Herpetic whitlow is a viral infection that specifically affects the fingers or thumbs, caused by the herpes simplex virus (HSV). This condition, also known as digital herpes simplex, finger herpes, or hand herpes, manifests with distinct visual characteristics, which aid in recognizing this painful infection.
Identifying Herpetic Whitlow: Key Visual Signs
Herpetic whitlow appears as a cluster of small, fluid-filled blisters on the fingers, often around the fingernails or on the fingertips. These blisters (vesicles) usually measure 1 to 3 millimeters. They can initially be clear but may become cloudy or yellowish as the infection progresses.
The skin surrounding these blisters often becomes red or darker, and may also appear swollen and feel tender. While the infection can occur anywhere on the finger or thumb, it commonly affects the fingertip. The blisters can appear as a single lesion or, more commonly, in groups.
As the blisters evolve, they may rupture, forming shallow sores or ulcers. These lesions then dry out and form crusts or scabs. This progression from fluid-filled blisters to crusted lesions is a characteristic visual sign of herpetic whitlow.
Accompanying Symptoms
Beyond the visible lesions, herpetic whitlow is often accompanied by uncomfortable sensations in the affected finger. Individuals commonly report pain, throbbing, tingling, or burning in the infected area. This pain or tingling sensation can sometimes precede visible skin changes by a few days.
In addition to localized discomfort, general bodily symptoms may also occur. These can include a fever, indicating the body’s systemic response to the viral infection. Swollen lymph nodes, particularly in the armpit of the affected arm, are also common.
Progression and Healing
The development of herpetic whitlow begins with a tingling, burning, or painful sensation in the affected finger, occurring 5 to 7 days after initial exposure to the virus. The finger can become inflamed and swollen over the next week or two. Small blisters then develop, often grouped on a reddened or darker base.
These fluid-filled blisters may rupture, leading to the formation of shallow ulcers. Following this, the lesions begin to dry out, forming crusts or scabs. The entire outbreak of herpetic whitlow typically resolves within 2 to 4 weeks, with sores healing completely and rarely leaving a scar. While the virus remains in the body, recurrent outbreaks are possible. These are usually less severe and heal more quickly than the initial infection.
When to Consult a Doctor
Consult a healthcare professional if you suspect herpetic whitlow, especially for a proper diagnosis. While the condition often resolves on its own, early intervention can help manage symptoms and shorten the outbreak duration. Antiviral medications, if prescribed within 48 hours of symptom onset, can help the finger heal more quickly.
Seek medical attention for severe pain, worsening infection, or signs of a bacterial infection such as increasing redness, warmth, or pus. A persistent high temperature or spreading lesions also warrant a doctor’s visit. Individuals with a weakened immune system should also consult a doctor promptly if they suspect herpetic whitlow.