Would acyclovir help for Hand, Foot, and Mouth Disease (HFMD)?

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Last updated: June 8, 2025View editorial policy

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From the Research

Acyclovir is not recommended for Hand, Foot, and Mouth Disease (HFMD). HFMD is typically caused by enteroviruses, most commonly coxsackievirus A16 and enterovirus 71, not by herpes viruses. Acyclovir specifically targets herpes viruses by inhibiting viral DNA polymerase, but it has no effect on enteroviruses which have RNA genomes and use different replication mechanisms.

Key Points to Consider

  • Treatment for HFMD is primarily supportive care, including adequate fluid intake to prevent dehydration, over-the-counter pain relievers like acetaminophen or ibuprofen to manage fever and discomfort, and topical oral anesthetics such as viscous lidocaine to relieve mouth sores 1, 2.
  • Cold foods like popsicles can also provide relief.
  • HFMD is generally a self-limiting illness that resolves within 7-10 days.
  • If symptoms are severe or complications develop, such as dehydration or neurological symptoms, medical attention should be sought immediately.
  • Good hygiene practices, including handwashing and disinfection of contaminated surfaces, are important to prevent spread to others.

Recent Evidence

The most recent study from 2022 2 supports the idea that treatment for HFMD is mainly symptomatic and supportive, with no specific antiviral agents approved for the treatment of the disease.

Exceptions and Considerations

While there may be rare cases where antiviral treatment is considered, such as in immunocompromised patients 3, the general consensus is that acyclovir is not effective against enteroviruses that cause HFMD.

Prevention and Control

Prevention of HFMD includes vaccination of susceptible individuals in high-risk areas and good personal hygiene, such as handwashing and disinfecting potentially contaminated surfaces and fomites 1, 2.

References

Research

Hand-Foot-and-Mouth Disease: Rapid Evidence Review.

American family physician, 2019

Research

Hand, Foot, and Mouth Disease: A Narrative Review.

Recent advances in inflammation & allergy drug discovery, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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