Hand, Foot, and Mouth Disease Management

Introduction to HFMD Treatment

The American Academy of Pediatrics and other authoritative sources do not recommend corticosteroid therapy, including dexamethasone, for the treatment of hand, foot, and mouth disease (HFMD), and instead suggest supportive care with oral analgesics, hydration, and symptom management 1

The mainstay of treatment for HFMD remains supportive care, which includes pain and fever control using acetaminophen or NSAIDs for a limited duration to relieve pain and reduce fever 1
Oral lesion management involves applying white soft paraffin ointment to lips every 2 hours, using benzydamine hydrochloride oral rinse or spray every 3 hours, employing gentle oral hygiene with warm saline mouthwashes, and considering chlorhexidine oral rinse twice daily as an antiseptic 1
Skin care for hand and foot lesions includes applying intensive moisturizing with urea-containing creams, avoiding friction and heat exposure to affected areas, and using zinc oxide as a protective barrier for itchy lesions 1

It is essential to distinguish HFMD from conditions where steroids are indicated, such as COVID-19, pemphigus vulgaris, and chemotherapy-induced hand-foot syndrome, as these conditions have different treatment approaches 2, 3, 4, 5, 6
Accurate diagnosis is crucial to differentiate HFMD from herpes simplex virus, which has antiviral treatment options 1

Monitor for signs requiring hospitalization, including neurological complications, respiratory distress, cardiovascular instability, and inability to maintain hydration due to severe oral lesions 1