Herpetic Whitlow

What is herpetic whitlow?

Herpetic whitlow is an infection of the skin around your fingernail. The herpes simplex virus causes the condition when the virus penetrates your skin through a break in your skin near your nail. Herpetic whitlow causes painful blisters on your fingers.

Who does herpetic whitlow affect?

Herpetic whitlow can affect anyone at any age, but the condition is most common in:

• Children who suck their thumbs.
• Healthcare workers, like dental hygienists and respiratory therapists with exposure to peoples’ mouths (oral mucosa).
• People exposed to genital herpes.
• Athletes, like wrestlers, who have close contact with others.
• People with a weakened immune system.

How common is herpetic whitlow?

Infection is uncommon. An estimated 2 people per 100,000 receive a herpetic whitlow diagnosis in the United States.

What are the stages of herpetic whitlow?

Herpetic whitlow causes painful blisters on your fingers around your nails. The early stages of the condition include pain and a tingling sensation on your finger. Then, blisters form near your fingernail, which causes your skin to be tender and sensitive. Within a few days, a crust will form, along with drying and healing. Most cases of herpetic whitlow affect one finger, but it can spread to other fingers, too.

What are the signs and symptoms of herpetic whitlow?

Signs and symptoms of herpetic whitlow include:

• Blisters or fluid-filled bumps on the skin near your fingernail.
• Color changes to the skin around your nail, usually darker than your normal skin tone, or red to purple.
• Swollen finger.

What causes herpetic whitlow?

The herpes simplex virus (type 1 or type 2) causes herpetic whitlow. You usually acquire it from contact with another person who has the virus, especially after contact with a cold sore or “fever” blister. The virus usually penetrates your skin if you have a cut.

Is herpetic whitlow contagious?

Yes, herpetic whitlow is contagious. The condition can spread from person to person through physical contact. The condition is most contagious when you have blisters on your skin. When blisters begin to crust, the virus is no longer contagious.

How is herpetic whitlow diagnosed?

Your provider will diagnose herpetic whitlow based on the appearance of the signs and symptoms localized on your finger. The condition has a unique look on your skin. To confirm the diagnosis, your provider will provide a PCR test or a culture test.

How is herpetic whitlow treated?

Treatment for herpetic whitlow focuses on the infection. It could include compresses two to three times per day, coupled with an oral or topical antiviral medication (acyclovir). An over-the-counter pain reliever (analgesic) treats pain.

How long does herpetic whitlow last?

Herpetic whitlow typically lasts about two weeks, sometimes longer if left untreated.

How do I manage herpetic whitlow?

Herpetic whitlow deserves good wound care. Use compresses and protection with bandages to prevent secondary infection. Covering your blisters also prevents the spread of the virus to others.

How can I prevent herpetic whitlow?

Prevention may be difficult, but the following measures can help:

• Frequent hand washing with soap and water.
• Wearing gloves in a healthcare setting, especially with close contact with people’s mouths.
• Stopping your child from sucking their fingers, especially their thumb.

What can I expect if I have herpetic whitlow?

Herpetic whitlow is a temporary, painful condition that typically resolves in two to three weeks. Antiviral treatment may be necessary to help the condition go away faster.

The first episode is typically the most severe. Herpetic whitlow may recur, especially with finger cuts, but recurrent episodes are usually less symptomatic.

Occasionally, scars may develop if an infection is persistent or extensive.

Is there a cure for herpetic whitlow?

There isn’t a cure for herpetic whitlow. Treatment simply helps relieve signs and symptoms and makes them go away faster.

When should I see my healthcare provider?

If your situation suggests a herpetic whitlow diagnosis, a healthcare provider will complete an evaluation. After your evaluation, your provider will offer treatment, like a prescription to help the condition resolve.

What questions should I ask my doctor?

• How do I prevent the spread of herpetic whitlow?
• What can I do to relieve symptoms of pain?
• How do I prevent the condition from returning?

What other conditions may resemble herpetic whitlow?

Herpetic whitlow may resemble the following conditions:

• Paronychia: Inflammation or swelling of your fingers and toes in the folds of your nail. A polymicrobial infection causes the condition.
• Dyshidrotic eczema: Noninfectious dermatitis with small, itchy, uncomfortable blisters on your palms, the sides of your fingers and the soles of your feet.
• Felon finger: An infection of your finger, accompanied by pain and swelling.

Can herpetic whitlow occur on my toes?

Yes, herpetic whitlow can occur on your toes, though it’s infrequent.

Is herpetic whitlow an STD?

Herpetic whitlow isn’t a sexually transmitted infection (STI or STD). Herpes simplex, the virus that causes the herpetic whitlow, can cause genital herpes (HSV-2), which is a sexually transmitted infection.

A note from Cleveland Clinic

Herpetic whitlow is a temporary, painful skin condition. A prompt medical evaluation will help confirm your diagnosis and establish treatment to offset signs and symptoms. Managing and preventing the infection is critical. The condition usually resolves within two to three weeks.