What is the treatment for hand foot mouth disease rash?

Treatment of Hand-Foot-Mouth Disease Rash

Hand-foot-mouth disease (HFMD) requires only supportive care focused on hydration and pain relief, as there is no specific antiviral treatment available and the rash typically resolves spontaneously within 7-10 days. 1

Primary Treatment Approach

Symptomatic management is the cornerstone of HFMD treatment:

• Pain control with acetaminophen or ibuprofen as needed for oral ulcerations and discomfort 1
• Maintain adequate hydration, particularly important given painful oral lesions that may limit oral intake 1
• Avoid oral lidocaine - this is specifically not recommended for HFMD 1

Skin Care for the Rash

While the evidence base focuses on chemotherapy-induced hand-foot syndromes rather than viral HFMD, general principles of gentle skin care apply:

• Avoid mechanical irritation to affected hands and feet - no prolonged walking, tight footwear, or heavy carrying without cushioned protection 2
• Avoid chemical irritants including harsh soaps, solvents, and disinfectants on affected areas 2
• Gentle moisturization may provide comfort, though this is not specifically studied for viral HFMD 3

Expected Clinical Course

• Lesions resolve in 7-10 days without intervention in typical cases 1
• Late complications can occur: Onychomadesis (nail shedding) may develop 3-8 weeks after initial infection as a postinfectious sequela 4, 5
• Atypical presentations may occur in children with atopic dermatitis, manifesting as "eczema coxsackium" which can mimic herpetic superinfection 5

Prevention of Transmission

Rigorous hygiene measures are essential to prevent spread:

• Handwashing is the most effective preventive measure 1
• Disinfect potentially contaminated surfaces and fomites 1
• Transmission occurs via fecal-oral, oral-oral, and respiratory droplet routes 1

Red Flags Requiring Escalation

While rare, watch for signs of serious complications:

• Neurological symptoms (altered mental status, seizures, weakness) 6
• Cardiopulmonary complications (respiratory distress, tachycardia) 6
• These severe manifestations are more commonly associated with Enterovirus 71 strains 5, 6

What NOT to Do

• Do not use antiviral medications - none are available or indicated for HFMD 1
• Do not apply oral lidocaine - specifically contraindicated 1
• Do not confuse with chemotherapy-induced hand-foot syndrome - these are entirely different entities requiring different management 7