Q: Hello Doc, what is a whitlow and what’s the treatment?

A: Whitlow usually refers to Herpetic whitlow caused by Herpes Simplex Virus. It usually affects the tip of the index finger or thumb. It happens when the finger skin, especially the cuticle, is broken and invaded by virus causing infection of the soft tissue around the nail. This can happen through skin to skin contact or when infected fluid touches the breach/cut in the finger skin. In children, this can happen when a child with cold sore (what we usually term fever blister), sucks on a finger with a cut on the thumb or also through contact with someone who has genital Herpes.

The virus may remain inactive in the skin for up to 3 weeks before symptoms manifest. This condition is intensely painful and patients would complain of swelling and blisters in the affected area, tenderness over the…