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Herpetic Whitlow – Symptoms, Causes, Treatment, Contagious, Pictures

Written by Dr.Mary

What exactly is Herpetic Whitlow?

This is an infection also referred to as finger herpes, digital herpes simplex or hand herpes. This is a painful infection in the area of the fingertip that is caused by the herpes virus. In fact, herpetic whitlow is the most common virus infection of the hand. It is often misdiagnosed as felon that is another serious finger infection or as a paronychia which is a nail infection.


Infections to the finger are a very common situation and can range from mild to some cases possibly serious. Other times infections begin small and very easy to treat. But failure to treat these infections can cause complications and herpetic whitlow is one of these complications.

Herpetic Whitlow Symptoms

Symptoms include:

This infection normally starts with swelling and inflammation that is painful on one or even more fingers. The area of the infection turns red and redness is a very common symptom of this virus. There are often lesions over the affected area of the thumb or finger. The entire area is tender to the touch and in many individuals the tenderness is actually very painful. There can be a burning or tingling sensation in some individuals. This pain and swelling in some cases can be accompanied by a high temperature but this is mostly in cases that are rare. In some cases, the patients may also develop inflammation of the lymph nodes located under the arms.

Herpetic Whitlow Causes

This infection is mostly caused by herpes simplex virus or HSV 1 and 2. These are viruses that are mostly located in the genital or oral secretions. Dentists as well as other medical care workers are constantly open to these viruses and often suffer from this infection.

Individuals with immunity that is low are also at risk of this infection. Individuals with HIV have a high risk of infection.

In children, the orofacial region is the primary site of HSV infection. Chewing the fingers or thumbs are ways that this virus is transmitted from the mouth by children. HSV 1 is the main infection in children while HSV 2 is the cause of infections in adolescents as well as adults.

Recurrent HSV infections are fairly common and triggers include:

  • Sun exposure
  • Fever or illness
  • Hormonal changes
  • Trauma
  • Stress
  • Surgery

Herpetic Whitlow Treatment

Self Care Guidelines

Ibuprofen or acetaminophen can help in the reduction of pain as well as the fever caused by this infection. Cool compresses or ice packs can be applied to the area to also help in relieving some of the inflammation, swelling and discomfort.

Since HSV infections are highly contagious, it is vital to observe the following steps in order to prevent transmission of the virus during the infectious stages of herpetic whitlow:

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  • Avoid the sharing of towels and other personal items
  • Cover the infected finger with bandages
  • Wear gloves if you are a medical care provider
  • Do not pop blisters as this can make the problem worse

Regrettably, this virus will still be able to be spread even when there are no active lesions. But it is rare for individuals with herpetic whitlow.

Seeking medical care

A physician should be seen if an individual develops a painful, tender sore on the finger, particularly when it is not going away or seems to be getting worse.

Medical treatment

Most infections are very easy for a primary care physician to diagnose – but occasionally a swab of the infected skin can be sent to the lab for viral cultures. Tests of the blood may be performed as well.

Infections by HSV that are untreated will get better on their own, but drugs from a physician can diminished the symptoms as well as reduce the length of the outbreaks. There is not any cure for the herpetic whitlow infection.

Your physician will often prescribe antiviral medications to help relieve symptoms as well as to prevent the spread of this infection to others. These medications include:

  • Valacyclovir oral
  • Acyclovir oral
  • Famciclovir oral
  • Acyclovir ointment topical

These medications are normally taken for seven to fourteen days. Herpetic whitlow that is more severe can also need oral antibiotic pills if the area is infected also with bacteria.

In rare cases, patients can have recurrent infections of herpetic whitlow that are severe enough or frequent enough to rationalize suppressive treatment where medications are taken every day so as to decrease the severity or rate of recurrence of attacks.

Herpetic Whitlow Contagious

Many wonder if herpetic whitlow is infectious. It is an infectious disease caused by the herpes simplex virus and can be transmitted from one local area to other areas of the body. Spreading between individuals is also possible.

Herpetic Whitlow Pictures

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