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What is a Herpes Whitlow?

Mary McMahon
By
Updated Mar 03, 2024
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A herpes whitlow is a sore on a finger caused by exposure to the herpes simplex virus (HSV). Most commonly, HSV-I is the causative agent behind a herpes whitlow. The sore is usually very painful, but not dangerous, and it will resolve on its own, although patients are sometimes provided with a topical antiviral to use to hasten healing. People with herpes need to be careful about handling active outbreaks, especially if they have broken skin on their hands, as this can result in the development of a herpes whitlow.

This sore typically appears red and swollen, and sometimes ruptures after forming a blister. The patient may have difficulty bending the finger if the whitlow is located near a joint. The whitlows form when people handle a herpes outbreak around the mouth or genitals and fail to wash their hands properly. The virus can enter broken skin on the hand, such as a torn cuticle, and will create a small secondary sore.

In addition to being a risk for people who have herpes, whitlows are also a known problem for health care workers. Before the widespread use of gloves for patient contact, many people in the dental industry developed herpes whitlows during the course of patient care, and these sores were also a problem for other medical professionals. Using gloves and washing hands between patients has greatly reduced the incidence of problems like these among medical practitioners.

The main risk with a herpes whitlow is the possibility of the development of an open sore. If the whitlow bursts, bacteria can colonize it and cause an unpleasant infection. Keeping the affected hand clean and dry, and remaining alert to signs of infection like foul-smelling discharges and pus is recommended. Antivirals can also help resolve the sore more quickly. If it blisters, popping the blister is not recommended.

It is also important to protect other people from a whitlow caused by herpes. While a closed sore does not pose a significant danger, once the sore bursts, it can spread the virus to others. People who handle food should not do so with active herpes sores on their hands, and it is advisable to avoid physical contact with mucus membranes and open wounds, both of which can create avenues for transmission of herpes. This condition can be managed, but not cured, making it important to avoid transmission in the first place if at all possible.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a The Health Board researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments
By anon950637 — On May 11, 2014

@anon353201: Yikes! Under the fingernail?

I have a whitlow on my left index finger. I first contracted it three years ago. I have had outbreaks every four months or so since then, normally directly above my nail matrix, although the latest outbreak was on my finger pad. I would *highly* recommend keeping some acyclovir on hand, so that at the very first sign of an outbreak, you can start attacking the virus. (My outbreaks always start with something that feels like a splinter or a piece of glass embedded in the infected finger, so I know when one is coming.) It reduces the pain/throbbing substantially and allows me to sleep.

By anon353201 — On Oct 28, 2013

To discographer: I've had herpes whitlow in my right index finger since I was a baby. As a child, I would have one to three outbreaks a year in just that finger. I had a long period of no outbreaks, and I've only had three outbreaks in the past seven years. All of them have been in the same finger, so I believe the fingers have to be individually infected.

It's kind of interesting that the virus just stays in one area. While I haven't kept track, since it started when I was a baby (and I can't remember that far back), I can say that the sores can appear on different parts of the finger.

At age 11 or 12, I had my most painful bout with the sores. That time, the sores were all under my fingernail from the root to the tip. There were probably five of these sores, and they were extremely painful because I couldn't get to them, and the nail kept a constant pressure on the sores. After that outbreak though, I had a 10-plus year break from the outbreaks.

By anon329607 — On Apr 10, 2013

A herpes whitlow can be HSV1 or HSV2. Typically, one gets HSV1 as a cold sore in or around the mouth and HSV2 is typically genital herpes. However, 40 percent of the time, HSV2 can be oral and HSV1 genital. Also, a herpes whitlow is usually HSV1 60 percent of the time and HSV2 40 percent of the time.

By discographer — On Feb 04, 2013

Once there is a herpes whitlow on a finger, does this become a permanent site for the sore?

The reason I ask is because I had a herpes whitlow sore on my thumb two years ago. Recently, I had another one come up on the same finger and on the same exact spot.

This can't be a coincidence, right? Does herpes whitlow usually act this way?

By serenesurface — On Feb 04, 2013

@MikeMason-- Yes, HSV-1 is the same virus that causes cold sores. It's a different virus than HSV-2 which is a sexually transmitted disease and causes sores in the genital area.

The treatments that you use for cold sores can also be used for herpes whitlow. I've had herpes whitlow and a cold sore on my lip at the same time before and I used the same balm with pain reliever on both.

By stoneMason — On Feb 03, 2013

The virus that causes herpes whitlow, is it the one that also causes cold sores on the lips? Can it be treated like a cold sore?

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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