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

Treatment of Hand, Foot, and Mouth Disease (HFMD)

The treatment for Hand, Foot, and Mouth Disease is primarily supportive care, focusing on symptom management, as HFMD is typically a self-limiting viral illness that resolves within 7-10 days without specific antiviral therapy. 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
• Soft, cold foods and beverages can help minimize discomfort from oral lesions 1
• Mild toothpaste and gentle oral hygiene are recommended for managing oral lesions 1

Management of Specific Symptoms

Oral Lesions

• Early intervention is recommended for oral lesions 1
• For severe oral ulcers, normal activities may need to be delayed until symptoms resolve 1
• Topical oral anesthetics may provide temporary relief for painful mouth sores 2

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
• Monitor for and treat any secondary bacterial infections that may develop 1

Severe HFMD Management

• Most cases of HFMD are mild and self-limiting, but severe cases can occur, particularly with Enterovirus 71 infections 3, 2
• Intravenous immunoglobulin should be considered for severe/complicated HFMD cases, as recommended by several guideline committees 2
• Severe cases may require hospitalization and monitoring for neurological complications (encephalitis, meningitis) or cardiopulmonary complications 3, 2
• Mechanical ventilation may be necessary in cases with severe respiratory symptoms such as pulmonary edema 3

Prevention Measures

• Hand hygiene is the most important preventive measure, with thorough handwashing with soap and water being more effective than alcohol-based hand 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
• Standard precautions and good hand hygiene practices should be followed in healthcare settings 1

Special Considerations

• Immunocompromised patients may experience more severe disease and should be monitored closely 1
• HFMD caused by Enterovirus 71 tends to be more severe and has a higher rate of complications than that caused by other viruses such as Coxsackievirus A16 2
• Atypical presentations of HFMD have been reported, particularly with Coxsackievirus A6, which may affect adults and present with more severe symptoms 4
• Nail dystrophies (e.g., Beau's lines or nail shedding) may occur weeks after initial symptom onset 5

Emerging Treatments

• Currently, there are no FDA-approved specific antiviral agents for HFMD 2, 6
• Potential drug candidates under investigation include ribavirin, suramin, mulberroside C, aminothiazole analogs, and sertraline 2
• Research is ongoing for vaccines against HFMD, with monovalent vaccines against EV-A71 currently limited to the Chinese market 6