare workers

To reduce transmission:

• Practice regular handwashing
• Avoid direct contact with infected children
• Disinfect surfaces regularly
• Stay home if symptoms develop

Final Thoughts

Hand foot and mouth disease is not usually dangerous, but it can be very uncomfortable for your child and disruptive to your family’s routine. The key is to recognise symptoms early, offer supportive care, and know when to seek professional guidance. If your child is refusing to eat, showing signs of dehydration, or has worsening symptoms, don’t hesitate to reach out to a healthcare provider. You can book a pediatrician visit or consult online for fast advice. Parents often know when something isn’t right. If your instincts are telling you to get help—it’s always better to be safe.

Frequently Asked Questions (FAQs)

• What are the first symptoms of hand foot and mouth disease?

Early signs include fever, sore throat, runny nose, and general fussiness—followed by mouth sores and skin rash.

• Is hand foot and mouth disease contagious?

Yes, highly. It spreads through saliva, stool, and blister fluid. Children are most contagious in the first week.

• How do you treat hand foot and mouth disease at home?

There is no specific cure. Focus on fluids, soft foods, pain relief, and rest. Consult a doctor if symptoms worsen.

• Is hand foot and mouth disease serious?

Usually not. Most children recover within a week. But complications like dehydration or viral meningitis (rare) can occur in severe cases.

Disclaimer

Medical Advice: The information provided in this blog post is for educational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare professional for personalized guidance regarding your specific medical condition.

Accuracy of Information: While we strive to provide accurate and up-to-date information, the field of medicine and viral fevers is constantly evolving. The content in this blog post may not reflect the most current research or medical guidelines. Therefore, it is advisable to cross-check any information provided with reliable sources or consult a healthcare professional.

Individual Variations: The symptoms, causes, treatment options, and preventive measures discussed in this blog post are general in nature and may not apply to everyone. It is important to remember that each individual’s situation is unique, and personalized medical advice should be sought when making healthcare decisions.

External Links: This blog post may contain links to external websites or resources for additional information. However, we do not endorse or have control over the content of these third-party websites. Accessing these links is done at your own risk, and we are not responsible for any consequences or damages that may arise from visiting these external sources.

Results May Vary: The effectiveness of treatment options or preventive measures mentioned in this blog post may vary from person to person. What works for one individual may not work the same way for another. It is essential to consult with a healthcare professional for personalized advice tailored to your specific needs.