Herpetic Whitlow

Herpes is everywhere. It’s an STD that is caused by the Herpes Simplex Virus (HSV), which divided into two types and is most commonly known for causing cold sores and genital herpes. The World Health Organization estimates that about 3.7 billion people have HSV-1 worldwide, and that doesn’t even account for the millions with HSV-2.

It’s safe to say that herpes is common, and that is no doubt thanks to how easy it is to spread. The virus is highly contagious and can be transmitted in many ways. While herpes sores are most often found on either the mouth or genitals, it can spread to your fingers. This is known as herpetic whitlow.

What is Herpetic Whitlow, and What Causes it?

Herpetic WhitlowHerpetic whitlow is a very painful viral infection of the hand that is caused by one of the two types of herpes simplex virus. The most common and significant symptom of herpetic whitlow is an outbreak of infected blisters on the fingers (particularly, the fingertips). These blisters are extremely similar to herpes sores found elsewhere on the body.

There are two types of HSV: HSV-1 and HSV-2. Each type is commonly associated with different regions of the body. HSV-1 known to be the leading cause of oral herpes, which causes sores to develop on or near the mouth. HSV-2 is the common cause of genital herpes. Regardless of the region in which the herpes virus came from, herpes can infect the hand to cause herpetic whitlow.

HSV is spread through the exchange of bodily fluids or through contact with herpes sores. While this is most commonly done through sexual contact, it generally requires fairly specific circumstances to get a herpes infection on your hand. This is because HSV infects the area in which it comes into contact with. You would need to either have infected bodily fluids spread to an open wound on your fingers or directly touch a herpes sore to contract herpetic whitlow.


When the herpes virus infects the hand, it causes a whitlow to form. A whitlow is an infection that is specifically located on the tips of the fingers. A herpetic whitlow is similar in both size and appearance to the herpes sores you would find more commonly on the facial or genital regions. Along with the blisters, the finger(s) may swell up and turn red.

The time it takes for herpetic whitlow to develop after the fingers are exposed to herpes is estimated to be between 2 and 20 days. This is known as the “incubation period”. The first outbreak of herpetic whitlow is almost always the worst outbreak because of the severity of the symptoms. But each outbreak generally becomes less severe with time after the body begins to develop antibodies for the virus.

Once the sores have developed, it takes about 3 weeks for them to heal. Those who have herpes say they can usually feel a tingling sensation in the areas in which the sores develop shortly beforehand. Healing begins after the pus-filled blisters rupture on their own and scab over. It is highly advised not to force these blisters to rupture, as it will just make things worse.

Who is at risk

  • Dentists and healthcare workers: Herpetic whitlow has been known to be an occupational hazard to medical and dental professionals. Because oral herpes is so common, contact with saliva (or any other bodily fluid for that matter) should be avoided. Open cuts on the hands can become infected if a patient’s saliva comes in contact, which may develop into herpetic whitlow if it does become infected. It is common practice, of course, to wear gloves when working with patients now, but it still should be kept in mind.
  • Children: Young children are particularly known to contract herpetic whitlow through autoinoculation, a term that describes giving an infection to yourself. HSV-positive parents unknowingly transmit the virus to children through kissing them with a cold sore or by sharing food. The herpes-positive children can then infect their fingers by sucking on their thumbs to the point of being open to the risk of infection.
  • Sexually Active Adults: While it is less common, sexually active adults are still at risk of contracting herpetic whitlow. Because people, in general, have less exposure to others’ bodily fluids than the examples above, the risk of herpetic whitlow is fairly low. The overall annual incidence rate of herpetic whitlow is estimated to be between 2.4-5.0 cases per 100,000 people. Still, it’s good to keep in mind that if an open cut on your fingers or hands comes into direct contact with herpes sores or touching bodily fluids with open sores, wounds, or cuts herpetic whitlow can be contracted..


All forms of HSV are currently incurable, which means herpetic whitlow is a perpetually recurrent disease. There may not be a cure, but fortunately, there are treatments available to reduce the pain and impact herpetic whitlow can have on your life. Antiviral medications are the most common types of treatments available for herpetic whitlow. These effectively reduce the duration and severity of symptoms related to HSV.

It is important to treat herpetic whitlow as soon as you notice symptoms; the earlier you begin treatment, the more effective it is at reducing the healing time and pain. Fast treatment will also lower the chances of spreading the virus to other parts of your own body (there’s that autoinoculation word again).


Cuts, sores, bumps, and lesions can be fairly common on the hands. This makes self-diagnosis fairly difficult. Add in the fact that herpetic whitlow is both uncommon, and not well known, and it becomes even more of a challenge. The best options are either to visit a doctor to inspect the sores, or to get tested for HSV. Testing can be more affordable than a doctor’s visit and will determine with great accuracy if you have one of the two HSV strains responsible for herpetic whitlow.

Taking Precautions

It is important to be mindful of herpetic whitlow when having an outbreak. This is the period of time in which the virus is the most contagious. Infecting others is never intentional, but often times can be avoided. Since herpes is a lifelong infection, greater precautions should be taken to protect others.

One of the more simple and effective measures you can take to protect others from becoming infected is to cover the sores with gloves or a bandage. If you have glasses, it would be ideal to wear those instead of contacts to reduce the risk of spreading the infection to your eyes.

Final Thoughts

Herpetic whitlow is a fairly niche infection. You may not have even heard of it before reading this article. While it may not be a life-threatening condition, it is one that lasts a lifetime. Taking this into consideration  Fortunately, it is simple to avoid if the proper steps are taken to protect yourself and others.

Author Bio:

Nick Corlis is a digital marketer and content writer. When he isn’t writing, Nick likes to race cars, listen to Daft Punk, and eat Japanese food.