Treatment for Hand, Foot, and Mouth Disease (HFMD)
There is no specific ointment or topical treatment recommended for Hand, Foot, and Mouth Disease, as HFMD is a self-limited viral illness that requires only supportive care and symptom management. 1, 2, 3
Understanding HFMD
HFMD is a common viral infection in children under 5 years of age, primarily caused by enteroviruses (particularly Coxsackievirus A16 and Enterovirus A71), characterized by painful oral lesions and rashes on the hands and feet. 1, 3, 4
The disease typically resolves spontaneously within 7-10 days without complications or sequelae. 3, 5
Recommended Management Approach
Symptomatic Treatment Only
Treatment is fundamentally palliative, focused on reducing pain and irritation rather than applying specific ointments. 1, 5
- The mainstay of treatment remains supportive care with no approved topical pharmaceutical interventions. 1, 3
- Most mild cases can be managed as outpatients with isolation to prevent cross-infection. 2
Pain Management for Oral Lesions
For painful oral lesions (the most bothersome symptom):
- Topical lidocaine preparations may be applied to affected oral areas not more than 3-4 times daily for temporary relief. 6
- After applying any topical anesthetic, hands should be washed with soap and water. 6
- Avoid use on large areas, cut or irritated skin, or for more than one week without medical consultation. 6
Skin Care for Hand and Foot Lesions
The vesicular rashes on hands and feet typically do not require specific ointment treatment, as they are generally asymptomatic and self-resolving. 3
Critical Monitoring Points
Early recognition of severe cases is paramount, particularly in children under 3 years with EV-A71 infection and disease duration less than 3 days. 2
Warning signs requiring immediate medical attention include:
- Persistent high fever 2
- Neurological involvement 2
- Respiratory distress or abnormal breathing patterns 2
- Circulatory dysfunction 2
Special Considerations
Atypical Presentations
Children with atopic dermatitis may develop "eczema coxsackium," where eczematous skin becomes superinfected with coxsackievirus, potentially mimicking herpetic infection and requiring different diagnostic consideration. 1
What NOT to Use
Do not confuse HFMD with chemotherapy-induced hand-foot syndrome (HFS/HFSR), which requires urea creams and high-potency steroids—these are completely different conditions despite similar anatomical distribution. 7