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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.