Herpetic Whitlow (Finger Whitlow)

What Is Whitlow?

Whitlow is a self-limited disease, which means it can resolve on its own. It is also known as herpetic whitlow, finger whitlow or digital herpes simplex. A whitlow appears as an abscess in the soft tissue near a fingernail or toenail. A herpetic whitlow or whitlow finger usually affects the fleshy area of the fingertip. It can be very painful and highly contagious.

A whitlow can occur when broken skin on your finger comes in direct contact with body fluids infected with the herpes simplex virus (HSV). These body fluids may come from you or someone else. HSV infection usually appears as small blisters or sores around the mouth, nose, genitals, and buttocks.

There are 2 types of HSV: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Both of them can cause a whitlow.

Causes and Risk Factors of Finger Whitlow

Anybody, whatever the age, gender or race, can be at risk of developing a herpetic whitlow. However, children and health workers, especially dental health workers, are more at risk for developing a whitlow.

Children are more exposed to HSV through thumb sucking and nail biting when they have herpes infection of the mouth or lips. Dental and medical workers are more exposed to contact with infected body fluids from patients.

A number of factors increase the risk of developing whitlow. These include:

Symptoms of Whitlow

There are both local and general symptoms that may accompany a herpetic whitlow.

A whitlow usually causes local symptoms on your fingers including:

  • Burning feeling.
  • Development of small bumps or blisters.
  • Itchy feeling.
  • Redness, warmth or swelling.
  • Tingling or other unusual sensations in the hands.

However, general symptoms of whitlow may include:

  • Blisters or sores at other sites on the body.
  • Enlarged lymph nodes in arms (near the elbow or underarm).
  • Fever.
  • Red streaks on the arms (lymphangitis).

These symptoms usually disappear as the condition resolves. But when there is confusion or loss of consciousness for even a brief moment, it indicates that the condition has become very serious. This would require urgent medical attention.

How It Is Diagnosed

Your doctor will ask you a couple of questions when taking your health history. The main focus of the history is to identify the possible source of the infection. Information about exposure to infected individuals or body fluids will be elicited by your physician. The doctor has ascertain if this is the primary infection or a recurrence.

During the physical examination, the physician will examine the affected fingers to identify the symptoms that are present. However, the physician may request other laboratory tests to confirm the diagnosis.

The presence of HSV may be confirmed by performing either through a viral culture, fluorescent antibody testing, serum antibody titers or DNA hybridization. It is ideal that the specimen for testing should be obtained from newly developed lesions in order to maximize the sensitivity of the diagnostic test.

Treatment of Finger Whitlow

As earlier stated, herpetic whitlow is self-limiting and will resolve on its own without medications. You can use pain medications such as acetaminophen or ibuprofen to relieve the pain and swelling. A cool compress with ice packs may also help with the swelling and discomfort.

In the situation where the whitlow does not resolve on its own but getting worse, you should seek for medical attention. If your symptoms are very severe, you should also pay your doctor a visit. Your doctor may prescribe antiviral medications for you to help resolve your symptoms.

How To Prevent Whitlow

There are things you can do to prevent developing a whitlow finger. Here are a few prevention tips to consider:

  1. To avoid spreading, cover the infected blisters with dry plaster.
  2. Avoid popping the blisters.
  3. Beauty therapists should avoid treating individuals with herpes infection.
  4. Take what will boost your Immune system to fight against herpetic whitlow or whitlow finger.
  5. Hand gloves can be used for preventing herpetic whitlow or whitlow finger while doing regular daily activities.
  6. Personal towels along with hygienic items should not be shared with anyone that has whitlow
  7. Stay away from infected people and from virus contact. In condition of infection
  8. Use of ibuprofen as well as acetaminophen is preferred. These painkillers give quick relief from fever or soreness.
  9. To deal with the condition of swelling or discomfort
  10. To restrict further spread of herpetic whitlow or whitlow finger
  11. Doctors and nurses who treat HIV patients should wear rubber gloves.


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