First-Line Treatment for Hand, Foot, and Mouth Disease with Open Sores on Feet
For open sores on the feet from hand, foot, and mouth disease, apply intensive moisturizing care with urea-containing creams (10% urea cream three times daily), use oral analgesics like acetaminophen or NSAIDs for pain relief, and avoid friction or chemical irritants to the affected areas. 1
Skin Care for Foot Lesions
The cornerstone of managing open sores on the feet involves:
- Apply urea 10% cream three times daily to maintain skin hydration and promote healing 1
- Use moisturizing creams intensively on hands and feet, particularly urea-containing products 1
- Avoid friction and heat exposure to affected areas to prevent worsening of lesions 1
- Do not use chemical agents or plasters to remove corns or calluses, as these can worsen open sores 1
Pain Management
For symptomatic relief of painful foot lesions:
- Use oral analgesics such as acetaminophen or NSAIDs for a limited duration to relieve pain and reduce fever 1
- These medications address both the discomfort from foot sores and any associated fever 1
Wound Protection and Hygiene
To prevent secondary complications:
- Wash feet daily with careful drying, particularly between the toes 2
- Treat any secondary bacterial infections that may develop in open sores 1
- Avoid walking barefoot and wear appropriate cushioned footwear to protect open lesions 2
- Do not soak feet in footbaths, as this induces skin maceration and can worsen open sores 2
Topical Barrier Protection
For additional symptom relief:
- Consider zinc oxide application to soothe inflamed areas and reduce itchiness, applying after gentle cleansing 1
- Apply zinc oxide in a thin layer to intact skin around lesions, but avoid open or weeping wounds 1
- For nighttime relief, apply zinc oxide followed by loose cotton socks to enhance effectiveness 1
Monitoring and Follow-Up
- Monitor for signs of secondary infection including increased redness, warmth, purulent drainage, or worsening pain 2
- Reassess after 2 weeks if lesions are not improving with standard care 2
- Most HFMD lesions resolve spontaneously within 2-3 weeks without complications 3
Common Pitfalls to Avoid
- Do not use topical antiseptic or antimicrobial dressings routinely for HFMD foot lesions, as these are not recommended for wound healing 2
- Avoid excessive debridement of foot lesions, as HFMD sores are viral and self-limiting 4, 5
- Do not restrict activity based solely on healing skin lesions once fever resolves and oral sores heal 1
Special Considerations
The American Academy of Pediatrics emphasizes that hand hygiene is the most important preventive measure, with thorough handwashing being more effective than alcohol-based sanitizers 1. Children can return to normal activities once fever resolves and mouth sores heal, even if foot lesions are still present 1.