What is the typical duration of hand, foot, and mouth disease?

Duration of Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease typically resolves within 7 to 10 days without complications. 1

Clinical Course Timeline

• Fever is usually the first symptom to appear, often accompanied by malaise, general discomfort, sore throat, and irritability in young children 2
• The characteristic rash and oral lesions typically develop 1-2 days after the onset of fever 2
• Lesions usually resolve in 7-10 days in most cases 1
• Symptoms are generally self-limiting and resolve without specific treatment 3

Symptom Progression

• Initial phase (Days 1-2):

  • Low-grade fever (can sometimes exceed 102.2°F/39°C) 2
  • Sore throat and general discomfort 2
  • Possible respiratory symptoms (cough, rhinitis) in some cases 2

• Middle phase (Days 2-5):

  • Development of painful oral ulcerations 1
  • Appearance of maculopapular or papulovesicular rash on hands and feet 1
  • Peak of discomfort and symptoms 3

• Resolution phase (Days 5-10):

  • Gradual healing of skin lesions and oral ulcerations 1
  • Fever typically resolves before skin lesions completely heal 4
  • Return to normal activities can occur once fever resolves and mouth sores heal, even if skin rash is still present 4

Special Considerations

• Atypical presentations with coxsackievirus A6 may have:

  • Higher fever and longer duration of disease than typical HFMD 5
  • More severe skin manifestations with wider distribution 5
  • May affect adults as well as children 5

• Complications (rare):

  • Neurological complications such as encephalitis/meningitis can occur in severe cases, particularly with EV-71 infection 4
  • Nail dystrophies (e.g., Beau's lines or nail shedding) may appear weeks after initial symptom resolution 6
  • In very rare cases, cardiopulmonary complications may occur 7

Return to Daycare/School Guidelines

• Children can return to daycare once fever has resolved and mouth sores have healed, even if skin rash is still present 4
• By the time HFMD is diagnosed, the child has likely had the infection for some time, posing limited additional risk to others 4

Treatment Approach

• Treatment is supportive and focused on hydration and pain relief with acetaminophen or ibuprofen as needed 1
• Intensive skin care with moisturizing creams may help manage skin lesions 4
• There is no specific antiviral treatment available for HFMD 1, 3

Prevention of Spread

• Handwashing is the most important preventive measure 4
• Environmental cleaning, particularly of toys and objects that may be placed in children's mouths 4
• Avoiding sharing utensils, cups, or food 4