How Hand, Foot and Mouth Rash Can Start

The first signs can include fever, tiredness, sore throat or painful mouth ulcers. Skin changes may then appear on the palms, soles, fingers, toes, legs, buttocks or around the mouth. Early spots can be subtle and may become blister-like. A rash that begins in a fold, follows a new product or forms a ring can have another explanation, such as Heat Rash, Contact Dermatitis or Ringworm. The pattern over time is useful when a clinician is assessing it.

Take a clear photo in good light if the appearance is changing, and note fever, mouth pain, drinking and urine output. Offer cool fluids and soft foods. Keep skin clean, dry and uncovered when practical; use loose clothing and avoid scratching or popping blisters. Wash hands often, especially after toileting or nappy changes, and avoid sharing cups, towels and eating utensils. Do not start steroid, antibiotic or antifungal cream without advice, because different rashes need different treatment.

Seek urgent medical advice when a child cannot drink, urinates much less, is hard to wake, has breathing difficulty, develops severe headache or neck stiffness, or is rapidly getting worse. Have an early rash assessed if it becomes hot, swollen, increasingly painful or pus-filled. A very young infant with fever, or anyone with a weakened immune system and a new blistering rash, should receive individual medical guidance.

Ask whether the first spots fit hand, foot and mouth disease, what symptoms to record, which comfort measures are suitable, and when to seek another review.