From the Guidelines
Herpetic whitlow is a painful viral infection affecting the fingers, typically caused by herpes simplex virus (HSV-1 or HSV-2), and treatment should begin with oral antiviral medications such as acyclovir, valacyclovir, or famciclovir, which work best when started within 48 hours of symptom onset. The symptoms of herpetic whitlow include pain, swelling, and blisters on the fingers, and can be accompanied by fever, swelling of the lymph nodes, and general feeling of being unwell 1.
Treatment Options
- Oral antiviral medications such as acyclovir (400 mg five times daily for 7-10 days), valacyclovir (1 gram twice daily for 7-10 days), or famciclovir (250 mg three times daily for 7-10 days) are effective in reducing the duration and severity of symptoms 1.
- For pain management, acetaminophen or ibuprofen can be used to alleviate discomfort and reduce inflammation.
- Keeping the affected area clean and dry, avoiding touching or breaking any blisters, and covering with a loose bandage can help prevent secondary infection and transmission.
- Avoiding contact with others, especially immunocompromised individuals, pregnant women, and newborns, and washing hands frequently can help prevent the spread of the virus.
Prevention and Complications
- Herpetic whitlow can recur, as the virus remains dormant in nerve cells, and symptoms can worsen if left untreated or if secondary bacterial infection develops 1.
- If symptoms worsen, include fever, spreading redness, or pus formation, seeking medical attention is necessary to prevent further complications.
- Healthcare workers should avoid direct patient care until lesions have crusted over completely to prevent transmission of the virus.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Symptoms of Herpetic Whitlow
- Herpetic whitlow is characterized by erythema and painful, non-purulent vesicles on the fingers 2
- It can occur after auto-inoculation from herpes stomatitis, herpes labialis, or genitalis 2
- Lesions are self-limited, but recurrences can occur, with 23% of cases reported to have recurrences 2
Treatment Options for Herpetic Whitlow
- Acyclovir can be used to treat herpetic whitlow, with oral or intravenous administration depending on the severity of the infection 3, 4
- Topical acyclovir can speed healing and decrease viral shedding and pain in immunocompromised patients 3
- Other topical antiviral agents, such as idoxuridine, interferons, and penciclovir, have shown significant clinical benefit against Herpes simplex virus infections 5
- Surgical interventions should be avoided, as they can be harmful 2
- Advanced diagnostic techniques, such as PCR, can help clinicians achieve a definite diagnosis and choose the right treatment 6