By Jon
Johnson
Johnson
Reviewed by
Alana Biggers, MD, MPH
Alana Biggers, MD, MPH
Herpetic
whitlow or whitlow finger is a painful infection that may cause other symptoms
to show up. The infection may appear in adults or children, and there are
several ways to treat it.
whitlow or whitlow finger is a painful infection that may cause other symptoms
to show up. The infection may appear in adults or children, and there are
several ways to treat it.
Herpetic
whitlow is an infection created by the herpes simplex virus (HSV). The
infection produces a painful wound called a whitlow on the fingers.
whitlow is an infection created by the herpes simplex virus (HSV). The
infection produces a painful wound called a whitlow on the fingers.
Caused by
the herpes simplex virus (HSV), herpetic whitlow occurs mostly on the fleshy
part of the index finger or thumb. Sometimes herpetic whitlow can develop on
the toes.
the herpes simplex virus (HSV), herpetic whitlow occurs mostly on the fleshy
part of the index finger or thumb. Sometimes herpetic whitlow can develop on
the toes.
This
article explores the symptoms, causes, and various treatment methods for this
painful infection.
article explores the symptoms, causes, and various treatment methods for this
painful infection.
Symptoms
When the
herpes simplex virus infection appears on the finger in the form of a whitlow, the
symptoms are similar to herpes on other parts of the body:
herpes simplex virus infection appears on the finger in the form of a whitlow, the
symptoms are similar to herpes on other parts of the body:
- Timing: The
first symptoms usually appear 2-20 days after the person is exposed to the
herpes simplex virus. - Sensation:
The infected area will burn or tingle, and the person may begin to experience
pain before any noticeable lesion shows up. - Infection:
The finger will then begin to swell and redden as the infection develops.
Blisters will appear and begin to fill with liquid or pus. There may be just
one blister, or a group of them may develop. They are typically small and very
painful to the touch. - Rupture:
These blisters will then burst and scab over in the weeks to come. Once the
scabs heal, the infection returns to its dormant state.
Other
symptoms may appear at any time during the infection, including:
symptoms may appear at any time during the infection, including:
- swollen
lymph nodes in the armpits or elbow area - a fever
- red marks
surrounding or leading away from the whitlow
The sores
that the infection creates may recur in some people over time. Whitlows will
usually reappear in the same area as the primary infection.
There may
be certain factors which trigger recurrent HSV infections, such as herpetic
whitlow, including:
be certain factors which trigger recurrent HSV infections, such as herpetic
whitlow, including:
- fever or
recurring illness - excessive
stress - hormonal
imbalance - excessive
sun exposure - surgery
- physical,
mental, or emotional trauma
Recurrent
infections will also typically follow a pattern similar to the primary
infection. People will feel sensations of tingling, burning, or itching about
24 hours before the sores show up.
infections will also typically follow a pattern similar to the primary
infection. People will feel sensations of tingling, burning, or itching about
24 hours before the sores show up.
A recurrent
infection usually lasts little more than a week and is not as strong as the
primary infection. There may be fewer blisters during a recurrent infection,
and those blisters may also be smaller and less painful.
infection usually lasts little more than a week and is not as strong as the
primary infection. There may be fewer blisters during a recurrent infection,
and those blisters may also be smaller and less painful.
Causes and
risk factors
risk factors
HSV is the
virus that commonly causes cold sores and genital herpes. It is also the cause
of herpetic whitlow.
virus that commonly causes cold sores and genital herpes. It is also the cause
of herpetic whitlow.
There are
two types of HSV; HSV-1 and HSV-2. HSV-1 infections usually occur around the
face, in the mouth, nose or lips. HSV-2 infections typically involve the area
around the genitals.
two types of HSV; HSV-1 and HSV-2. HSV-1 infections usually occur around the
face, in the mouth, nose or lips. HSV-2 infections typically involve the area
around the genitals.
The
infection can occur in men and women of all ages, though symptoms caused by
HSV-1 appear to be more common in children and young adults.
infection can occur in men and women of all ages, though symptoms caused by
HSV-1 appear to be more common in children and young adults.
Certain professionals
may be more at risk for HSV-1 and complications, such as herpetic whitlow.
These people may include medical or dental professionals and anyone who works
in close collaboration with people who have the infection.
may be more at risk for HSV-1 and complications, such as herpetic whitlow.
These people may include medical or dental professionals and anyone who works
in close collaboration with people who have the infection.
The rest of
the population is commonly infected by HSV-2, often through sexual contact.
People with weakened immune systems are more at risk for becoming infected with
HSV.
the population is commonly infected by HSV-2, often through sexual contact.
People with weakened immune systems are more at risk for becoming infected with
HSV.
Herpetic
whitlow is very contagious. Infections are easily spread by coming into direct
contact with the infected sores or blisters of someone with herpetic whitlow. A
person can also infect themselves if they touch one of their own cold sores or
genital herpes sores with their fingers.
whitlow is very contagious. Infections are easily spread by coming into direct
contact with the infected sores or blisters of someone with herpetic whitlow. A
person can also infect themselves if they touch one of their own cold sores or
genital herpes sores with their fingers.
