Hand, Foot and Mouth Disease: Symptoms and Care
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 31 October 2026
Hand foot and mouth disease: first signs, how long it is contagious, nursery rules in Spain, UK and US, care at home and the signs that need a doctor.
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Dr. Pedro Yelamo Vera is an independent, bilingual GP licensed in Spain. Book a 15-minute video consultation in English or Spanish for €50, with a private electronic prescription issued under Spanish law when clinically appropriate.
Hand, foot and mouth disease is a common viral infection, mostly in children under 5. It starts with a fever and sore throat. Painful mouth ulcers and a spotty rash on the hands and feet follow. It is usually mild and clears by itself in 7 to 10 days. There is no cure, so care at home focuses on drinks and pain relief.
- Signs: fever, sore throat, mouth ulcers, then spots or blisters on hands, feet and sometimes the bottom.
- It is caught from coughs, sneezes, poo and blister fluid. It spreads most in the first 5 days.
- Antibiotics do not help. Cool drinks, soft food and paracetamol or ibuprofen ease the pain.
- In Spain and the UK, a child can go back to nursery once well and fever-free. Blisters do not need to heal first.
- The main risk is dehydration. A child who will not drink needs a doctor today.
Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).
For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.
What are the first signs of hand, foot and mouth disease?
The NHS describes two stages. First come a sore throat, a high temperature and not wanting to eat. A few days later you may see:
- Mouth ulcers on the tongue, gums, inside the cheeks or the back of the throat. They can make eating and drinking painful.
- A rash of spots on the palms and soles. They may turn into small grey or pale blisters.
- Spots on the bottom, groin, legs or arms in some children.
The CDC says the rash is usually not itchy. Babies may drool more, refuse feeds or only want cold drinks. Some children have very mild signs, or none at all.
In Spain it is called enfermedad boca-mano-pie. It has nothing to do with foot-and-mouth disease in farm animals (fiebre aftosa). Mayo Clinic notes you cannot catch it from pets.
What causes it, and can adults get it?
It is caused by enteroviruses, most often coxsackieviruses. The Spanish Paediatric Association (AEP) says it is most common between 1 and 3 years old. Outbreaks are more common in spring and summer.
Adults can get it too. The NHS says the symptoms are the same as in children. Mayo Clinic adds that most adults have built some immunity, so they get it less often. Several viruses cause it, so you can catch it more than once.
How long is hand, foot and mouth disease contagious?
Symptoms start about 3 to 6 days after contact, according to the AEP and Mayo Clinic. It spreads through:
- Coughs, sneezes and saliva.
- Fluid from the blisters.
- Poo, for example during nappy changes.
- Toys, towels and surfaces.
The NHS says you can pass it on from a few days before symptoms start. You are most infectious in the first 5 days. Mayo Clinic and the AEP say the virus can stay in the body for weeks after you feel better. That is why careful handwashing matters even after the spots fade.
Can my child go to nursery or school?
The rules differ between countries:
- Spain: the AEP says a child with no fever who feels well can go to the guardería or school. Keeping them home does not stop the spread.
- UK: the NHS says to keep a child home while they are too unwell. They can go back once they feel better, even if blisters remain.
- US: Mayo Clinic advises keeping a child out of child care until the fever is gone and the mouth sores have healed.
Some Spanish nurseries set their own rules, so ask yours. Tell the nursery or school about the illness.
Not sure if your child's spots are hand, foot and mouth disease?
You can book a video visit with a GP licensed in Spain, in English or Spanish. He looks at the rash and mouth on camera, checks for dehydration and tells you what to watch for.
How do you treat hand, foot and mouth disease at home?
There is no specific treatment and antibiotics do not work, because it is a virus. These steps help:
- Plenty of cool drinks. Water and milk are good. Avoid fruit juice and fizzy drinks, which sting the ulcers.
- Soft, cold food, such as yoghurt. Avoid hot, salty or spicy food.
- Pain relief. Paracetamol or ibuprofen can ease a sore mouth and fever. Use the child's form and follow the leaflet for their age and weight. Never give aspirin to anyone under 16.
- Mouth gels or sprays. A pharmacist can suggest ones that suit children.
- Leave the blisters alone. Keep them clean and do not pop them.
Is hand, foot and mouth disease a risk in pregnancy?
Usually not. The NHS says there is normally no risk to the pregnancy or the baby. Still, avoid close contact with anyone who has it. Catching it shortly before birth can mean the baby is born with a mild form. If you are pregnant and have been in contact, or have symptoms, speak to your GP or midwife (matrona).
Why do nails sometimes fall off afterwards?
A few weeks later, some children get ridges in their nails, or lose a nail. The AEP places this at about 5 to 6 weeks after the rash. The CDC calls it very rare. It is painless and the nails grow back by themselves.
When should you see a doctor?
See a doctor today if your child:
- Is not drinking well, has a dry mouth or lips, or has had no wee or wet nappy for 8 hours.
- Has had a fever for more than 3 days, or a temperature that will not come down.
- Is under 6 months old, or has a weak immune system.
- Has spots that become more red, swollen and painful, which may mean infection.
- Is no better after 10 days, or you are worried.
Call 112 if your child has a fit (seizure), is struggling to breathe, is very sleepy or hard to wake, or has a rash that does not fade under a pressed glass. Go to urgencias too if a baby under 3 months has a temperature of 38°C or more. Call also for a stiff neck with fever and a bad headache. Serious problems such as meningitis are rare, but need help at once.
Talking it through with a doctor by video
Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:
- Look at the rash, hands, feet and mouth on camera.
- Check for signs of dehydration and other warning signs.
- Explain how to manage pain and fluids, and when the child can go back to nursery.
- Tell you if your child needs an in-person check.
He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.
A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.
See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.
This guide is general information. It does not replace a consultation with your doctor.
Frequently asked questions
What are the first symptoms of hand, foot and mouth disease?
Usually a fever, sore throat and poor appetite. Mouth ulcers and spots on the hands and feet follow a day or two later.
How long does hand, foot and mouth disease last?
It usually clears by itself in 7 to 10 days. Nails may change or shed some weeks later, then grow back.
How long is it contagious?
From a few days before symptoms. It spreads most in the first 5 days, but the virus can stay in the body for weeks, so keep washing hands.
Can my child go to nursery with hand, foot and mouth disease?
In Spain and the UK, yes, once they have no fever and feel well. The blisters do not need to have healed. Some nurseries set their own rules.
Can adults get hand, foot and mouth disease?
Yes. Adults have the same symptoms as children, though most get it less often because of past immunity.
Is hand, foot and mouth disease the same as foot-and-mouth disease?
No. Foot-and-mouth disease affects farm animals. You cannot catch hand, foot and mouth disease from animals.
Do antibiotics help?
No. It is caused by a virus. Fluids, soft cold food and pain relief are the treatment.
Sources
- NHS: Hand, foot and mouth disease
- CDC: Hand, foot, and mouth disease symptoms and complications
- Mayo Clinic: Hand-foot-and-mouth disease
- NHS Healthier Together: Hand, foot and mouth disease (when to get help)
- AEP En Familia: Enfermedad boca-mano-pie (Spanish)
Related guides
Medical Citations & Sources
This content is written and reviewed by a licensed physician with reference to the following official health authorities.
