Whitlow, usually referred to as herpetic whitlow, is a painful and highly contagious infection on the fingers or toes caused by the herpes simplex virus (the "cold sore virus") - HSV, a virus that affects about 90% of people worldwide. There are two types of herpes simplex virus - type 1 and type 2 - and both can cause herpetic whitlow.
Whitlow is an abscess that usually affects the fleshy area of the index fingertip, tip of the thumb or on the toes. It is easily treated but can come back. The infection may appear in adults or children.
Whitlow can occur when broken skin on your finger comes in direct contact with body fluids infected with the herpes simplex virus. These body fluids may come from you or someone else. You're more likely to get herpetic whitlow if you've had genital herpes.
The term whitlow is sometimes misapplied to paronychia, which is an infection of the tissue at the side or base of the nail.
Symptoms of Whitlow
Some of the signs you will notice include:
A painful swell below the finger nails
A painful couple of blisters that are filled with fluid
A redness around the finger
Burning sensation on fingers
Swollen and extremely painful
Tingling or other unusual sensations in the hands
Symptoms of whitlow primarily affect the fingers or toes, but other general body symptoms such as:
blisters or sores at other sites on the body,
enlarged lymph nodes in arms (near the elbow or underarm),
red streaks on the arms (lymphangitis),
may indicate a severe infection. Rarely, whitlow may lead to a serious infection that should be immediately evaluated in an emergency setting.
How to Diagnose Whitlow
The appearance of a sore or blister on your finger isn’t usually a cause for concern. Some sores are due to friction, insect bites, or injury, and typically heal on their own. However, if you develop a painful pocket of pus, called an abscess, on your finger and can’t pinpoint a cause, see your doctor.
Doctors can usually identify viral infections based on the appearance of sores or lesions. If your doctor suspects a virus, a skin swab or blood test can confirm or rule out herpetic whitlow.
How is Whitlow Treated?
Whitlow often resolves without treatment in two to three weeks. However, your health care provider may prescribe medications to reduce symptoms such as pain or itching. If you experience frequent or severe cases of whitlow, your heath care provider may prescribe antiviral medications to prevent or limit the severity of future infections and sometimes use antibiotic medication only in cases complicated by bacterial super-infection.
Antiviral medications are only effective when taken within 24 hours of developing symptoms. Antiviral medications also lower the risk of spreading the infection to other people.
Whitlow is rarely associated with a serious medical condition. However, seek immediate medical care if your whitlow, or that of someone you are with, is associated with a high fever (higher than 101 degrees Fahrenheit), confusion, or loss of consciousness for even a brief moment.
Seek prompt medical care if your whitlow is persistent, recurrent, or causes you concern.
Care for People with Herpetic Whitlow
People can support the recovery of herpetic whitlow in the home through a few different methods:
Avoid popping the blisters
Take what will boost your Immune system to fight against herpetic whitlow or whitlow finger
Use of ibuprofen as well as acetaminophen is preferred. These painkillers give quick relief from fever or soreness
Use ice packs or effective cooling compressors
Use of bandage to cover affected finger with herpetic whitlow
What are the Risk Factors of Whitlow?
A number of factors increase the risk of developing whitlow. Not all people with risk factors will get whitlow. Risk factors for whitlow include:
Career in a health care profession such as dentistry or nursing
Small children (self-inoculation with unwashed fingers)
Reducing your risk of whitlow
You may be able to lower your risk of whitlow or prevent the spread of herpes simplex virus by:
Avoiding chewing or sucking on your fingers or thumbs
Avoiding direct contact with open herpes lesions, including cold sores or genital lesions
Not sharing personal towels along with hygienic items with anyone that has whitlow
Avoiding nail biting
Frequent hand washing
Practicing safe sex (use condoms)
Using gloves and universal precautions when at-risk of contact with body fluids, especially if you are in a health care profession
What is the Prognosis for Herpetic Whitlow?
Unfortunately, there’s no treatment available to cure the herpes simplex virus. Once an initial infection goes away, the virus may remain dormant in your body for years. So even after herpetic whitlow symptoms disappear, you could experience another outbreak later on, although this is unlikely.
In the event of a recurrent infection, your doctor may prescribe antiviral medication to decrease the frequency of attacks.