Symptoms of hand, foot, and mouth disease

Written by Yao Li Qin
Pediatrics
Updated on May 31, 2025
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Hand, foot, and mouth disease is caused by an intestinal virus infection. It primarily manifests as a disseminated rash of maculopapules or vesicular papules on the hands, feet, mouth, and buttocks. The main symptoms of hand, foot, and mouth disease start with a fever in children, accompanied by a sore throat, reluctance to eat, and some children may have mild cough and runny nose.

During a physical examination, small vesicles can be found on the oral mucosa, or they may have already ulcerated into shallow ulcers. Subsequently, rashes appear on the hands and feet, starting as maculopapules and slowly transforming into vesicular papules, about 3 to 7mm in size, with a firm base. The skin of the vesicle is slightly thicker, surrounded by erythema, and the rash is mostly located at the extremities. Sometimes, it can extend to the arms, legs, buttocks, and perineum, showing a centrifugal distribution.

The number of rashes is relatively small, typically ranging from a few to several dozen. Most of them resolve on their own in 2 to 3 days without scaling, scarring, or pigmentation. Vesicles or ulcers in the mouth mostly heal within a week. Most cases of hand, foot, and mouth disease have a short duration and mild condition, with generally good prognosis.

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Written by Yan Xin Liang
Pediatrics
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Hand, foot, and mouth disease is spread through:

Hand, foot, and mouth disease is an infectious disease caused by enteroviruses. There are more than 20 types of enteroviruses that can cause the disease, among which Coxsackievirus A16 and Enterovirus 71 are the most common. It frequently occurs in children under the age of 5 and manifests as mouth pain, loss of appetite, low fever, and small blisters or ulcers on the hands, feet, and mouth. Most affected children can recover within about a week. The main routes of transmission for hand, foot, and mouth disease can include the gastrointestinal tract, as well as respiratory transmission, and close contact such as through saliva, cough droplets, etc. Sharing utensils can also spread the disease.

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Written by Yan Xin Liang
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Is hand, foot and mouth disease itchy?

Hand, foot and mouth disease is an infectious disease caused by enteroviruses. There are more than 20 types of enteroviruses that cause hand, foot and mouth disease, among which Coxsackievirus A16 and Enterovirus 71 are the most common. Its main clinical symptoms include mouth pain, decreased appetite, mild fever, and the appearance of small vesicles or small ulcers on the hands, feet, mouth, and other areas. Most infected children can recover in about a week. The rash of hand, foot and mouth disease typically appears on the hands, feet, buttocks, arms, and legs as maculopapular rash, which can later turn into vesicles. These vesicles are surrounded by an inflammatory red halo and contain relatively little fluid. The rash is not itchy. Thus, the rash of hand, foot and mouth disease is unlike other allergic rashes; it does not cause itching or discomfort.

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Written by Yao Li Qin
Pediatrics
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Is hand, foot, and mouth disease dangerous?

Hand, foot, and mouth disease is a common pediatric disease caused by an intestinal viral infection, characterized by fever and rash, with severities ranging from mild to severe. If caused by a typical enterovirus infection, hand, foot, and mouth disease generally recovers quickly with antiviral treatment and proper care of the mouth and skin. However, if caused by an EV71 virus infection, it poses certain risks. This is because the EV71 virus can affect the central nervous system, leading to symptoms such as increased intracranial pressure and respiratory and circulatory dysfunction. These complications can result in respiratory failure and cardiac failure, which are severe manifestations. Therefore, hand, foot, and mouth disease caused by the EV71 virus carries certain risks. Thus, it is important to administer a vaccine made from the EV71 virus to children to prevent severe hand, foot, and mouth disease.

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What should I do about hand, foot, and mouth disease?

Hand, foot, and mouth disease is a common exanthematous infectious disease in children caused by enterovirus infections. Most cases are mild to moderate and can be treated at home with oral medication. Doctors generally prescribe antiviral medications, and if the child's temperature exceeds 38.5 degrees Celsius, antipyretic medications are also required. If there is discomfort in the throat, some medications can be sprayed to relieve local discomfort. For severe cases, such as those caused by EV71 virus infection, it is crucial to be vigilant. This type of infection can lead to symptoms involving the nervous system and may rapidly progress to severe conditions. Therefore, if it is confirmed that the hand, foot, and mouth disease is caused by EV71 infection and the child's condition is serious, hospitalization should be promptly sought. Additionally, for children under three years old, it's important to actively vaccinate against hand, foot, and mouth disease to prevent illness caused by EV71 virus infection.

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Written by Yao Li Qin
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Characteristics of hand, foot, and mouth disease rash

Hand, foot, and mouth disease is a rash disease caused by an intestinal virus infection, characterized by scattered maculopapular and vesicular rashes on the hands, feet, buttocks, and other areas. Typically, small vesicles appear on the oral mucosa, or they may already have ruptured into shallow ulcers, primarily located on the tongue, buccal mucosa, palate, and inner lips. Subsequently, rashes appear on the hands and feet, most commonly as maculopapules, which then develop into vesiculopapules about three to seven millimeters in size. The vesicles have a relatively thick covering and are surrounded by reddened skin, predominantly located at the extremities. Sometimes, they may extend to the arms, legs, buttocks, or perineal area. The distribution of the rash is centrifugal, with the number of lesions varying from a few to dozens. Generally, the lesions absorb on their own within two to three days without desquamation, scarring, or pigmentation. The vesicles and ulcers in the mouth mostly heal on their own within a week.