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

Treatment of Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease (HFMD) treatment is primarily supportive care focused on symptom management, as the condition is typically self-limiting and resolves within 7-10 days without specific antiviral therapy.

Supportive Care Measures

• Pain and fever management: Use oral analgesics such as acetaminophen or NSAIDs for a limited duration to relieve pain and reduce fever 1, 2
• Hydration: Ensure adequate fluid intake, especially important when oral ulcers make drinking painful 2
• Oral lesion management:
  • Use mild toothpaste and gentle oral hygiene for oral lesions 1
  • Cold foods, ice chips, or popsicles may help numb pain and maintain hydration 1
  • Avoid spicy, salty, acidic foods and beverages that may irritate mouth sores 1

Skin Manifestation Management

• Moisturizing care: Apply intensive skin care with moisturizing creams, particularly urea-containing products, to affected hands and feet 1
• Zinc oxide application: Can be used as a protective barrier on skin lesions to reduce itchiness and inflammation 1
• Avoidance measures: Prevent friction and heat exposure to affected areas to minimize discomfort 1

Complications Management

• Secondary infections: Treat any secondary bacterial infections that may develop on skin lesions 1
• Severe cases: For rare severe cases with neurological complications (particularly with EV-71 infections), intravenous immunoglobulin should be considered 3

Prevention of Transmission

• Hand hygiene: Thorough handwashing with soap and water is the most important preventive measure 1
• Environmental cleaning: Disinfect toys and objects that may be placed in children's mouths 1, 2
• Isolation guidelines: Children should avoid close contact with others until fever resolves and mouth sores heal 1

Return to Daycare/School Guidelines

• Children can return to daycare once fever has resolved and mouth sores have healed, even if skin rash is still present 1
• Avoid sharing utensils, cups, or food to prevent spread 1

Special Considerations

• Immunocompromised patients: May experience more severe disease and should be monitored closely 1
• Neurological monitoring: Watch for signs of rare complications such as encephalitis, meningitis, or acute flaccid paralysis, especially in infections caused by EV-A71 4, 5

Important Caveats

• Oral lidocaine is not recommended for pain management due to risk of numbing the gag reflex 2
• Currently, there are no approved specific antiviral agents for HFMD treatment 3, 5
• The EV-A71 vaccine is available in China but not globally, and only protects against one causative agent 5
• HFMD can affect adults, though it's less common, and intra-familial transmission from children to adults can occur 6