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Confused and concerned about whitlow...

Okay, so I was diagnosed with herpetic whitlow when I was 23. The outbreaks have always come the same way and in the same place (middle finger of my left hand). About 1-2 days before the outbreak, I feel some tingling and swelling in my finger followed by it being really itchy and erupting into a blister that is quite painful. I have always been very careful about keeping it covered and have taken Acyclovir to help. It's always covered with a band aid or other dressing unless I'm washing my hand or putting ointment on. The last outbreak that I had was earlier this summer and it came and went in the same way. As the infection was clearing up, I noticed what appeared to be a small white pimple on the outside of the knuckle on my right hand. No pain or itching...it was just there and I didn't think much of it. It took longer to go away than a normal pimple would and as that one was clearing up, a second one appeared between my knuckle and where my finger joins my hand. It cleared up in about the same time. Nether instance itched, swelled, or became painful. Friday night I was sitting watching tv and I noticed my finger getting really itchy and I look down and there is a patch of read skin where the second pimple was. This area itched like a *******, I panicked and wrapped it up in a band aid. I never noticed a sore or anything like I experience when I'm having an outbreak in the primary infection site. The only thing was the itching.... I made a Dr.'s appointment, but he can't see me until Thursday, and I was wondering if it is possible that I may have infected my other finger. The only time my outbreaks on my left hand are uncovered are when I'm washing my hands and changing the dressing on it. I have been so careful over the last 5 years and this is the first time I'm had anything like this happen. I was just wondering if anyone had any answers/comments..... Also, it's only been a few days, but all that is left on my right finger is a small red spot....
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Avatar universal
Hi Grace please can you advise, I am a healthcare worker and a couple of years or more ago developed a red, itchy stingy,burny red spot on my finger  which developed into a blister and a round red itchy mark on the palm of my hand near the base of my thumb which also blistered,thought little of it and thought maybe a contact allergy or something, many months later it happened again exact same place, symptoms and sequence of events again I never thought about the possibilty of cold sore/whitlow until quite recently when trying to research what the problem could be having got the problem again . I have the same problem again at the moment apart from the exact same signs, symptoms and sequence of events but in exactly the same places on the opposite hand ,could it be herpetic Whitlow, why would it develop in the same manner on the opposite side and as a healthcare worker what precautions other than covering and using universal precautions should I take , If I take a swab does the blister have to be wet or dry occupational health have advised me to see my gp but I am pretty certain that the blister and symptoms will have resolved before I can get an appointment , Many thanks for any advice you can offer JudithA  
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Avatar universal
So, It's been a while since I've posted, but I had a new issue to talk about on here... I was recently diagnosed with Raynaud's Phenomenon to go along with all of the other stuff I've been dealing with and one of the issues I'm having with that is that it appears to be causing an issue with hyperhidrosis in my left hand. My question is, what can I use to cover up an outbreak that will actually stick to my hands now? The Band aids I used to use on my outbreaks will not stick anymore due to the sweat... Is there something I can get from the Dr that will help a bandage stay in place?
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Avatar universal
Hello.....

Do you wear the bandaid every day all day Or do you only wear it when you are having an Outbreak ?
I have been wearing a bandaid every day for the last 3 weeks. The only time I take it off is when I am in the shower.
I am afraid of spreading the virus to others or even to my own eyes.
Am I Contagious all of the time ?
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Avatar universal
Hi Grace, I was wondering if you had any advice to offer me too. My partner and I discovered we had HSV-2 about 5 years ago:( in that time we have had minimal outbreaks and had a bubba. Yesterday all the points in my fingers started hurting and on a toe, first thought i had glass in my foot, and then looked down and saw some raised bumps, i then noticed these same raised bumps about 6 on my index finger and the tips of my thumbs, they dont hurt hurt but they do sting. They are itchy as hell so i got worried and started looking it up and found out about this - i never knew herpetic whitlow existed:( I have about 6 bumps on my dominant hand index finger, 2 on my thumb, 3 bumps on other index finger and thumb and on my big toe. At the same time as this all happening, breastfeeding became suddenly painful - i have been breastfeeding for a year with no problem! and i think it could be thrush which i think is a sign of my immune system being attacked... im going to go to the hospital when i get a chance- we only have public hospital here. How hard is it to pass this onto my baby? Do i just cover it up? they r not open wet blisters or anything just under the skin small lumps:(((((
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101028 tn?1419603004
once the lesions have scabbed, you can stop the band aid.
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1174003 tn?1308160819
Have you gotten a type specific igg test done yet to know your status?  What about getting the lesion culture done?  Not trying to be annoying but it helps to tell you if what you are getting is whitlow.  

Once the skin has completely healed (redness is gone) then yes the area is fine and no longer need the bandaid.  

