Drool Rash vs. Hand, Foot, and Mouth Disease (HFMD): What Are the Differences?

Patty Weasler, RN, BSN
·5 min read

Medically reviewed by Susan Bard, MD

Hand, foot, and mouth disease (HFMD) is a viral illness typically seen in children five years and under. Mouth sores, hand and foot rashes, and a low-grade fever are all characteristics of HFMD. Drooling also causes a rash around the mouth and can be mistaken for HFMD. This article will cover the differences between a drool rash and HFMD. It will also discuss the symptoms and treatments for both rashes.

<p>Pawel Wewiorski / Getty Images</p>

Pawel Wewiorski / Getty Images

Rash From Drool vs. Infection From HFMD

Hand, foot, and mouth disease and a rash from drool can look similar. They both cause facial skin irritation and discomfort. However, a few key features help distinguish the two conditions.

A drool rash appears as skin irritation, redness, and bumps on the face. Drooling is a common developmental phase in babies. It often becomes most apparent around three to six months old.

HFMD is characterized by a fever, mouth sores, and a skin rash. The skin rash is also commonly found on the hands and feet. It is typically seen in children six months to four years old.

Other Symptom Differences

Here is a list to compare drool rash and hand, foot, and mouth disease symptoms:

Drool Rash

  • Red, slightly raised bumps near the mouth, chin, or neck

  • Redness around the mouth

  • Swollen gums

  • Biting

  • Drooling

  • Irritability

  • Refusing to eat

Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease causes blisters that can leave a reddened sore. There may also be a rash on other parts of the body, including the buttocks and thighs.

Drool Rash vs. HFMD Causes

One of the primary causes of a drool rash is teething and excessive saliva production. When babies are teething, they will often drool. This excessive saliva on the skin can cause irritation and rashes. Other causes of drool rashes include using a pacifier and wiping the skin frequently to remove drool.

A viral infection causes HFMD, most often the Coxsackievirus. It is highly contagious, especially during the first week. It spreads easily through:

  • Feces

  • Contact with a contaminated surface

  • Touch (person-to-person contact)

  • Saliva/mucus droplets from sneezes or coughs

Hand, foot, and mouth disease commonly spreads in places where young children are close together, such as daycare, school, and summer camp.

How to Confirm Rash From Drool vs. HFMD

One of the key distinguishing features of a drool rash from hand, foot, and mouth disease is that a drool rash does not appear on the hands and feet, and it does not cause blisters. Additionally, a drool rash won't cause lesions inside the mouth, unlike hand, foot, and mouth disease.

A healthcare provider can generally determine if someone has hand, foot, and mouth disease by evaluating their age, rash appearance, and other symptoms.

If they cannot conclusively determine if the rash is a hand, foot, and mouth disease, they can order a lab test; however, this is rarely used.



When To Call a Healthcare Provider

Hand, foot, and mouth disease does not have a specific remedy and will normally resolve with at-home treatment. However, there are circumstances in which a healthcare provider should be contacted. They include:

  • Fever longer than three days

  • No symptom improvement after ten days

  • Concern of dehydration

  • Severe symptoms

  • Any child who is younger than six months old



Soothing Rash at Home

A drool rash and hand, foot, and mouth disease can be uncomfortable, making sleeping and eating difficult for babies and small children. While there is no cure for either skin condition, there are ways to soothe the rash and minimize symptoms.

Drool and Teething

Preventing a drool or teething rash is one of the best treatments. Do this by wiping away drool from the face, chin, and neck. Use a soft cloth and do not excessively rub the skin.

When a drool rash has already formed gently clean and pat the rash dry. Apply a thin layer of petrolatum or zinc to the rash to act as a barrier between saliva and the skin. This will help the rash heal and prevent further irritation.

HFMD

Hand, foot, and mouth disease is an uncomfortable childhood illness that does not have a specific treatment or cure. There are several ways to minimize the discomfort and make the healing process a little easier. They are:

  • Use over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil): Babies and children use weight-based medication dosing. Check with a healthcare provider for correct dosing.

  • Offer plenty of fluids: HFMD mouth sores can be painful and can decrease a child's interest in drinking.

  • Provide cold drinks and foods: These will numb the mouth and make it easier to drink and eat. Avoid hot and acidic foods and drinks.

  • Do not cover blisters on the hands and feet: Keep them clean and dry. If blisters pop open, apply a small amount of antibiotic ointment and cover with a bandage.



HFMD Treatment and Progression

Hand, foot, and mouth disease does not have a specific treatment available. Unfortunately, the virus just needs to run its course. Thankfully, the above treatment options can minimize discomfort and make the healing process a little easier.



Recovery Timeline for Viral HFMD

Hand, foot, and mouth disease typically begins with a fever and flu-like symptoms for three to five days. It progresses to mouth sores and blisters. Hand, foot, and mouth disease symptoms usually resolve within one week to ten days.

How to Keep Rash From Returning

One of the best ways to prevent a drool rash is to keep the face clean and dry. Use a clean, dry cloth to wipe the face.

The best prevention for hand, foot, and mouth disease is frequent handwashing. This is especially important after using the bathroom, diaper changes, before making food, and before eating. Clean hard surfaces with disinfectants and wash regularly wash toys.

Summary

Hand, foot, and mouth disease (HFMD) and drool rashes are two types of face rashes that babies and young children can develop rashes on their face that can be difficult to differentiate. HFMD will not only cause a rash on the face, but it will also cause mouth sores and spots or blisters on the hands and feet. A drool rash will only appear on the face, neck, or chin (any spots where saliva touches). Treatment is aimed at providing comfort and reducing symptoms.

Read the original article on Verywell Health.