What is whitlow?
Whitlow is a very painful and contagious finger infection caused by the herpes simplex virus. It is also known as a herpetic whitlow.
There are two types of herpes simplex viruses – type 1 and type 2 – and both can cause a flare of herpes. Whitlow can happen when the wrecked skin on your finger comes in direct contact with body liquids tainted with the herpes simplex infection. These body fluids may come from you or someone else.
Whitlow can cause pain, itching, redness, or swelling in your fingers. Your fingers may also have small blisters. Whitlow may be associated with more general symptoms, such as fever, swollen lymph nodes, or red streaks on the hands or arms. These symptoms may indicate a serious infection.
Often whitlow resolves without treatment within two to three weeks. However, your health care provider may prescribe medications to reduce symptoms such as pain or itching. If you have frequent or severe cases of white paronychia, your health care provider may prescribe antiviral medications to prevent or reduce the severity of future infections.
Rarely, Whitlow has been linked to a serious medical condition. However, seek immediate medical attention if your whitlow or the person you live with is associated with a high temperature (above 101 degrees Fahrenheit), confusion, or loss of consciousness for even a brief moment. Look for critical clinical consideration if your whitlow is ceaseless, continuous, or is causing you concern.
Symptoms of whitlow
Herpes whitlow develops when the HSV enters a finger, especially the fingertip, often through a small cut in the skin. Less commonly, a whitlow can form on the toe.
The virus infects soft tissues and causes localization:
- Fluid-filled blisters
A person may feel a burning, tingling, or pain before the finger or tip of the finger swells. At this stage, there may be a colour change, such as redness. Then, one or more blisters will appear and fill with fluid or pus. It is usually small and very painful to touch. These eventually explode and coalesce.
A person with herpetic whitlow may also have herpetic skin:
- Swollen lymph nodes in the armpit or elbow area
- Red lines surround or separate from the affected finger or toe
It may be easy to confuse a paronychia, which is a bacterial or fungal infection around the nail, or another type of finger infection.
What causes herpetic whitlow?
You can build up this condition if your finger interacts with Type 1 or Type 2 HSV. Some people who develop whitlow have a history of cold sores or genital herpes, but this is not always the case. If you are infected with the herpes simplex virus, it may occur as a secondary condition.
This can happen if you have an open cut or sore on a finger that comes into contact with sores or blisters around your face or genital area. The infection can enter your finger through this cut. If you do not have a history of infection with the herpes simplex virus, a herpetic whitlow may occur if you come into contact with herpes sores or blisters, which can transmit the infection from one person to another.
How does a doctor diagnose herpetic whitlow?
A sore or blister appearing on your finger is not usually a cause for concern. Some sores are caused by rubbing, insect bites, or injury, and they usually heal on their own. However, if you develop a sore pocket of pus called an abscess on your finger and you cannot determine the cause, talk to your doctor.
Specialists can ordinarily distinguish viral conditions dependent on the presence of wounds or sores. If your doctor suspects a virus, a skin swab or blood test can confirm or rule out the flow of the whitlow.
Untreated whitlow can come with serious complications including;
- Pain and discomfort
- Spread of infection
- Skin ulcerations and infections
How is whitlow treated?
In many cases, this infection will heal without treatment after two to three weeks. Even though no treatment dispenses with the herpes simplex infection from your body, your medical care supplier may recommend meds to improve the manifestations of whitlow.
Treatments to manage symptoms
To manage or reduce the symptoms of whitlow, your health care provider may recommend or prescribe:
- Painkillers, such as ibuprofen (Advil, Motrin) and acetaminophen (Tylenol), to reduce pain and fever, if any
- Antiviral medicines, such as aciclovir (Zovirax), famciclovir (Famvir), and valaciclovir (Valtrex), to prevent or control infections, especially in individuals with frequent or severe infections or a weakened immune system.
- Local anaesthetics, such as prilocaine, lidocaine, benzocaine, and tetracaine, to reduce local itching and pain on the fingers
The herpes simplex virus can remain dormant in nerve cells for some time. It may or may not be activated. Some people with whitlow have symptoms only once, but the infection is repeated in 30-50% of people with it.
It is best to discuss symptoms and treatment options with your health care professional. They can help create a plan to make the treatment as comfortable and effective as possible.