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Herpetic Whitlow – Treatment, Symptoms, Causes, Pictures

Updated on February 11, 2014

Herpetic whitlow is a skin infection of the hand caused by the herpes simplex virus. This condition typically appears at the end of the fingers or thumb. It is generally a secondary infection that results when the finger has a cut or an open wound and comes in contact with a cold sore. This is common especially in children who like to thumb suck or put their fingers in their mouths. If a child has a cold sore and he or she puts a finger with broken skin in his/her mouth, the virus from the cold sore can transfer to the open wound, and hence, cause infection.

Occurrence of Herpetic Whitlow

Herpetic whitlow is a skin lesion that develops typically on the thumb or index finger as a result of an infection of the Herpes simplex virus. It is spread through direct contact with an infected skin. This condition is most common in children. However, it also affects adults especially those who work in close proximity with individuals who may be infected with the virus and have the lesions and sores. These include health care workers and dental personnel who may have direct skin to skin contact with the cold sores or oral secretions of their patients.

Causes of Herpetic Whitlow

Two types of the herpes simplex virus can cause herpetic whitlow. The HSV-1 is the most common cause of this condition, accounting for six out of ten cases. HSV-1 herpetic whitlow cases are generally those that involve children and medical and dental health staff. Although adults between 20 and 30 years old can also develop the disease after coming in contact with genital herpes. In this case, HSV-2 is the culprit for the condition.

Symptoms of Herpetic Whitlow

The virus enters the body through a break in the skin of the finger, such as a small cut, a torn cuticle and others of the sort. The signs and symptoms of herpetic whitlow will become obvious about two to twenty days after getting infected. A tingling sensation or burning and painful feeling will be felt on the affected area. Inflammation, tenderness and redness will eventually develop on the affected finger. Blisters filled with fluid will then form. These will continue to get bigger until they fuse to form bullae. These fluid-filled vesicles will ultimately rupture resulting in lesions which will form scabs. This condition can be quite painful. Furthermore, fever, inflammation of the lymph nodes specifically those in the armpits, as well as body malaise may be experienced even before the signs on the finger become noticeable. The symptoms may continue on for 10 to 14 days, while the lesions will crust over and improve in two to three weeks.

Diagnosis and Treatment of Herpetic Whitlow

Diagnosis of the condition involves a physical examination of the infected site as well as assessment of the symptoms being experienced. The doctor may also inquire about any other similar looking blisters on other parts of the body, like the mouth, fingers or genitals.

Herpetic whitlow being viral in origin is self-limiting and will clear up even without treatment between 21 to 28 days. Treatment is usually to address the symptoms and help alleviate the distress suffered by the patient. Prescription drugs may also be given to prevent its reappearance. Antiviral drugs and OTC pain relievers are commonly prescribed.

Herpetic whitlow can be a recurring condition. But generally, the first bout of infection is the worst, with the signs and symptoms being really severe. The symptoms during succeeding episodes may not be as intense or as long.

Prevention of Herpetic Whitlow

HSV is transmitted through direct contact. So to prevent getting infected, it is important not to be in skin-to-skin contact with individuals affected with herpes simplex infections, such as genital herpes and cold sores. If it is really necessary for you to be exposed to people who may have these infections, it is important to wear gloves and wash your hands properly especially after being exposed. For young kids who still have the habit of putting their fingers in their mouths, remind them not to do this especially if they have mouth sores. Frequent hand washing also goes a long way.

If, on the other hand, you have already been infected with the disease, prevent the spread of the infection to other parts of your body or to other people. Cover the infected site so you and others cannot touch it; do not share linens or towels with others; and wash your hands frequently.


If herpetic whitlow infection frequently recurs, the fingers or thumb may experience scarring as well as numbness. The symptoms could also be significantly worse for people who have compromised immune systems or are under medications that repress the immune system. It is very crucial to see a doctor if you have a weak immune system and are showing signs of herpetic whitlow infection as this could lead to grave complications.


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