Getting the testing done at this point is only going to help you.
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Avatar universal
One more thing... at what point is it completely safe to stop wearing the band aid? I have always wondered about this. Is it at the point when the blister actually falls off? Is it after all the itching and burning stop and the swelling goes away? Normally after the blister falls off, the skin is generally reddish where the blister was, but looks like new skin. Is it safe to not be wearing the band aid at this point? I was just curious, because I'm probably wearing the band aid a lot longer than needed.
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1174003 tn?1308160819
What you are referring to is autoinculation and while it can happen it is not as much as one things.  Your antibodies will fight the infection at a new site.  No the virus isn't going to do anything if you have the area covered.  Remember skin to skin contact needs to take place.  
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Avatar universal
Well, as always, I appreciate all the answers that you guys give and the invaluable asset that you can be for people. My last question for now may sound silly, but it was just a passing thought. For people with herpetic whitlow, is there any chance of passing it to the mouth area via eating with your hands (like a sandwich or hamburger) or smoking, even if the blister is covered up at the time and the effected area is kept away from the face. I know the skin on the hands is thick, but the lips are not. I think with the blister covered, it would be hard to pass it on indirectly like this, but I was wondering if it was a possibility. Thank you all again.
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1174003 tn?1308160819
No you can be on daily therapy for life.  
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Avatar universal
I undestand completely what you are saying. When I started this post last year, it was all about the small little blister like pimple things that I was getting and wondering if they were related to what happens on my left middle finger. As I had mentioned before, there was never any swelling and sometimes only some minor itching, but nothing like what happens on my finger. There was also never any rhyme or reason to where they would show up. The outbreaks that happen on my left finger cause typically intense pain and swelling and itch tremendously and look almost exactly like the pictures I've seen online. These ones always come back in the same 2 places, everytime. They normally happen every 6 months or so. But I got an extra 3 months this time, I'm assuming because of the daily acyclovir. Is there a limit to how long one can be on daily suppressive therapy?
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101028 tn?1419603004
nope, no incredible hulk worries :) steroids just make your herpes more active, it doesn't cause the virus to mutate into something worrisome.

your description of symptoms is why I continue to doubt that you have whitlow or only have whitlow. sounds far more like a contact dermatitis which can result from many things including ingredients in hand soaps, contact with metal as well as many other things including latex.  hopefully you can get that dermatology consult soon.  
Helpful - 0
Avatar universal
I've been taking them for the 9 months since the last outbreak I've had. That is why the original question that started this post about the small pimple like things I had been getting were so perplexing. From all of my reading, antiviarals were supposed to make things better, not worse, and it seemed like every 3 weeks or so, a new pimple like thing would pop up. I'm still on the dermatologists waiting list for those things. I thought, where I was on them, that the virus would show up in different ways which was possibly causing these. There was never any swelling or itching, only the small little things on my skin. What I have now is every bit as typical an outbreak as I've ever had. It is a little less servere by means of overall pain, but it itched and burned just the same...there are even 3 small vesicles that I can see when I'm changing the band aid. I had always wondered if antivirals changed the way it would appear during an outbreak, but no...I've found out they do not. Looks the same...just a little less intense. Is there a limit to how long someone can be on antiviral therapy before taking a break from it and can you ever become immune to it? I did read that you should also never use cortizone cream ON a herpes blister, I guess my main concern would have had to have been IF there were stray viral particles on my hand that the cortizone cream would turn them into like, Incredible Hulk particles with an angry vengeance on their host. I'm not terrified of what's going on with me, I'm just trying to become more informed. this has been my 'go to' place for my random questions and I appreciate your patience. I know everyone is different and has outbreaks in different ways, but once someone has established outbreaks in a certain form, do they ever change and look different, or is once you have a certain thing going on, is it pretty much what to expect from here on out? Who knows....someone, somewhere may stumble on this thread and may have their whole views changed by reading through this whole thing.... It's helped me so far....
Helpful - 0
101028 tn?1419603004
yes it's fine to use hand lotion on your hands even when you have a whitlow recurrence.  Hopefully you can get a lesion culture done the next time you have symptoms to confirm that this is herpes because if it's not, better ways to treat it in general than what you've been so far.  You don't have to worry that you've left virus on the keyboard for the next person to touch and contract.

