What is herpetic whitlow?

Herpetic whitlow is a viral infection 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 an infected sore.

The herpes simplex virus (HSV) causes this infection. There are two types of HSV. Type 1 usually affects the area around the mouth, lips, and face, whereas type 2 usually affects the genitals.

Since herpetic whitlow is caused by the same virus responsible for cold sores and genital herpes, it is extremely contagious. For that reason, it’s important that you recognize symptoms of this condition and take steps to protect yourself.

Pictures of herpetic whitlow

What are the symptoms of herpetic whitlow?

Herpetic whitlow can develop on any of your fingers. Although the presence of a blister is a common sign of this infection, your fingers may become red or swollen before a blister forms.

Symptoms of herpetic whitlow can appear one to two weeks after exposure to the virus. You may develop one blister or a cluster of blisters. It can take up to three weeks for the blisters to heal.

Eventually, the blister ruptures on its own and a scab forms. Herpetic whitlow can also produce a fever and swollen lymph nodes.

It’s possible to get recurrent infections after an initial infection, but this is rare. However, recurrent infections of herpetic whitlow are usually less severe and heal faster because the body has developed antibodies to fight the virus.

What causes herpetic whitlow?

You can only develop this condition if your finger comes in contact with type 1 or type 2 HSV. Some people who get herpetic whitlow have a history of cold sores or genital herpes, but this isn’t always the case.

If you’ve been diagnosed with HSV, herpetic whitlow may occur as a secondary infection. 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 on an infected person.

How does a doctor diagnose herpetic whitlow?

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, see your doctor.

Doctors can usually identify viral infections 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.

How is herpetic whitlow treated?

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 infection. Antivirals are only effective when taken within 24 hours of developing symptoms.

Antivirals also lower the risk of spreading the infection to other people. If a blister ruptures and becomes infected with bacteria, your doctor can prescribe an antibiotic.

You can treat herpetic whitlow at home by:

  • taking a pain reliever — such as acetaminophen or ibuprofen — to reduce pain and fever
  • applying a cold compress several times a day to reduce swelling
  • cleaning the infected area daily and covering it with gauze

Complications of herpetic whitlow

Due to the contagious nature of this infection, you should keep the blistered area covered until it heals. If you don’t, the infection could spread to other parts of your body or infect other people. Wearing gloves while cleaning an infected area also prevents spreading the infection 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 an infected finger, the virus could spread to your eye.

What is the outlook for herpetic whitlow?

Unfortunately, there’s no treatment available to cure the herpes simplex virus. Once an initial infection 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 a recurrent infection, your doctor may prescribe antiviral medication to decrease the frequency of attacks.