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Herpetic Whitlow: A Guide to the Cold Sore on Your Finger

A person in a grey shirt stands in front of a white wall wrapping a band-aid around herpetic whitlow on their left thumb.

Many people are familiar with the two most common types of herpes infection: cold sores and genital herpes. But they may not know about another type of herpes infection: herpetic whitlow.

Herpetic whitlow, in essence, is a cold sore that develops on your finger.

Today we'll discuss what herpetic whitlow is, its causes, and what to do if you think you may have herpetic whitlow.

What Is Herpes?

Herpes is a family of more than 100 viruses, a handful of which can infect humans. The two illnesses most commonly associated with herpes viruses are oral herpes (cold sores) and genital herpes.

Cold sores, sometimes called fever blisters, are small, fluid-filled blisters that erupt on or around the lips. These blisters are usually caused by the herpes simplex virus, type 1 (HSV-1). HSV-1 spreads through contact with infected bodily fluids like saliva and the fluid inside the cold sore, or with the skin around the mouth.

Genital herpes is a sexually transmitted infection that causes outbreaks of painful blisters on and around the genitals. It is usually caused by the herpes simplex virus, type 2 (HSV-2), but can also be caused by HSV-1. Genital herpes primarily spreads through contact with an infected person's genitals.

Both HSV-1 and HSV-2 are highly contagious and incurable. They often cause a more severe initial herpes outbreak followed by milder recurrent outbreaks.


What Is Herpetic Whitlow?

Herpetic whitlow is a rare herpes infection that affects an estimated 2.5 people per 100,000 people each year.

"Whitlow" means an infection of the finger, especially the fingertip. Herpetic whitlow occurs when a cut or abrasion on a person's finger comes into contact with a herpes virus and becomes infected.

Causes of Herpetic Whitlow

Herpetic whitlow is usually caused by HSV-1, the same virus that causes cold sores. HSV-1 accounts for about 60% of cases of herpetic whitlow. The remaining 40% are caused by HSV-2, the virus that usually causes genital herpes.

The herpes simplex viruses spreads when a person touches active cold sores on the lips or herpes lesions on the genitals. This holds true whether the sores are their own or those of a partner.

Symptoms of Herpetic Whitlow

The hallmark symptom of herpetic whitlow is an inflamed, red finger with a cluster of small blisters. Pain or tingling may precede the appearance of the blisters, and the skin surrounding the blisters may become darker than your normal skin color.

Herpetic whitlow occurs when a cut or abrasion on a person's finger comes into contact with a herpes virus and becomes infected.


You may develop a single blister filled with clear fluid or a cluster of small blisters that eventually merge together. Itching is not uncommon. Over time the fluid in the blisters may become cloudy, and the blisters may burst.

Symptoms usually appear within 1-2 weeks of virus exposure. Sometimes a fever and swollen lymph nodes accompany the infection.

Herpetic Whitlow Diagnosis

Blisters on your fingers can have a number of causes — bug bites, burns, friction, etc. — so the appearance of a sore does not mean you have herpetic whitlow.

If your finger becomes red and inflamed or if the blister worsens or gets larger, talk with a doctor. They know how to identify herpetic whitlow and other types of sores based on appearance, skin swabs, and blood tests.

Only a doctor can conclusively diagnose herpetic whitlow.


Herpetic Whitlow Treatment

Herpetic whitlow usually resolves itself within 2-3 weeks. Because the virus remains in your system, there is a possibility that herpetic whitlow can recur. But unlike cold sores and genital herpes, this is uncommon.

If your herpetic whitlow does come back, or if it takes longer than a few weeks to heal, you can speak with your doctor about taking an antiviral medication like valacyclovir.

How To Avoid Spreading Herpes During a Herpetic Whitlow Outbreak

Herpes spreads through contact with infected bodily fluids and skin cells. This can be a little difficult to prevent when the herpes sore is on your finger!

To avoid spreading the herpes virus to others or to other parts of your body, keep the lesion on your finger covered as much as possible until the blister heals.

If you develop recurring herpetic whitlow, avoiding an outbreak in the first place is one of the best ways to reduce your risk of spreading the herpes virus.

Be vigilant to protect your skin from anything that might trigger an outbreak, such as any of the well-known triggers for herpes. Take good care of the skin on your hands and avoid dryness, irritation, and prolonged exposure to harsh wind and sunlight. Antiviral drugs may also help prevent future outbreaks.

Red light therapy has shown positive results for many conditions, including cold sores and genital herpes, but the Luminance RED treatment devices have not yet been tested on herpetic whitlow in particular.

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