Symptoms of hand, foot and mouth disease

The illness is usually noticed in children as a fever, reduced appetite, sore throat, or irritability followed by tender ulcers inside the mouth. Small red spots or fluid-filled blisters may appear on the palms, soles, fingers, toes, buttocks, or around the knees. A rash can be present without every feature, and other childhood infections can look similar. Mouth pain may make drinking difficult, which is the main concern to watch at home.

Offer frequent sips of cool fluid and soft foods if swallowing hurts. Encourage rest, keep hands clean, and avoid sharing cups, cutlery, towels, or toys that go into the mouth. Clean visibly soiled surfaces and keep the child away from group settings while feverish or too unwell to participate. A [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) can help if the diagnosis is uncertain or drinking is becoming difficult. Never give a child medicine that is unsuitable for their age.

Seek urgent advice if the child is difficult to wake, has breathing trouble, develops a stiff neck, has a seizure, or shows dehydration such as very little urine, a dry mouth, or unusual sleepiness. Arrange medical review when fever persists, mouth pain prevents drinking, blisters become very red or pus-filled, or the child has a weakened immune system. See the [Fever](/symptoms/fever/) page for additional guidance.

Ask whether the rash fits hand, foot and mouth disease, how to manage mouth pain safely, when the child can return to nursery or school, and which dehydration signs require immediate review.