What is the treatment for hand foot mouth disease?

Treatment for Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease is a self-limiting viral illness that primarily requires supportive care focused on hydration and pain relief with acetaminophen or ibuprofen until symptoms resolve in 7-10 days.

Clinical Presentation and Diagnosis

• Characterized by:
  • Low-grade fever
  • Painful oral ulcerations/enanthem
  • Maculopapular or papulovesicular rash on hands and soles of feet
  • Sometimes buttock involvement
• Most commonly affects children under 5 years, but can occur in adults
• Caused by human enteroviruses and coxsackieviruses (commonly Coxsackievirus A16, Coxsackievirus A6, and Enterovirus 71)
• Transmission occurs via:
  • Fecal-oral contact
  • Oral-oral contact
  • Respiratory droplets

Treatment Approach

Primary Treatment (Supportive Care)

• Hydration

  • Encourage fluid intake despite painful oral lesions
  • Cold liquids, popsicles, or ice cream may soothe oral discomfort
  • Avoid acidic, spicy, or hot foods/beverages that may irritate ulcers

• Pain Management

  • Acetaminophen or ibuprofen as needed for pain and fever 1
  • Avoid oral lidocaine (not recommended) 1

Specific Symptom Management

• For oral lesions:

  • Saltwater rinses (for older children/adults)
  • Cold fluids and soft foods

• For skin lesions:

  • Keep areas clean and dry
  • No specific topical treatments required

Important Considerations

• Duration: Symptoms typically resolve in 7-10 days without specific treatment 1, 2
• No antiviral treatment is currently available or approved for hand, foot, and mouth disease 1
• No role for antibiotics unless secondary bacterial infection occurs

Prevention of Spread

• Handwashing is the most effective preventive measure 1
• Disinfection of potentially contaminated surfaces and fomites
• Avoiding close contact with infected individuals
• Children should stay home from school/daycare until fever resolves and mouth sores have healed

Monitoring for Complications

• While rare, watch for potential complications:
  • Neurologic manifestations (meningitis, encephalitis)
  • Cardiopulmonary complications
  • Dehydration due to painful swallowing

Special Populations

• Adults: May experience more severe symptoms than children
• Immunocompromised patients: May require closer monitoring for complications
• Pregnant women: Should avoid contact with infected individuals due to potential risk of severe disease

The evidence consistently shows that hand, foot, and mouth disease is typically benign and self-limiting, with supportive care being the mainstay of treatment. No specific antiviral therapy is currently recommended for routine cases, and the focus should be on symptom management and prevention of transmission.