do you have antivirals on hand to start at the very first sign of a recurrence ( but not until after the lesion culture is done of course! )?
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Avatar universal
I do understand the utmost importance of having a lesion culture done. Based on my history, aside from the last 9 months of worrying about something that seems silly now, I have always been confident in this diagnosis and have accepted it. I was just wondering if, based on my belief that the ER docter did diagnose it correctly and with the blood test showing antibodies for HSV1 (I do understand that without the lesion culture that this is still not 100%, but based on all of my symptoms I think I'm 98% sure), if I was putting myself in a possible danger of spreading it by using certain products to keep my hands from being dry and cracking. I know having dry and cracked skin can't be safe during an outbreak, but I was jsut wondering if certain things were safer than others.
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101028 tn?1419603004
the reason I did not answer those questions specifically is because I was waiting to hear if you had gotten a lesion culture to confirm that this is herpes or not. I wasn't ignoring them - I needed more information.
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Avatar universal
No... as I I had said very early on, I took the ER doc at the time's word for it because he sounded like he really knew what he was talking about and the acyclovir that he prescribed me has always worked when one popped up. I did, however, get the blood test done and it showed positive for the HSV1 antibodies. I'm assuming that this doesn't change my course of action either way. So, am I to assume your lack of response about the hand lotion/ cortaid cream question means it was probably a stupid question? I know you all have a bazillion questions and posts to read and respond too and I'm not trying to waste anyone's time, just trying to finally get answers to questions that I've had floating around in my mind. I realize some of them may sound dumb at the time, but I've never asked anything that wasn't a real concern for myself.
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101028 tn?1419603004
did you ever get a lesion culture to confirm that this was whitlow?

no, the virus isn't working its way out of the band aid and laying around to infect folks.
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Avatar universal
Hey Grace, it's been a little while, but 9 months after my last 'real' outbreak, and low and behold, herpetic whitlow has made it's way back. My question this time has to do with the fact that it's really been cold lately and I'm fighting dry skin as I deal with my finger. Is it safe to use hand lotions during an outbreak? I found earlier this winter while I was dealing with dry skin and fighting the endless battle against the small pimple like bumbs that I was getting, that cortaid cream was really helping. I know this isn't good for a herpes blister, but is it still safe to use on my other fingers and even the surrounding area around where the band aid is on my finger? It probably sounds like a stupid question, but it's one that concerns me. Also, I would like to go back to one topic and this is the one that is still bothering me. I've talked to 5 or 6 different doctors and they were almost split in half about how effective a band aid really was to stop the virus when there is an active blister. I understand that HSV is fragile, but how long does it take to die when exposed to air? Could some of the virus be making it's way out of the band aid? I guess even after all of my initial questions, this is the one thing about all of this that still bothers me the most. It's made a little worse because I recently started a new job (the stress from the job switch could be the root of my outbreak) and I get scared anytime anyone uses a computer or phone immediately after I'm done using it. I guess the couple of docters that said a band aid wouldn't be enough to stop the virus have really gotten into my head about this. Any insight or thoughts would be welcome. Thank you.
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101028 tn?1419603004
at this point you both need tested to see who has what and then go from there. assume nothing based on a presumed lack of symptoms - you both need testing.
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Avatar universal
Not yet...I was planning on ordering up the blood test when I go in on Wednesday for the swabbing... based on what she has told me, she has hod no history of cold sores and/or other herpes related issues. I know this doesn't rule anything out on her part by any means . I know like you have said before...the skin on the hands is thick, and I know she washed her hands really well after we were done. I was just wondering the 'ifs' risk involved assuming she's had no history of herpes related infections and if in fact what is going on with me is in fact herpes related. I know it probably sounds like I'm being paranoid, I'm just trying to get an idea of things before my appointment. Thanks...
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101028 tn?1419603004
have you and your gf had type specific herpes igg blood tests yet to know each other status?

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Avatar universal
Hey Grace, so I have something new to ask you.... Thinking back to your post where you said that people who have herpetic whitlow usually have it in another place besides on their hands, I noticed after being manually stimulated by my girlfriend last night that I had redness and irritation on my foreskin around the top part of my penis. It didn't look like there were any ulcerations (that I could see) after a close inspection. This is someting that happens usually a couple of times per year but doesn't happen exactly in the same place. It's usually on different spots around my foreskin. It doesn't bother me...like itching or burning, but it got me to thinking... Is it possible that this could be herpes? I made a Dr's appt., but it's gonna be Wednesday before I can be seen. Where it has never bothered me before, I've never really thought to go to the docter for it before now. It wasn't until I started looking into things about my finger that I read different things about genital outbreaks as well, so I guess I am kind of concerned now.
Where I already know that I have whitlow, I'm a little freaked out about my gal now. What happens to me is pretty painful and awful and I wanted to know that if what is on my foreskin IS herpes, is she at risk of getting it on her hand as well? I know that outbreaks for people are all different, but IF this was an active outbreak, I would like to think that she is going to be okay. I asked her if there were any cuts or scrapes on her hand, and she said there was nothing. No torn cuticles or anything like that either.
So I guess for me...it's gonna be waiting until Wednesday to see the doctor, but would she now be at risk of getting whitlow if in fact it was an active herpes outbreak?
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101028 tn?1419603004
incredibly low risk. the skin on our hands protects us very well or we'd have infections on them all the time. think about all the germs your hands come into contact with every day!
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