There’s no cure for hand, foot, and mouth disease (HFMD), and no antibiotic or antiviral will make it go away faster. The illness is caused by a virus, so the only real strategy is managing your child’s symptoms while their immune system clears the infection, which typically takes 7 to 10 days. The good news: most cases are mild, and with the right comfort measures at home, kids recover fully without complications.
What Causes It and How Long It Lasts
HFMD is caused by a group of viruses called enteroviruses. The most common culprit in the United States is coxsackievirus A16, though a strain called coxsackievirus A6 can cause more severe-looking rashes that spread beyond the hands, feet, and mouth to the arms, legs, trunk, buttocks, and even genitalia. A6 sometimes produces a chickenpox-like rash, which can alarm parents who weren’t expecting it.
The illness usually follows a predictable arc. Fever and sore throat come first, often followed a day or two later by painful mouth sores and a rash or blisters on the hands and feet. The fever tends to break within a few days, and the rash resolves over the course of a week to 10 days. In some cases, fingernails or toenails may peel or fall off weeks after the illness. This looks alarming but is harmless, and the nails grow back normally.
Managing Pain and Fever
The mouth sores are usually the worst part. They make eating and drinking painful, which is why pain control matters so much. Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) both work well for reducing fever and easing mouth pain. Follow the dosing instructions on the package for your child’s age and weight.
Two important things to avoid: never give aspirin to children with a viral illness, because it’s linked to a rare but serious condition called Reye’s syndrome. And don’t use throat sprays containing benzocaine on children under 2, as it can cause a dangerous blood condition in young children.
Keeping Your Child Hydrated
Dehydration is the most common complication of HFMD, and it happens because kids refuse to drink when their mouths hurt. This is the single most important thing to stay on top of during the illness. Treat the pain first with acetaminophen or ibuprofen, then offer fluids about 30 minutes later when the medicine kicks in.
Cold liquids tend to feel better than warm ones. Ice pops are especially useful because they numb the mouth slightly while delivering fluid. For toddlers and older kids, soft foods like yogurt, pudding, pasta, and smoothies provide both calories and hydration without irritating the sores. Avoid anything acidic or salty, like orange juice, tomato sauce, or chips, which will sting.
Plain water alone isn’t ideal if your child has stopped eating, because it doesn’t provide the energy or salt their body needs. Offer a mix of fluids: milk, diluted juice, broth, or an electrolyte solution. For babies still on breast milk or formula, continue offering frequent feeds in smaller amounts if needed.
Watch for signs of dehydration: fewer wet diapers than usual (babies over a month old should have at least six heavy wet diapers a day), no tears when crying, dry lips, or unusual sleepiness. If your child can’t keep fluids down or stops urinating, that’s a sign they need medical attention.
Soothing the Rash
The blisters on the hands and feet are generally less painful than the mouth sores, but they can still be uncomfortable. Keep the skin clean with gentle soap and water. Don’t pop the blisters, as the fluid inside contains virus and popping them increases the risk of spreading it. Let them dry and heal on their own. Most blisters flatten and fade within a week without leaving scars.
If your child has the A6 strain with a more widespread rash, the same approach applies. The rash may look more dramatic, but it follows the same timeline and resolves without specific treatment.
Preventing Spread to Siblings and Adults
HFMD is highly contagious and spreads fast through households and daycare settings. The virus travels through respiratory droplets (coughs, sneezes, talking), direct contact like kissing and hugging, shared cups and utensils, and contact with stool during diaper changes. It can also linger on surfaces like doorknobs and toys.
Frequent handwashing is your best defense. Wash your hands thoroughly after changing diapers, wiping noses, and helping your child eat. Clean and disinfect shared surfaces and toys daily. A diluted bleach solution works well: mix 5 tablespoons (one-third cup) of regular unscented household bleach per gallon of room-temperature water. Clean surfaces with soap first, then apply the bleach solution and let it sit for at least one minute while visibly wet before wiping. Make a fresh batch every day, because the solution loses effectiveness after 24 hours.
Keep your sick child’s cups, utensils, and towels separate from the rest of the family’s. Adults can catch HFMD too, though they often have milder symptoms or no symptoms at all while still being contagious.
When Kids Can Return to Daycare
CDC guidelines say children can go back to daycare or school as long as they have no fever, feel well enough to participate, and aren’t drooling uncontrollably from mouth sores. You don’t need to wait until the rash is completely gone. That said, your local health department or daycare may have stricter rules, especially during an outbreak, so check their specific policy.
Keep in mind that even after symptoms clear, children can shed the virus in their stool for weeks. This is why good hand hygiene after diaper changes and bathroom trips matters long after the illness seems over.
Signs That Need Medical Attention
Most kids sail through HFMD without any lasting problems, but a few red flags warrant a call to your pediatrician or a trip to urgent care. These include a fever lasting longer than 3 days, inability to drink enough fluids, symptoms that haven’t improved after 10 days, or any signs of severe illness like unusual sleepiness, persistent vomiting, or a stiff neck. Babies under 6 months and children with weakened immune systems should be seen by a provider early in the illness.
Serious complications like viral meningitis (fever, headache, stiff neck) or encephalitis (brain swelling) are extremely rare but are more commonly associated with a strain called enterovirus 71, which is uncommon in the United States. The vast majority of HFMD cases resolve completely at home with nothing more than pain relief, cold fluids, and patience.