It is vital
that the whitlow is treated properly. Unchecked whitlows put a person at risk
for superinfections or conditions, such as herpetic encephalitis, which is a
herpes infection in the brain.
that the whitlow is treated properly. Unchecked whitlows put a person at risk
for superinfections or conditions, such as herpetic encephalitis, which is a
herpes infection in the brain.
Treatment
Antiviral
medications are often used to treat herpetic whitlow. These antivirals are
effective in reducing the duration of symptoms in the primary infection as well
as in recurrent infections.
medications are often used to treat herpetic whitlow. These antivirals are
effective in reducing the duration of symptoms in the primary infection as well
as in recurrent infections.
It is
crucial to begin antiviral treatment within the first 48 hours of any symptoms
occurring. Using an antiviral to treat herpetic whitlow after the initial 48
hours will likely have little effect.
crucial to begin antiviral treatment within the first 48 hours of any symptoms
occurring. Using an antiviral to treat herpetic whitlow after the initial 48
hours will likely have little effect.
Antiviral
treatment is used to help reduce the healing time and time spent in pain.
Antiviral treatment may also reduce the risk for the virus to spread to other
parts of the body.
treatment is used to help reduce the healing time and time spent in pain.
Antiviral treatment may also reduce the risk for the virus to spread to other
parts of the body.
However, if
the person does not take antiviral medications, the whitlow will heal itself
over a few weeks without any drugs.
the person does not take antiviral medications, the whitlow will heal itself
over a few weeks without any drugs.
Antiviral
agents that are commonly used to treat herpetic whitlow include:
agents that are commonly used to treat herpetic whitlow include:
- oral
valacyclovir - oral
acyclovir - oral
famciclovir - topical
acyclovir ointment - analgesics
to numb pain
Antiviral
medications are typically used for 1-2 weeks or until the infection clears up.
In cases where the whitlow develops a secondary bacterial infection,
antibiotics may also be necessary.
medications are typically used for 1-2 weeks or until the infection clears up.
In cases where the whitlow develops a secondary bacterial infection,
antibiotics may also be necessary.
On rare
occasions, where people have severe recurrent outbreaks, a doctor may prescribe
suppressive medications. People should take these suppressive antiviral
medications daily to try to decrease outbreaks.
occasions, where people have severe recurrent outbreaks, a doctor may prescribe
suppressive medications. People should take these suppressive antiviral
medications daily to try to decrease outbreaks.
It is
important to note that antiviral medications can help treat an HSV outbreak,
such as a herpetic whitlow, but they do not prevent future outbreaks. Antiviral
drugs are not a treatment for HSV itself, only the symptoms.
important to note that antiviral medications can help treat an HSV outbreak,
such as a herpetic whitlow, but they do not prevent future outbreaks. Antiviral
drugs are not a treatment for HSV itself, only the symptoms.
Home care
People can
support the recovery of herpetic whitlow in the home through a few different
methods:
support the recovery of herpetic whitlow in the home through a few different
methods:
- Covering
the infection: Lightly covering the infected area can help keep the virus from
spreading. It is also important for people to refrain from popping or draining
the blisters. This can cause the virus to spread even further or cause a
secondary infection. - Being
hygienic: People should follow proper hygiene at all times, especially after
coming into contact with the whitlow. People working in the medical or dental
field should always follow basic hygiene rules and work with gloves whenever
possible to protect themselves and other people. - Switching
to glasses: People who wear contacts may want to switch to glasses until the
infection heals to avoid it spreading to the eyes. Many people take over the
counter drugs or use ice packs to lessen the pain of the whitlow as well. - Preventing
spread: Avoiding contact with lesions is an important step in keeping the virus
from spreading. - Telling key
people: People with HSV should also tell any medical or dental professional who
works close to them about the virus so they can take measures to avoid it.
Outlook
Herpes
simplex virus can remain inactive in the nerve cells for a time, and may or may
not cause symptoms.
simplex virus can remain inactive in the nerve cells for a time, and may or may
not cause symptoms.
In some
cases, people never have a recurring whitlow. In others, whitlows often return
and require regular treatment.
cases, people never have a recurring whitlow. In others, whitlows often return
and require regular treatment.
It is best for people to
discuss their symptoms and treatment options with a qualified health care
professional. Together they can work out a plan that fits the person’s
individual needs and makes treatment as comfortable as possible.
discuss their symptoms and treatment options with a qualified health care
professional. Together they can work out a plan that fits the person’s
individual needs and makes treatment as comfortable as possible.
SOURCE:
MEDICAL NEWS TODAY
MEDICAL NEWS TODAY
Kayode Emmanuel Ojo is the Co-Founder and Managing Director at SHEFFA Limited. He is presently studying Computer Science at the National Open University, Victoria Island, Lagos.