Patient information · Paediatrics
Hand, foot and mouth disease
unpleasant, very common, and rarely serious
A common childhood viral illness causing mouth ulcers and a blistering rash on the hands and feet. It has nothing to do with foot and mouth disease in animals. It clears by itself in about a week — the main challenge is keeping a child drinking when their mouth hurts.
Seek medical advice if your child
- is refusing all fluids, or shows signs of dehydration — no wet nappy for 12 hours, dry mouth, no tears, unusual drowsiness
- has a fever lasting more than three days, or a very high temperature
- becomes drowsy, floppy, or very difficult to rouse
- has a stiff neck, severe headache or dislike of bright light
- has skin that becomes red, hot, swollen and increasingly painful around the spots
- is under three months old, or has a weakened immune system
Complications are uncommon but dehydration from painful mouth ulcers is the usual reason a child needs to be seen. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
What happens
It usually starts with a temperature, sore throat and being off food. A day or two later, small painful ulcers appear in the mouth, followed by flat red spots that blister on the palms, soles, and often the buttocks, legs and around the mouth. The spots are typically not itchy in children, though adults sometimes find them uncomfortable.
Keeping a child comfortable
Helps
- Cold drinks, milk, ice lollies and ice cream — cold numbs the ulcers
- Soft, bland food: yoghurt, mashed potato, custard, smooth soup
- Paracetamol or ibuprofen at the dose for age and weight
- Drinking through a straw, which bypasses sore areas
- Small amounts offered very frequently rather than full meals
Avoid
- Acidic drinks — orange juice, apple juice, fizzy drinks — which sting badly
- Salty, spicy or crunchy foods
- Very hot food and drinks
- Bursting the blisters
- Mouthwashes containing alcohol
Children do not automatically need to stay off school
UK public health guidance does not require exclusion from school or nursery for hand, foot and mouth disease. A child should stay home if they are genuinely unwell, feverish, or too uncomfortable to take part — but not simply because spots are present. Keeping children off until the rash disappears makes no difference to spread, because the virus is shed for weeks afterwards regardless.
Stopping it spreading
- Wash hands thoroughly with soap and water, especially after nappy changes and before food.
- Bin used tissues immediately and wash hands afterwards.
- Do not share cups, cutlery, towels or bedding while anyone is unwell.
- Clean toys and surfaces that go in mouths.
- The virus continues to be present in stools for several weeks after recovery, which is why handwashing matters longer than the illness lasts.
Two things that surprise people afterwards
- Peeling skin on the hands and feet in the week or two after the rash fades. Harmless.
- Nail changes or nail shedding one to two months later. Fingernails or toenails may develop lines, lift and come away. It looks alarming, it is painless, and the nails grow back normally without any treatment.
Adults and pregnancy
Adults can catch it, usually mildly, though the mouth ulcers can be surprisingly painful. Most adults are already immune.
Catching it in pregnancy is not generally thought to harm the baby. If you are pregnant and have been in contact with hand, foot and mouth disease, particularly close to your due date, mention it to your midwife or to us for reassurance and advice rather than worrying about it.
Book an appointment if your child is not drinking, the fever is persisting, the rash is looking infected, or you would simply like the diagnosis confirmed. We see children seven days a week, usually the same day.
Seen today, not next week
Same-day appointments most days, seven days a week, 9am–7pm, on Whitechapel Road.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.