Treatment of Hand, Foot, and Mouth Disease
The treatment of hand, foot, and mouth disease (HFMD) is primarily supportive care, focusing on symptom management as the condition is typically self-limiting and resolves within 7-10 days without specific antiviral therapy. 1, 2
Supportive Care Measures
- Oral analgesics such as acetaminophen or NSAIDs should be used for pain relief and fever reduction 1
- Adequate hydration should be maintained, especially when oral lesions make drinking painful 1, 2
- For oral lesions, mild toothpaste and gentle oral hygiene are recommended to manage discomfort 1
- Children with severe oral ulcers may need to delay normal activities until symptoms improve 1
Management of Specific Symptoms
Oral Lesions
- Cold liquids, ice chips, or popsicles can help soothe oral pain 1
- Avoid spicy, salty, acidic foods and beverages that may irritate mouth sores 1
- Oral rinses with warm salt water may provide relief for older children and adults 2
Skin Manifestations
- Apply moisturizing creams such as urea cream/ointment to affected hands and feet 1
- Avoid friction and heat exposure to affected areas to prevent worsening of symptoms 1
- Monitor for secondary bacterial infections which may require antibiotic treatment 1
Special Considerations
- Immunocompromised patients require closer monitoring due to risk of more severe disease 1
- For severe cases, particularly those caused by Enterovirus A71, intravenous immunoglobulin should be considered 2
- Nail changes such as shedding may occur weeks after initial infection and typically resolve without specific treatment 3, 4
Prevention Measures
- Hand hygiene with soap and water is the most important preventive measure 1
- Environmental cleaning 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
- In healthcare settings, standard precautions and good hand hygiene practices should be followed 1
When to Seek Medical Attention
- Persistent high fever beyond 3 days 2
- Signs of dehydration (dry mouth, decreased urination, lethargy) 2
- Development of neurological symptoms such as persistent headache, neck stiffness, or altered mental status 2, 5
- Respiratory distress or rapid breathing 5