What is the treatment for hand, foot, and mouth disease?

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.

Supportive Care Measures

• Pain and Fever Management

  • Oral analgesics such as acetaminophen or NSAIDs are recommended for a limited duration to relieve pain and reduce fever 1, 2
  • These medications should be dosed appropriately based on the patient's age and weight 2

• Hydration

  • Maintaining adequate hydration is crucial, especially when oral ulcers make drinking painful 2
  • Cold liquids, popsicles, or ice chips may help soothe oral discomfort and maintain hydration 1

Management of Specific Symptoms

Oral Lesions

• Mild toothpaste and gentle oral hygiene are recommended for managing oral lesions 1
• Avoid spicy, acidic, or hot foods that may irritate oral ulcers 1
• Oral lidocaine is not recommended for pain relief 2

Skin Manifestations

• Intensive skin care of hands and feet with moisturizing creams, particularly urea-containing products 1
• Zinc oxide can be applied to affected skin areas to reduce itchiness and provide a protective barrier 1
• Apply zinc oxide in a thin layer after gentle cleansing of affected areas 1
• For nighttime relief, consider applying zinc oxide followed by loose cotton gloves 1

Prevention of Transmission

• Handwashing with soap and water is the most important preventive measure (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
• Avoid sharing utensils, cups, or food to prevent spread 1

Return to Daycare Guidelines

• Children can return to daycare once fever has resolved and mouth sores have healed, even if skin rash is still present 1
• Exclusion based solely on healing skin lesions is not necessary 1

Special Considerations

• Immunocompromised patients may experience more severe disease and should be monitored closely 1
• Monitor for rare neurological or cardiopulmonary complications, which can occur particularly with EV-71 infections 3, 4
• Secondary bacterial infections may develop and require appropriate antibiotic treatment 1

Important Caveats

• No specific antiviral treatment is currently approved for HFMD 3, 5
• Intravenous immunoglobulin should be considered only for severe/complicated cases of HFMD 3
• The disease is typically self-limiting in immunocompetent individuals and resolves within 7-10 days 2, 3
• Hand-foot-and-mouth disease can occasionally affect adults, particularly those in close contact with infected children 6