Is It Herpangina or HFMD? Signs Parents Should Spot
- Aug 28, 2025
- 4 min read
When your child complains of a sore throat, develops mouth ulcers, or becomes unusually irritable, it is natural to wonder: is it herpangina or Hand, Foot and Mouth Disease (HFMD)? While the two conditions share some similarities, there are key differences that can help you tell them apart. At Joyful Seeds Paediatric & Development Clinic, located in Bukit Timah, Dr Charmaine Teo and Dr Martha Liu provide parents with clear, practical advice to recognise symptoms, care for their child, and prevent further spread.
What Exactly Is Herpangina?
Herpangina is a viral illness caused by enteroviruses, most often coxsackievirus A strains, and typically affects children aged between three and ten years. It often starts suddenly, with a high fever and sore throat. Within a short time, small ulcers, around 1 to 2 mm in size, appear at the back of the mouth, particularly on the soft palate or near the tonsils. These lesions can have a red border and may appear dull grey or white.
In most cases, herpangina resolves within about seven days. Like HFMD, it is a self-limiting illness, meaning it usually clears up without specific medical treatment. Care focuses on rest, fluids, and age-appropriate pain relief. Antibiotics are not effective because the illness is viral, not bacterial.
How Herpangina Differs from HFMD
Although both herpangina and HFMD are caused by viruses from the same family, their symptoms and presentation can be quite different.
Location of ulcers and rash
Herpangina Ulcers are located only at the back of the mouth and throat. There is no skin rash.
HFMD Starts with a fever, followed by blisters or flat red spots on the hands, feet, and inside the mouth. The rash may also appear on the buttocks or groin.
Typical age group affected
Herpanginal More common in children aged three to ten years.
HFMD Most often seen in children under five, especially those in childcare or preschool environments.
Incubation period Both herpangina and HFMD have an incubation period of three to six days after exposure to the virus.
How they spread
Both illnesses are highly contagious, spreading through droplets, saliva, nasal mucus, fluid from blisters, stools, and contaminated surfaces. This means children can contract the infection easily in group settings.
Quick Comparison Guide
Condition | Ulcer Location | Rash on Skin | Typical Age Group | Duration |
Herpangina | Back of mouth/throat only | No | 3–10 years | ~7 days |
HFMD | Mouth + hands, feet, buttocks | Yes | Under 5 years most | 7–10 days |
Home Comfort Measures That Help
Whether your child has herpangina or HFMD, most cases can be managed at home with supportive care. The focus should be on keeping them comfortable and hydrated while their immune system fights the virus.
Keep your child hydrated Offer cool fluids such as water, diluted fruit juices, clear broths, or cold milk. Ice lollies and yoghurt can help soothe painful ulcers and encourage fluid intake.
Relieve pain and fever Use age-appropriate paracetamol or ibuprofen to ease discomfort and reduce fever. Always follow your doctor’s dosage instructions.
Choose soft, non-acidic foods Mashed vegetables, porridge, or soft noodles are gentle on sore mouths. Avoid spicy, salty, or acidic foods that can irritate ulcers.
Practise good hygiene Wash hands regularly, disinfect toys and frequently touched surfaces, and discourage sharing of utensils, cups, or towels.
At Joyful Seeds, located at Bukit Timah Road, Dr Charmaine Teo and Dr Martha Liu often guide parents on how to adapt these measures to suit their child’s needs, helping make recovery smoother and less stressful.
When Medical Assessment Is Advised
Most children recover from herpangina or HFMD without complications, but it is important to seek medical advice if you notice:
A high fever that does not improve with medication
Signs of dehydration, such as dry lips, dark urine, or reduced urination
Difficulty swallowing or excessive drooling
A rash that spreads or worsens (in HFMD)
Unusual drowsiness, persistent irritability, stiff neck, or any neurological symptoms . Rare, but important to treat promptly, especially in HFMD
At Joyful Seeds Paediatric & Development Clinic, located in Bukit Timah, our doctors can examine your child, confirm the diagnosis, and advise on the safest and most effective care plan.
Preventing the Spread
Because both herpangina and HFMD are highly contagious, preventing transmission is essential, particularly in homes with more than one child.
Keep your child at home until symptoms have resolved and they are cleared to return to school or childcare in line with the medical certificate provided.
Clean and disinfect toys, tables, doorknobs, and high-touch surfaces daily.
Teach children not to share cups, utensils, or towels.
Encourage proper cough etiquette and thorough handwashing, even within the family.
Following these measures helps protect siblings, classmates, and the wider community.
The Joyful Seeds Assurance
At Joyful Seeds Paediatric & Development Clinic, located in Bukit Timah, we understand the concern that comes with childhood illnesses like herpangina and HFMD. Dr Charmaine Teo and Dr Martha Liu offer straightforward, evidence-based guidance, combined with a warm and supportive approach that puts parents at ease.
If you are unsure whether your child has herpangina or HFMD, book a consultation with our team. We will help you identify the condition and guide you through the right care plan, so you can feel confident and reassured in looking after your child.