Herpetic whitlow is a viral condition where small blisters form on the fingers and the fleshy area around the fingertips. These sores or blisters are often painful and develop after direct contact with a contagious sore.
The herpes simplex virus (HSV) causes this condition. There are two types of HSV.
- Type 1 usually affects the area around the mouth, lips, and face.
- Type 2 usually affects the genitals.
Since the same virus causes herpetic whitlow, cold sores, and genital herpes, it’s extremely contagious. For that reason, it’s important that you recognize symptoms of this condition and take steps to protect yourself.
Herpetic whitlow can develop on any of your fingers. Although the presence of a blister is a common sign of this condition, your fingers may become red or swollen before a blister forms.
Symptoms of herpetic whitlow can appear 1 to 2 weeks after exposure to the virus. You may develop one blister or a cluster of blisters. It can take up to 3 weeks for the blisters to heal.
Eventually, the blister — or group of blisters — ruptures. This forms a shallow ulcer with a crust-like scab.
You may experience a burning or tingling pain that’s worse than what you would expect from the blisters. Herpetic whitlow can also produce a fever and swollen lymph nodes.
It’s possible to get recurrent outbreaks after an initial outbreak, but this is rare.
However, recurrent outbreaks of herpetic whitlow are usually less severe and heal faster because the body has developed antibodies to take measures against the virus.
You can only develop this condition if your finger comes in contact with type 1 or type 2 HSV. Some people who develop herpetic whitlow have a history of cold sores or genital herpes, but this isn’t always the case.
If you’ve contracted HSV, herpetic whitlow may occur as a secondary condition.
This can happen if you have an open cut or sore on a finger that comes in contact with sores or blisters around your face or genital area. The virus can enter your finger through this cut.
If you don’t have a history of HSV, herpetic whitlow may develop if you come in contact with herpes sores or blisters, which can transmit the virus from one person to another.
The appearance of a sore or blister on your finger isn’t usually a cause for concern. Some sores are due to friction, insect bites, or injury, and typically heal on their own.
However, if you develop a painful pocket of pus, called an abscess, on your finger and can’t pinpoint a cause, talk with your doctor.
Doctors can usually identify viral conditions based on the appearance of sores or lesions. If your doctor suspects a virus, a skin swab or blood test can confirm or rule out herpetic whitlow.
Herpetic whitlow doesn’t require treatment.
The condition usually heals within a few weeks without medication, but a prescription antiviral drug can shorten the duration of an outbreak.
Antivirals are only effective when taken within 24 hours of developing symptoms.
Antivirals also help lower the risk of transmitting the virus to other people. If a blister ruptures and an infection develops, your doctor can prescribe an antibiotic.
You can treat herpetic whitlow at home by:
- taking a pain reliever — such as acetaminophen or ibuprofen — to help reduce pain and fever
- applying a cold compress several times a day to help reduce swelling
- cleaning the affected area daily and covering it with gauze
Due to the contagious nature of this condition, you should keep the blistered area covered until it heals. Not covering the area means it could spread to other parts of your body or be transmitted to other people.
Wearing gloves while cleaning an affected area also prevents spreading the condition to other parts of your body.
As a precaution, don’t wear contact lenses if you have herpetic whitlow. If you touch your eye with the finger containing the affected area, the virus could spread to your eye.
Unfortunately, there’s currently no cure for HSV, though researchers are making progress on future treatments.
Once an initial outbreak goes away, the virus may remain dormant in your body for years. So even after herpetic whitlow symptoms disappear, you could experience another outbreak later on, although this is unlikely.
In the event of recurrent outbreaks, your doctor may prescribe antiviral medication to help decrease the frequency of attacks.