What are the symptoms of Hand, Foot, and Mouth Disease (HFMD)?

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Last updated: April 18, 2025View editorial policy

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From the Guidelines

Hand, foot, and mouth disease typically presents with fever, sore throat, and a characteristic rash on the hands, feet, and inside the mouth, with symptoms lasting 7-10 days and usually resolving without medical treatment. The illness usually begins with a fever, reduced appetite, and sore throat, followed by painful sores developing in the mouth 1-2 days later, as noted in the context of enterovirus infections 1. These sores start as small red spots that blister and can become ulcers. A skin rash with red spots, sometimes with blisters, may appear on the palms of hands, soles of feet, and occasionally on the buttocks and genital area. Other symptoms can include irritability in infants and young children, and general malaise. The disease is most common in children under 5 years old but can affect anyone. It's highly contagious, spreading through contact with an infected person's saliva, respiratory droplets, fluid from blisters, or feces.

While the disease shares some symptoms with other conditions, such as Kawasaki disease, which also presents with extremity changes including erythema of the palms and soles and desquamation of the fingers and toes 1, the characteristic rash and oral sores of hand, foot, and mouth disease distinguish it. Symptoms typically last 7-10 days and usually resolve without medical treatment.

  • Key symptoms include:
    • Fever
    • Sore throat
    • Painful sores in the mouth
    • Skin rash on the hands, feet, and occasionally buttocks and genital area
  • Management focuses on relieving symptoms, with pain relievers like acetaminophen or ibuprofen helping to manage fever and pain, and staying hydrated being important, especially when mouth sores make drinking difficult.

From the Research

Symptoms of Hand Foot and Mouth Disease

  • The disease is characterized by a painful oral enanthem and asymptomatic exanthem on the palms and soles 2
  • Patients present with a low-grade fever, a maculopapular or papulovesicular rash on the hands and soles of the feet, and painful oral ulcerations 3
  • The main manifestations are fever, vesicular rashes on hand, feet and buttocks and ulcers in the oral mucosa 4
  • Symptoms usually include fever, oral ulcers, and skin manifestations affecting the palms, soles, and buttocks, with symptoms usually lasting less than 1 week 5
  • In rare cases, patients may experience severe complications such as meningitis, encephalitis, acute flaccid paralysis and neurorespiratory syndrome 4
  • Circulatory failure secondary to myocardial impairment and neurogenic pulmonary edema secondary to brainstem damage are the main causes of death 2

Duration and Resolution

  • Lesions usually resolve in seven to 10 days 3
  • The disease is usually benign and resolves in 7 to10 days without sequelae 2
  • Symptoms usually last less than 1 week 5

Affected Population

  • Children younger than 10 years are most commonly affected 3
  • Children younger than 5 years are most commonly affected 2
  • The disease can also occur in adults, although it is rare 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hand, Foot, and Mouth Disease: A Narrative Review.

Recent advances in inflammation & allergy drug discovery, 2022

Research

Hand-Foot-and-Mouth Disease: Rapid Evidence Review.

American family physician, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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