What is Herpetic Whitlow

Herpetic whitlow is an infection that affects the skin of the fingers or hand. It is caused by herpes simplex virus (HSV). The infection can come back (recur), but the first occurrence is usually the most severe.

HSV commonly affects the mouth and genitals, but it can affect many other parts of the body. Some people who get herpetic whitlow are already infected with HSV. The virus spreads to the fingers or hand after they come in contact with saliva or herpes sores.

What are the causes?

This condition is caused by herpes simplex virus (HSV) type 1 or HSV type 2. You can get herpetic whitlow if your fingers or hand have contact with body fluids that are infected with either of these viruses. Body fluids include:

• Discharge from a herpes sore.
• Saliva.
• Semen.
• Vaginal fluid.
• Vomit.
• Urine.
• Stool (feces).

What increases the risk?

This condition is more likely to develop in:

• People who are already infected with HSV.
• People who work in the health care industry, particularly in dentistry. Health care workers can get herpetic whitlow from touching the mouths of patients who have oral herpes.
• Young children. This is because they often put fingers in their mouths.
• Athletes who participate in contact sports, such as wrestling.

What are the signs or symptoms?

Symptoms of this condition usually develop 2–14 days after exposure to the virus. Symptoms may include:

• Pain, burning, or tingling in the affected area.
• Fever.
• Redness and swelling in the affected area.
• Small fluid-filled bumps around the infected area. These bumps will develop into sores or they may break open.
• Swollen lymph nodes.

Symptoms usually improve 7–10 days after they appear and can clear up within 3–4 weeks.

How is this diagnosed?

This condition may be diagnosed based on:

• A physical exam.
• Your medical history.
• Tests that examine a sample of fluid from the infected area. These tests check the fluid for signs of HSV.
• Blood tests.

How is this treated?

Treatment is not needed for this condition because symptoms usually get better on their own. However, your health care provider may recommend taking antiviral medicines to relieve symptoms and prevent the disease from spreading. Antiviral medicines can be taken through an IV, by mouth (orally), or through a skin (topical) ointment.

It is important to remember that the herpes virus cannot be completely eliminated from your system, but treatment can help to prevent future outbreaks.

Follow these instructions at home:

Prevent the spread of infection

The infection can spread to other people. It can also spread to other areas of your body, especially to your mouth and your genital area. To keep it from spreading:

• Cover the affected area with a bandage (dressing). Keep the dressing dry.
• If you work in the health care or dental industry, wear gloves.
• Avoid close contact with other people until your sores heal and your symptoms are gone.
• Do not share towels and washcloths.
• Do not touch the bumps with your other hand or pick at your scabs.
• Wash your hands often using soap and water. If soap and water are not available, use hand sanitizer.
• Do not touch your eyes, mouth, or genital area unless you wash your hands first.

General instructions

• Put ice on the affected area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times per day.
• Take or apply over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

To prevent this condition:

• If you work in the health care or dentistry field, wear gloves when working with patients.
• Wash your hands often with soap and warm water. If soap and water are not available, use hand sanitizer.
• Use latex condoms every time you have sex.
• Avoid putting fingers in your mouth unless you have cleaned them with soap and warm water.

Contact a health care provider if:

• The infection spreads to another area of your body.
• Your symptoms get worse.
• The infection returns.

Summary

• Herpetic whitlow is an infection that affects the skin of the fingers or hand.
• This condition is caused by herpes simplex virus (HSV) type 1 or HSV type 2. You can get herpetic whitlow if your fingers come in contact with body fluids that are infected with either of these viruses.
• Treatment is not needed for this condition because symptoms usually resolve on their own. However, your health care provider may recommend taking antiviral medicines.
• The infection can spread to other people. It can also spread to other areas of your body, especially to your mouth and your genital area.
• The herpes virus cannot be completely eliminated from your system, but treatment can help to prevent future outbreaks.