Hand, foot, and mouth disease is a self-limiting viral infection, and most people recover on their own within 7 to 10 days. There is no antiviral medication or cure. Treatment focuses on managing pain, protecting the skin, and staying hydrated while the rash runs its course.
What the Rash Looks Like and How It Heals
The rash typically appears on the palms of the hands, soles of the feet, and sometimes the buttocks. It often starts as flat red spots that can develop into small, blister-like lesions. Despite how it looks, the rash is generally not itchy, though the blisters can be tender. Painful sores also commonly form inside the mouth, on the tongue, and along the gums, which is usually the most uncomfortable part of the illness.
The blisters don’t need to be popped or drained. They dry out and flatten on their own as the body clears the virus. In most children, the full cycle from first symptoms to resolution takes about 7 to 10 days, though some skin peeling on the hands and feet can continue for a week or two after.
Managing Pain and Fever
The main tools for pain and fever are acetaminophen and ibuprofen, dosed by your child’s weight. Acetaminophen can be given every 4 hours for children under 12, with no more than 5 doses in a 24-hour period. If you don’t know your child’s exact weight, use their age as a guide from the dosing chart on the package. Acetaminophen should not be given to children under 2 without a doctor’s guidance.
Oral lidocaine, sometimes suggested as a numbing agent for mouth sores, is not recommended for children. Clinical evidence shows little benefit, and it carries a risk of harm if swallowed.
Soothing the Skin Rash
The blisters on the hands and feet don’t typically require aggressive treatment, but you can protect them and ease discomfort with a few simple steps. Applying zinc oxide or petroleum jelly over the blisters creates a barrier that shields broken skin and supports healing. This is especially helpful on the feet, where friction from walking or shoes can irritate open sores.
Keep the affected skin clean with gentle washing and pat it dry rather than rubbing. Avoid adhesive bandages directly over blisters, as pulling them off can tear fragile skin. Loose, soft clothing and socks reduce irritation. If your child is in diapers and the rash extends to the buttocks, change diapers frequently and apply a thick layer of barrier cream to protect against moisture.
Staying Hydrated With Mouth Sores
Mouth sores are often the biggest obstacle to recovery because they make eating and drinking painful, especially for young children. Dehydration is the most common complication of hand, foot, and mouth disease, so encouraging fluid intake matters more than solid food during the worst days.
Cold foods and drinks tend to be the most tolerable. Ice pops, ice chips, ice cream, and sherbet all work well because the cold naturally numbs the sores. Cool water and cold milk are good choices for hydration. Some children also find warm (not hot) tea soothing. The key things to avoid are acidic foods and drinks: citrus fruits, orange juice, fruit punch, lemonade, and soda. These sting open sores and make children less willing to drink.
Soft, bland foods like yogurt, mashed potatoes, applesauce, and smoothies are easier to get down than anything crunchy, salty, or spicy. If your child refuses to eat for a day or two but continues to drink fluids, that’s generally fine. Watch for signs of dehydration: fewer wet diapers, no tears when crying, a dry mouth, or unusual sleepiness.
How Long Your Child Is Contagious
Hand, foot, and mouth disease is most contagious during the first week of illness, when fever is present and blisters contain fluid. But the virus sticks around much longer than the visible symptoms. Studies tracking viral shedding in stool found that the viruses responsible for HFMD remain detectable for weeks. At 4 weeks after illness, roughly half of children were still shedding virus in their stool. Traces can persist for up to 6 to 10 weeks, depending on the specific virus strain.
This means strict quarantine for the entire shedding period isn’t realistic. In practical terms, most schools and daycares allow children to return once they’ve been fever-free for at least 24 hours (without fever-reducing medication) and the mouth sores and blisters are improving. Good hand hygiene, especially after diaper changes and bathroom use, is the most effective way to limit spread during those lingering weeks of viral shedding.
Preventing Spread at Home
The virus spreads through blister fluid, saliva, nasal secretions, and stool. Within a household, a few habits make a real difference. Wash your hands thoroughly after changing diapers, wiping noses, or helping your child eat. Clean and disinfect shared surfaces like toys, doorknobs, and highchair trays daily. Avoid sharing cups, utensils, and towels with the sick child.
Adults can catch hand, foot, and mouth disease too, though symptoms are often milder. If you’re caring for a sick child, consistent handwashing is your best protection.
When the Rash Isn’t Improving
Most cases resolve without any complications, but a few signs warrant a call to your child’s doctor. If symptoms haven’t improved after 10 days, something else may be going on. Watch for blisters that become increasingly red, swollen, warm, or start draining pus, as this can signal a secondary bacterial infection that may need treatment. A child who stops drinking fluids entirely, seems unusually lethargic, or develops a high fever that doesn’t respond to medication also needs medical attention.
Some children experience nail changes weeks after the illness, including horizontal ridges or even temporary nail shedding. This looks alarming but is harmless and the nails grow back normally.