Download this as a PDF on whitlows here.
A cold sore, when it occurs on the finger or hand, is called a herpetic whitlow, or simply whitlow. This name was given to cold sores and whitlows long before science was able to show they are the same thing, caused by herpes simplex, on different areas.
There are also have bacterial whitlows, caused by various different bacteria.
The symptoms of a herpetic whitlow may be like a cold sore: a blister, sometimes with clear fluid inside. They can often be much less obvious, especially recurrences, which can look like little cuts. (These are pictures of some very obvious whitlows.) Minor whitlows can be differentiated from other ‘cuts’ because they will be much sorer and itchier.
Whitlows are caught off another person:
- by putting your fingers in the mouth or on the lips of another person who has a cold sore (such as babies or dentists might do).
- by accidentally infecting another area of your own skin during your first infection. But, even in the first few months, this is very unusual. After a few months, you will have developed antibodies. These will then prevent self-inoculation (which means spreading herpes from a sore on one area of skin to another).
Recurrences are infrequent and whether you have a type 1 or a type 2 infection makes no difference. Recurrences will usually be at the same place. They could come up elsewhere on the affected arm, but will not appear on a different area of body. This means they will not appear on the face, ribs, genitals, etc.
Transmission
Transmission is, like any herpes infection: “skin to skin, with the affected area, when the virus is active, with friction.”
It is therefore very simple to protect people from your whitlow by using a plaster/Elastoplast/Band-Aid. You could use one from when you first feel the prodrome (warning nerve sensations) until any symptoms have stopped.
By age 25 over seven out of ten people you encounter will already have herpes simplex type 1 or 2, so they will be fully or partially protected: they would be very unlikely to catch it from you.
Treatment
Antiviral medication could be used to treat herpetic whitlows. However, there are few studies proving the efficacy of this. One double-blinded, placebo-controlled, crossover study of recurrent herpes simplex type 2 whitlows found that oral aciclovir administered during the prodromal stage (before symptoms appeared on the skin) helped reduce symptoms from 10.1 days to 3.7 days and positive viral cultures from 5.3 to 0.6 days. Research has also found that when people were having frequent recurrent whitlows, if they took daily tablets (suppressive therapy) the number of recurrences that they had was reduced.
As with facial and/or genital infection, aciclovir cream is not worth using.
Pain relief could be helpful: ibuprofen, paracetamol, etc. and you can use any cream with lidocaine in it. See list of products here. They are all sold for different uses, but there is no reason why you cannot put, for instance, Anbesol Adult Strength Gel 2% on your hand – or anywhere else – since it has been created to use in your mouth!
Lomaherpan cream is formulated to prevent the cold sore from developing when used before the skin is broken by viral sores. Used in Germany for many decades, it is sold in the UK only at https://herpes.org.uk/shop
Sources checked 7-10-2025. Published 11-2025
