What is the treatment for hand foot mouth disease?

Treatment of Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease (HFMD) is primarily treated with supportive care measures, as it is typically a self-limiting viral illness that resolves within 7-10 days without specific antiviral therapy. 1, 2

Supportive Care Measures

• Pain and fever management: Use oral analgesics such as acetaminophen or NSAIDs for pain relief and fever reduction 1, 2
• Hydration: Ensure adequate fluid intake, especially important when oral lesions make drinking painful 2
• Oral lesion management:
  • Use mild toothpaste and gentle oral hygiene to manage oral ulcerations 1
  • Consider delaying normal activities until symptoms resolve for severe oral ulcers 1
  • Note: Oral lidocaine is NOT recommended for pain relief 2

Skin Manifestation Management

• Apply moisturizing creams/ointments (such as urea-containing products) to affected areas on hands and feet 1
• Avoid friction and heat exposure to affected areas 1
• Monitor for and treat any secondary bacterial infections that may develop 1

Duration of Treatment

• Most cases resolve spontaneously within 7-10 days 2, 3
• Continue supportive care until symptoms resolve 1

Prevention of Spread

• Hand hygiene is the most important preventive measure, with thorough handwashing with soap and water being more effective than alcohol-based sanitizers 1
• Environmental cleaning, particularly of toys and objects that children may put in their mouths 1
• Children with HFMD should avoid close contact with others until fever resolves and mouth sores heal 1
• Follow standard precautions in healthcare settings 1

Special Considerations

• Atypical presentations: Children with atopic dermatitis may develop "eczema coxsackium," which can resemble herpetic infection 3
• Nail changes: Shedding may occur weeks after the initial infection 3
• Immunocompromised patients: May experience more severe disease and should be monitored closely 1
• Severe cases: In rare instances, particularly with Enterovirus 71 infection, neurologic or cardiopulmonary complications may occur and require more intensive supportive care 2, 4, 5

When to Seek Additional Care

• Persistent high fever beyond 3-4 days 5
• Signs of dehydration (decreased urine output, dry mouth, lethargy) 2
• Neurological symptoms (headache, irritability, altered consciousness) 4, 5
• Respiratory distress or circulatory problems 4, 5

Important Caveats

• No specific antiviral treatment is currently approved for routine use in HFMD 1, 2
• Intravenous immunoglobulin may be considered only for severe/complicated cases 5
• A vaccine against HFMD is not yet widely available 4