Whitlow is a very painful infectious viral disease of the thumb and fingertips. It is characterized by redness, tenderness, and fluid-filled blisters in the hand.


A person can develop herpetic whitlow through direct contact with skin containing the virus, which might be on the genitals, face, or hands. The transmission might involve:

  • touching these areas of someone with active oral or genital sores
  • a person touching their own cold or genital sores
  • a person sucking their thumb or biting their nails during an oral herpes outbreak

People with certain professions may have a higher risk of contracting herpes and its complications, such as herpetic whitlow, including medical and dental professionals and anyone else who works closely with people who have herpes. The following factors can trigger reoccurring episodes of HSV ( herpes simplex virus) infection, including herpetic whitlow:

  • a fever
  • a reoccurring illness
  • excessive stress
  • hormonal imbalances
  • excessive sun exposure
  • surgery
  • physical, mental, or emotional trauma
  • a weakened immune system


  • Burning or tingling sensation
  • Pain in the finger, or fingertip,
  • Redness of color
  • One or more blisters appear and fill with liquid or pus.
  • The finger becomes very painful and sensitive to the touch.
  • Swollen lymph nodes in the armpit or elbow areas
  • Fever
  • Red streaks surrounding or leading away from the affected finger or toe
  • The infection develops 2-20 days after exposure to the virus
  • Once the infection sets in, the fluid-filled blisters tend to form within 5–6 days.
  • The symptoms usually resolve without treatment in 2–4 weeks.


  • Herpetic whitlow tends to go away in 2–4 weeks on its own without treatment
  • Antiviral medications help to reduce the duration of whitlow symptoms. Antivirals that treat herpetic whitlow are Valacyclovir pills, Acyclovir pills, Famciclovir pills, Acyclovir ointment
  • Over-the-counter medication, such as acetaminophen or ibuprofen helps to reduce pain.
  • Antibiotics help to treat secondary infections if they occur around the area of the whitlow
  • Suppressive antiviral medications can be prescribed if whitlow reappears which a person takes daily to reduce the chances of future outbreaks.


  • Cover the infection site: Lightly covering the affected site of the infection helps to keep the virus from spreading.
  • Avoid a temptation to drain: Never pop or drain a blister, as this can spread the virus or leave the area open to a secondary infection.
  • Wash your hands regularly: Doing so frequently and thoroughly is key, especially before and after touching an area of whitlow.
  • Avoid contact lenses: Using these when whitlow is present can spread the virus to the eyes. Wear glasses until the symptoms resolve.
  • Avoid touching the blisters: This is an important way to keep the virus from spreading.


Prognosis is good for cases that aren’t complicated, it resolves spontaneously in 3-4 weeks.


  • Avoidance of exposure is important to the prevention of herpetic whitlow.
  • Health care workers should use protective equipment like gloves, practice strict handwashing, and scrupulously observe universal fluid precautions.

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