I love September! To me, Back-to-school means clean notebooks, new horizons and the memory of a fresh box of Crayolas. My excitement is just another in a long list of quirks that my children find perplexing and irritating. I somehow haven’t completely transmitted the enthusiasm my own parents had for the start of the school year.
My dad, a college president who saw the potential student in almost everyone, looked upon the beginning of the semester like a child anticipates Christmas morning. His own education was a transformative gift, and he never got over his wonder and gratitude. My mother excitedly planned first-day-of-school outfits and staged multiple photos, but one year she got a little ahead of herself. As she pulled out of the elementary school driveway, having dropped me and my brothers off at the front entrance, the custodian waved down her speeding station; the first day of school wasn’t until the NEXT day. I get it; summer vacation can get too long when you have three kids underfoot.
In the wonderful world of dermatology, the fall also brings particular skin conditions. One of these back-to-school rashes is hand, foot and mouth disease.
Hand, foot, and mouth disease is a viral infection that causes sores in the mouth and a rash on the hands and feet. It is common among children under the age of 5, particularly in daycare settings, as it spreads by close contact with infected people. It’s not usually serious, and nearly all people recover within 10 days without medical treatment. (1)
Symptoms of Hand, Foot and Mouth Disease
● Poor appetite
● Sore throat
● Rash – Small red bumps or blisters on the palms, soles of the feet, and sometimes the knees, elbows, buttocks, and genital area.
● Painful sores in the mouth
Symptoms typically appear 3-6 days after the initial infection (incubation period), with fever as the first sign, followed by a sore throat. (2)
Hand, foot, and mouth disease spreads through contact with infected individuals’ nasal secretions, throat discharge, saliva, stool, or respiratory droplets after a cough or sneeze. It may also spread through contact with blisters on the skin.
Infected individuals are typically most contagious during the first week of illness, but the virus can remain in the body for weeks after the signs and symptoms are gone, resulting in further transmission. Some people, particularly adults, can pass the virus without showing any signs of the disease. Outbreaks of the disease are common in the summer and autumn in the United States and other temperate climates. (3)
Treatment for Hand, Foot and Mouth Disease
There is no specific treatment for hand, foot, and mouth disease. Symptoms, such as fever, can be managed with over-the-counter analgesics, like Ibuprofen or Tylenol. It is important that infected individuals drink plenty of fluids to stay hydrated, particularly if fever is present. Complications of hand, foot, and mouth disease are rare, but may include viral meningitis or encephalitis. High fevers not relieved with analgesics, headache, stiff neck, or back pain warrant further evaluation by your physic.
(1) CDC (June 28, 2018). Hand, Foot, and Mouth Disease. Accessed online at:
(2, 3) Mayo clinic (July 26, 2017). Hand, Foot, and Mouth Disease . Accessed online at: