What is the treatment for Hand, Foot, and Mouth Disease (HFMD)?

Treatment of Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease (HFMD) is primarily managed with supportive care measures, as the condition is typically self-limiting and resolves within 7-10 days without specific antiviral treatment.1, 2

Supportive Care Measures

• Oral analgesics such as acetaminophen or NSAIDs are recommended for pain relief and fever reduction 1
• Adequate hydration should be maintained, especially when oral lesions make drinking painful 1, 2
• Mild toothpaste and gentle oral hygiene are recommended to manage oral lesions 1

Management of Specific Symptoms

Oral Lesions

• Early intervention for oral lesions is recommended 1
• For severe oral ulcers, consider:
  • Cold liquids, ice chips, or popsicles to soothe pain 1, 3
  • Avoiding spicy, salty, or acidic foods that may irritate mouth sores 1
  • Delaying normal activities until symptoms resolve for severe cases 1

Skin Manifestations (Hand and Foot Lesions)

• Intensive skin care with moisturizing creams, such as urea cream/ointment 1
• Avoid friction and heat exposure to affected areas 1
• Treat any secondary bacterial infections that may develop 1

Special Considerations

Severe Cases

• Intravenous immunoglobulin should be considered for severe or complicated HFMD cases 2, 4
• Glucocorticoid therapy may be beneficial in severe cases with neurological complications 4
• Close monitoring is essential for:
  • Immunocompromised patients who may experience more severe disease 1
  • Children with signs of neurological involvement (myoclonic jerks, seizures, headache) 4
  • Patients with atypical presentations, especially those with atopic dermatitis who may develop "eczema coxsackium" 5

Prevention Measures

• Hand hygiene is the most important preventive measure 1
  • Thorough handwashing with soap and water is more effective than alcohol-based hand sanitizers 1
• Environmental cleaning, particularly of toys and objects that may be placed in children's mouths 1
• Children with HFMD should avoid close contact with others until fever resolves and mouth sores heal 1, 3

Follow-up Considerations

• Nail changes such as shedding or Beau's lines may occur weeks after initial symptom onset 6, 5
• Monitor for rare but serious neurological complications, particularly with Enterovirus A71 infections 3, 4

Common Pitfalls to Avoid

• Failing to recognize atypical manifestations, especially in children with atopic dermatitis where HFMD may mimic herpetic superinfection 5
• Overlooking potential neurological complications, particularly in epidemic settings 3, 4
• Underestimating the importance of preventive measures in controlling outbreaks 1, 2