Patient education: Herpetic whitlow (The Basics)

What is herpetic whitlow? — 

This is an infection that affects the skin of the finger. It causes painful blisters.

Herpetic whitlow is caused by a virus called "herpes simplex virus," or "HSV." There are 2 types of this virus: HSV-1 and HSV-2. They can also cause cold sores and genital herpes.

The virus can get into a person's body if they have a cut or break in the skin on their finger. For example, this often happens in children who have the infection in their mouth and then suck their thumb.

Once a person has the HSV virus in their body, it stays there for life. Sometimes, this never causes hand symptoms again. Other times, herpetic whitlow can come back.

What are the symptoms of herpetic whitlow? — 

The main symptom is 1 or more blisters on the skin on the finger. The blisters can form a cluster. They are clear at first, then turn yellow. The skin around the blisters often looks red and swollen. The blisters can cause pain or a burning or tingling feeling in the area. Over a few weeks, the blisters break open, form crusts, and then heal.

Some people also have flu-like symptoms, like fever or swollen lymph nodes.

A person who had herpetic whitlow can sometimes get it again. That's because the virus stays in the body, even after the first infection has gone away. Repeat infections are sometimes "triggered" by things like illness, fever, or sun exposure. When herpetic whitlow comes back, it tends to be milder and lasts for a shorter time.

Is there a test for herpetic whitlow? — 

Yes. Your doctor or nurse can take some fluid from a blister and test it for the HSV virus. But this is not always needed. In some cases, doctors can diagnose herpetic whitlow just by looking at the skin.

How is herpetic whitlow treated? — 

Most of the time, herpetic whitlow goes away on its own within a few weeks. Sometimes, doctors prescribe an "antiviral" medicine to help it heal more quickly. This can come as pills or as a cream that you put on the skin.

What can I do on my own to feel better? — 

You can:

●Try not to use your finger too much.

●Raise your hand above the level of your heart, when possible. This helps with swelling.

●Put a cool compress on your finger to relieve pain.

●Take an over-the-counter medicine to help with pain and swelling. Examples include ibuprofen (sample brand names: Advil, Motrin), naproxen (sample brand name: Aleve), or acetaminophen (sample brand name: Tylenol).

How can I prevent herpetic whitlow? — 

You can lower the risk of getting or spreading the infection if you:

●Keep the blisters covered with gauze or a bandage. This lowers the risk of spreading the infection to other people.

●Wash your hands often with soap and water.

●Try to keep children from sucking their thumb or fingers, especially if they have a mouth infection.

●Wear gloves if you need to touch the inside of other people's mouths, for example, if you work in a dental or medical office.

When should I call the doctor? — 

Call your doctor or nurse for advice if you have:

●A fever of 100.4°F (38°C) or higher, or chills

●Worse swelling, redness, or warmth

●Pus, or a bad smell around the blisters

●Severe pain

More on this topic

Patient education: Cold sores (oral herpes) (The Basics)
Patient education: Viral culture (The Basics)