Hand, Foot, and Mouth Disease (HFMD) is a common viral infection primarily affecting young children, though older children and adults can also contract it. It is most frequently caused by viruses belonging to the Enterovirus genus, especially Coxsackievirus A16. While the disease is known for its distinctive rash, the lesions are typically characterized by tenderness and pain, particularly those found in the mouth. The skin rash may sometimes cause mild itching (pruritus), but this is generally not the most prominent symptom.
Identifying the Characteristic Rash and Blisters
The skin lesions associated with HFMD begin as small, flat or slightly raised spots. These spots can be pink, red, or darker than the surrounding skin, depending on skin tone. They often progress into small, fluid-filled blisters that are usually non-itchy, appearing mostly on the palms of the hands and the soles of the feet. The rash may also appear on the buttocks, legs, or arms, and the lesions typically have a surrounding area of redness. Discomfort usually stems from the tenderness of the blisters rather than an intense urge to scratch.
A separate, often more painful part of the illness involves sores inside the mouth and throat. These painful lesions start as small red spots and quickly become ulcers, making swallowing and eating challenging. This internal discomfort is frequently the most troublesome symptom, leading to reduced appetite and potential dehydration. While the rash is distinct from highly pruritic conditions like chickenpox, certain viral strains or individual reactions can lead to noticeable, though usually mild, itchiness on the hands and feet.
Managing Discomfort and Itching
Since there is no specific treatment to eliminate the virus, management focuses on relieving symptoms until the illness resolves itself within seven to ten days. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help manage fever and the pain from the mouth and skin lesions. It is important to avoid giving aspirin to children and teenagers, as it is linked to Reye’s syndrome.
To address painful mouth sores, offering cold items like popsicles, ice chips, or cold drinks can provide temporary numbing relief. Patients should consume soft, bland foods and avoid acidic, spicy, or hard items that could irritate the ulcers. If the skin rash causes mild itching, applying topical treatments like calamine lotion or taking a soothing oatmeal bath can help calm the skin. For more pronounced itching, a healthcare provider might recommend an oral antihistamine.
When to Seek Medical Guidance
Although HFMD is typically a mild illness that resolves without intervention, certain symptoms warrant contact with a healthcare provider. Dehydration is a concern, especially if painful mouth sores prevent fluid intake. Signs of dehydration include reduced urination, dry mouth and tongue, or a lack of tears when crying.
A medical professional should be consulted if a fever is high, lasts longer than three days, or if symptoms do not improve after ten days. Look out for rare but serious complications such as signs of neurological involvement. These symptoms can include a severe headache, neck stiffness, confusion, or unusual lethargy. Medical confirmation is also recommended for infants under six months of age or for individuals who have a weakened immune system.